Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies.

Abdullah Bandar Alansare,Bethany Barone Gibbs,Lauren C Bates,Mark A Faghy,Elizabeth Nagle,Lee Stoner,Erik D Hanson,Christopher E Kline,J Richard Jennings

doi:10.3390/ijerph18168508

Abstract

Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. Results: Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected. Conclusions: The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.

Highlights

Cardiovascular disease (CVD) remains the leading cause of death in adults worldwide [1,2]
This association is distinct from the harmful impacts of physical inactivity, which is defined as not engaging in sufficient levels of moderate-to-vigorous intensity physical activity (MVPA) [6]
We systematically reviewed the current evidence relating sedentary time (ST) to heart rate (HR) and heart rate variability (HRV) to shed light on whether this proposed mechanism is supported by the available research and to clarify the potential role of cardiac-autonomic dysfunction in the association of ST with CVD

Summary

Introduction

Cardiovascular disease (CVD) remains the leading cause of death in adults worldwide [1,2]. Recent evidence indicates that sedentary behavior (i.e., any waking behavior that has an energy expenditure of ≤1.5 metabolic equivalents and occurs in lying, reclining, or seated position [3]) is associated with CVD incidence and mortality [4,5]. This association is distinct from the harmful impacts of physical inactivity, which is defined as not engaging in sufficient levels of moderate-to-vigorous intensity physical activity (MVPA) [6]. The mechanisms by which greater sedentary time (ST) leads to elevated CVD risk remain unclear. Cardiac-autonomic dysregulation is a physiological mechanism that links risk factors such as hypertension and diabetes to CVD outcomes [8].

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