Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Faculty of Medicine and Health Science, Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, New Brunswick, Canada.
Sports Med. 2024 Dec;54(12):3097-3110. doi: 10.1007/s40279-024-02099-w. Epub 2024 Aug 20.
Cardiovascular diseases (CVD) are among the leading causes of mortality in the western world, and high blood pressure is among the greatest risk factors for CVD. Given that most of a person's waking hours are spent in sedentary behaviors, understanding the cardiovascular impact of a sedentary lifestyle is imperative. Although limiting sedentary time is encouraged in public health messaging, individual reviews analyzing its impact on clinically relevant cardiovascular outcomes such as blood pressure and CVD exhibit conflicting results.
We conducted an umbrella review of systematic reviews and meta-analyses synthesizing the effects of sedentary time/behaviors on blood pressure or CVD.
To be included, studies had to be a systematic review and/or meta-analysis that studied the impact of sedentary time or a sedentary posture on blood pressure or CVD incidence/mortality. The review was preregistered in PROSPERO (CRD4202342568) and conducted in May 2023. The Joanna Briggs Institute and Risk of Bias in Systematic Reviews tools assessed study quality. PRISMA reporting was followed.
Our umbrella review screened 2215 citations with 40 review studies meeting our inclusion criteria (n = 22 meta-analyses) that included 234 unique individual studies of 3,769,755 unique participants. The average study quality was high (9.2 ± 1.7 out of 11). A minority of studies (n = 7/20) supported that less sedentary time was associated with lower blood pressure, with reviews of interventional studies typically not observing a consistent effect (n = 9/12), whereas reviews of cross-sectional studies observed a positive effect (n = 5/7). When hypertension rates were used as the outcome, most (n = 3/4) studies observed a deleterious impact of sedentary time. For CVD incidence/mortality, less sedentary time or screen time was consistently associated with a lower CVD incidence/mortality (n = 17/23), with studies exhibiting a null effect generally including small sample sizes and being of a lower study quality. Total sedentary time and specific behaviors (i.e., television and screen time) exhibited similar findings.
Based on a high quality of evidence and large sample size, existing systematic reviews and meta-analyses demonstrate the negative impact of sedentary behaviors on CVD incidence/mortality, with conflicting reports for blood pressure that vary based on the study design.
心血管疾病 (CVD) 是西方世界主要的死亡原因之一，高血压是 CVD 的最大危险因素之一。由于一个人大部分清醒时间都处于久坐行为中，因此了解久坐生活方式对心血管的影响至关重要。尽管在公共卫生信息中鼓励限制久坐时间，但分析其对血压和 CVD 等临床相关心血管结局影响的个体综述结果相互矛盾。
我们对系统评价和荟萃分析进行了伞式审查，综合了久坐时间/行为对血压或 CVD 的影响。
要纳入的研究必须是一项系统评价和/或荟萃分析，研究久坐时间或坐姿对血压或 CVD 发病率/死亡率的影响。该综述在 PROSPERO（CRD4202342568）中预先注册，并于 2023 年 5 月进行。采用 Joanna Briggs 研究所和系统评价偏倚风险工具评估研究质量。遵循 PRISMA 报告。
我们的伞式综述筛选了 2215 条引文，其中 40 项综述研究符合我们的纳入标准（n=22 项荟萃分析），其中包括 3769755 名独特参与者的 234 项独特的个体研究。平均研究质量较高（11 分中得 9.2±1.7 分）。少数研究（n=7/20）支持较少的久坐时间与较低的血压相关，干预研究的综述通常观察不到一致的效果（n=9/12），而横断面研究的综述观察到积极的效果（n=5/7）。当高血压发生率作为结果时，大多数研究（n=3/4）观察到久坐时间的不利影响。对于 CVD 的发病率/死亡率，较少的久坐时间或屏幕时间与较低的 CVD 发病率/死亡率相关（n=17/23），一般具有无效效应的研究通常包括样本量较小且研究质量较低。总久坐时间和特定行为（即电视和屏幕时间）表现出相似的发现。
基于高质量的证据和大样本量，现有的系统评价和荟萃分析表明，久坐行为对 CVD 的发病率/死亡率有负面影响，而血压的报告相互矛盾，具体取决于研究设计。
