Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence: a population cohort study of 83,013 adults

ImportancePrevious studies have indicated that standing maybe beneficially associated with surrogate metabolic markers, while more time spent sitting has an adverse association. Studies assessing the dose-response associations of standing, sitting, and composite stationary behaviour time with cardiovascular disease (CVD) and orthostatic circulatory disease are scarce and show an unclear picture. ObjectiveTo examine associations of daily sitting, standing, and stationary time with CVD and orthostatic circulatory disease incidence MethodsWe used accelerometer data from 83,013 adults (mean age{+/-}SD= 61.3{+/-}7.8; Female=55.6%) from the UK Biobank to assess daily time spent sitting and standing. Major CVD was defined as coronary heart disease, heart failure, and stroke. Orthostatic circulatory disease was defined as orthostatic hypotension, varicose vein, chronic venous insufficiency, and venous ulcers. ResultsDuring 6.9 ({+/-}0.9) years of follow-up 6,829 CVD and 2,042 orthostatic circulatory disease events occurred. When stationary time exceeded 12 hrs/day orthostatic circulatory disease risk was higher by an average HR [95% CI] of 0.22 [0.16, 0.29] per hour. Every additional hour above 10 hrs/day of sitting was associated with a 0.26 [0.18, 0.36] higher risk. Standing more than 2 hrs/day was associated with an 0.11 [0.05, 0.18] higher risk for every additional 30 min/day. For major CVD, when stationary time exceeded 12 hrs/day, risk was higher by an average of 0.13 [0.10, 0.16] per hour. Sitting time was associated with a 0.15 [0.11, 0.19] higher risk per extra hour. Time spent standing was not associated with major CVD risk. ConclusionsTime spent standing was not associated with CVD risk but was associated with higher orthostatic circulatory disease risk. Time spent sitting above 10 hours/day was associated with both higher orthostatic circulatory disease and major CVD risk. The deleterious associations of overall stationary time were primarily driven by sitting. Collectively, our findings indicate increasing standing time as a prescription may not lower major CVD risk and may lead to higher orthostatic circulatory disease risk.