Log in to MyACC
Effects of Sedentary Behavior Reduction and BP in Desk Workers
Quick Takes
- Replacing approximately 1 h/d of sedentary behavior with mostly standing at work did not improve BP or arterial stiffness in desk workers with untreated elevated or high BP.
- At this time, a sit–stand desk to replace sitting with standing for approximately 1 h/d during work should not be prescribed as an effective lifestyle treatment for patients with elevated or high BP.
Study Questions:
What is the efficacy of a multicomponent sedentary behavior reduction intervention in reducing resting blood pressure (BP), 24-hour ambulatory BP, and pulse wave velocity (PWV)?
Methods:
The RESET-BP investigators conducted a parallel-arm, 3-month randomized clinical trial and recruited desk workers, ages 18-65 years, with systolic BP (SBP) 120-159 or diastolic BP (DBP) 80-99 mm Hg, off antihypertensive medications, and reporting <150 min/wk of moderate- to vigorous-intensity physical activity. Participants were randomized to a sedentary behavior reduction intervention or a no-contact control group. The intervention sought to replace 2-4 hours/day (h/d) of sedentary behavior with standing and stepping through coaching, a wrist-worn activity prompter, and a sit–stand desk. Sedentary behavior and physical activity were measured with a thigh-worn accelerometer and quantified during all waking hours and separately during work and nonwork times. Clinic-based resting SBP (primary outcome) and DBP, 24-hour ambulatory BP, and PWV were assessed by blinded technicians at baseline and 3 months. The authors used an intention-to-treat approach to evaluate the efficacy of the intervention for yielding greater improvements in sedentary behavior, activity, and study outcomes (BP, PWV, and weight), compared with control, with multiple imputation using Markov chain Monte Carlo method to account for missing data.
Results:
Participants (n = 271) had a mean age of 45 years and SBP/DBP of 129/83 mm Hg. Compared with controls, intervention participants reduced sedentary behavior (−1.15 ± 0.17 h/d), increased standing (0.94 ± 0.14 h/d), and increased stepping (5.4 ± 2.4 min/d; all p < 0.05). Sedentary behavior and activity changes mainly occurred during work time and were below the goal. The intervention did not reduce BP or PWV in the intervention group compared with controls. Between-group differences in resting SBP and DBP changes were −0.22 ± 0.90 (p = 0.808) and 0.13 ± 0.61 mm Hg (p = 0.827), respectively. The findings were similarly null for ambulatory BP and PWV. Decreases in worktime sedentary behavior were associated with favorable reductions in resting DBP (r = 0.15, p = 0.017). Contrary to their hypotheses, reductions in worktime sedentary behavior (r = −0.19, p = 0.006) and increases in worktime standing (r = 0.17, p = 0.011) were associated with unfavorable increases in carotid-femoral PWV. As expected, increases in non–worktime standing were favorably associated with carotid-femoral PWV (r= −0.14, p = 0.038).
Conclusions:
The authors report that a 3-month intervention that decreased sedentary behavior and increased standing by approximately 1 hour during the workday was not effective for reducing BP.
Perspective:
This study reports that replacing approximately 1 h/d of sedentary behavior with mostly standing at work did not improve BP or arterial stiffness in desk workers with untreated elevated or high BP. Additional studies are indicated in different populations (e.g., older age, higher BP, lower activity levels) to test the cardiovascular effects of greater reductions in sedentary behavior and replacing sedentary behavior with behaviors other than worktime standing at a sit–stand desk. At this time, a sit–stand desk to replace sitting with standing for approximately 1 h/d during work should not be prescribed as an effective lifestyle treatment for patients with elevated or high BP. The American Heart Association recommends that adults get ≥150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week to help manage high BP and improve cardiovascular outcomes, which is supported by data.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Exercise
Keywords: Blood Pressure, Exercise, Sedentary Behavior, Work
< Back to Listings
