The Association Between Time Spent in Sedentary Behaviors and Blood Pressure: A Systematic Review and Meta-Analysis

Background and Objective: Sedentary behaviors, defined as waking behaviors with low energy expenditure while sitting, are positively associated with several adverse health outcomes. However, the association between sedentary behaviors and blood pressure (BP) is inconclusive. This study aimed to conduct a systematic review and meta-analysis on the association between time spent in sedentary behaviors and BP. Methods: We searched PubMed, MEDLINE, and Web of Science for papers published before August 2014 that assessed the association between time spent in sedentary behaviors and BP. Studies on both adults and children were included. Only good quality studies were included. The pooled estimates of systolic BP (SBP) and diastolic BP (DBP) increase per hour of time spent in sedentary behaviors a day were computed using a fixed-effects model and a random-effects model, respectively. Another pooled estimate of odds ratio per hour of time spent in sedentary behaviors a day on having high BP was computed using a fixed-effects model. A sub-group analysis was conducted for studies using self-reported and objectively assessed time spent in sedentary behaviors separately. Results: A total of 31 papers of good quality were included in the systematic review, 18 of which found no association between time spent in sedentary behaviors and BP (58.1 %). A total of 28 papers were included in the meta-analysis. Pooled effects showed that an additional hour of time spent in sedentary behaviors per day was associated with an increase of 0.06 mmHg (108,228 participants, 95 % CI 0.01–0.11, p = 0.01) of SBP and 0.20 mmHg (107,791 participants, 95 % CI 0.10–0.29, p < 0.001) of DBP. Accelerometer-assessed time spent in sedentary behaviors was not associated with either SBP (p = 0.06) or DBP (p = 0.33). The odds ratio (OR) of having high BP with an additional hour of time spent in sedentary behaviors per day was 1.02 (98,798 participants, 95 % CI 1.003–1.03, p = 0.02). Conclusions: Self-reported but not accelerometer-assessed time spent in sedentary behaviors was associated with BP. Further studies are warranted to determine the preventive effect of reducing sedentary behaviors on high BP.