BACKGROUND Previous studies have indicated that standing may be beneficially associated with surrogate metabolic markers, whereas 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 ± standard deviation = 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. To estimate the dose-response hazard ratios (HR) we used Cox proportional hazards regression models and restricted cubic splines. The Fine-Gray subdistribution method was used to account for competing risks. RESULTS During 6.9 (±0.9) years of follow-up, 6829 CVD and 2042 orthostatic circulatory disease events occurred. When stationary time exceeded 12 h/day, orthostatic circulatory disease risk was higher by an average HR (95% confidence interval) of 0.22 (0.16, 0.29) per hour. Every additional hour above 10 h/day of sitting was associated with a 0.26 (0.18, 0.36) higher risk. Standing more than 2 h/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 h/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 h/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.

中文翻译：

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设备测量的静止行为以及心血管和直立性循环疾病的发生率。


背景 先前的研究表明，站立可能与替代代谢标志物有益相关，而久坐时间过多则具有不良关联。评估站立、坐姿和复合静止行为时间与心血管疾病 （CVD） 和直立性循环疾病的剂量反应关联的研究很少，并且显示的情况不清楚。目的 探讨每日坐姿、站立和静止时间与 CVD 和直立性循环疾病发病率的相关性。方法 我们使用来自英国生物银行的 83 013 名成年人 （平均年龄±标准差 = 61.3 ± 7.8;女性 = 55.6%） 的加速度计数据来评估每日坐着和站着的时间。主要 CVD 被定义为冠心病、心力衰竭和中风。直立性循环系统疾病定义为直立性低血压、静脉曲张、慢性静脉功能不全和静脉溃疡。为了估计剂量反应风险比 （HR），我们使用了 Cox 比例风险回归模型和限制三次样条。使用 Fine-Gray 子分布方法考虑竞争风险。结果 在 6.9 （±0.9） 年的随访中，发生了 6829 例 CVD 和 2042 例直立性循环疾病事件。当静止时间超过 12 小时/天时，直立性循环疾病风险更高，平均 HR （95% 置信区间） 为每小时 0.22 （0.16， 0.29）。坐着 10 小时/天以上每增加一小时，风险就会增加 0.26 （0.18， 0.36）。站立超过 2 小时/天与每增加 30 分钟/天的风险增加 0.11 （0.05， 0.18） 相关。对于主要 CVD，当静止时间超过 12 小时/天时，风险平均每小时高 0.13 （0.10， 0.16）。坐着时间与 0.15 （0.11， 0.19） 每增加一小时的风险更高。站立时间与主要 CVD 风险无关。结论 站立时间与 CVD 风险无关，但与较高的直立性循环疾病风险相关。坐着超过 10 小时/天的时间与较高的直立性循环疾病和主要 CVD 风险相关。总体静止时间的有害关联主要是由坐着驱动的。总的来说，我们的研究结果表明，增加处方站立时间可能不会降低主要 CVD 风险，并可能导致更高的直立性循环疾病风险。