Tackling Sedentary Behavior at Work

Typically, this column is dedicated entirely to drug therapy topics; however, on this occasion, I think that it’s time to break from that tradition.

Sedentary behavior is clearly linked to adverse cardiovascular outcomes. Unfortunately, the continued shift of the American workforce into office settings and behind desks for 8 hours per day has accelerated the negative impact of sedentary behavior. Recognition of this link has led to several innovations to reduce sedentary time at the office, perhaps the most popular of which is the standing desk.

In this installment of Talking Therapeutics, we discuss a new study that explores the effect of various interventions aimed at combating sedentary behavior on blood pressure and pulse wave velocity (PWV), a key marker of arterial stiffness.

Talking Point: No Signal for Benefit

This randomized clinical trial recruited desk workers who were normotensive and reported a sedentary lifestyle based on minutes/week of moderate to vigorous physical activity. The intervention sought to add 2 to 4 hours per day of standing and stepping through coaching, a wrist-worn activity prompter, and a sit-stand desk. Clinic-based resting systolic blood pressure (primary outcome) and diastolic blood pressure (DBP), 24-hour ambulatory blood pressure, and PWV were assessed by blinded technicians at baseline and at 3 months.

Nearly 300 people completed the study, and, compared with controls, intervention participants reduced sitting by about 1 hour per day and increased standing by the same amount. The intervention did not reduce blood pressure or PWV in the intervention group compared with controls.

Talking Point: More Work to Do

Based on the results of these findings, using a sit-stand desk to replace sitting with standing for about an hour during work should not be recommended to reduce blood pressure or to combat the negative cardiovascular effects of sedentary behavior.

It remains to be seen whether replacing sitting with standing for longer periods during the workday would yield more positive findings. Future trials will need to answer this question. It’s also possible that other interventions, such replacing sitting with other activities like walking or light calisthenics, might be more effective than standing. Hopefully these other interventions will be tested with robust clinical trials in the future.