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

Importance Previous 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. Objective To examine associations of daily sitting, standing, and stationary time with CVD and orthostatic circulatory disease incidence Methods We 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. Results During 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. Conclusions Time 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: tbc I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon application to the UK BioBank.