New Study Suggests Standing May Not Be as Heart-Healthy as Previously Believed

A new study has found that replacing sitting with standing without moving, like what you do at a standing desk, might not be enough to lower heart disease risk over time. In fact, it could actually be harmful to health, researchers reported in the International Journal of Epidemiology. 

The research looked specifically at whether people who stood more or sat more were more likely to develop two types of health problems: cardiovascular-related issues and orthostatic circulatory conditions like varicose veins and venous ulcers (open sores on the legs).

Not only did researchers discover that standing was not associated with improved heart health, they found that it might lead to a higher risk of circulatory problems in some cases.

“Being aware of potential circulatory risks is important, as these conditions can arise from insufficient blood flow, which can occur during long periods of being in a static position, such as sitting or standing,” Matthew Ahmadi, PhD, lead study author and a research fellow at the University of Sydney, told Health.

Here’s what else to know about the study, as well as what experts suggest you do in light of it.

Previous research has suggested that standing more might improve metabolic markers like high cholesterol and triglycerides, which can signal increased cardiovascular disease risk. But the authors noted that few studies had gone further to measure hospitalizations and deaths from cardiovascular disease and the development of circulatory diseases.

“This is important because it meant there wasn’t yet information on the benefits or risks for circulatory conditions for standing,” Ahmadi said. “Further, the majority of standing studies have examined cardiometabolic markers but not heart disease or circulatory conditions.'

To fill the gap, researchers from Australia and the Netherlands turned to the U.K. Biobank, a large biomedical database and research resource.

They pulled data collected over seven days via a wrist-worn accelerometer from more than 83,000 adults. Participants were 61 years old on average and most of them did not have a history of cardiovascular or circulatory issues. The accelerometers tracked movement, including when they were standing or sitting.

Participants were then followed for an average of 6.9 years to see if they developed or died from coronary heart disease, heart failure, stroke, or orthostatic circulatory diseases, defined as varicose veins, venous ulcers, orthostatic hypotension, or chronic venous insufficiency. 

After analysis, researchers found an association between sitting for at least 10 hours per day and increased risk of cardiovascular and circulatory diseases, with risk rising for every additional hour spent sitting beyond 10 hours.

Standing alone, on the other hand, didn’t increase the chances of cardiovascular diseases, but it also didn’t reduce the risk. Stationary behavior for over 12 hours, however, including standing, did raise the risk of CVD.

As for circulatory diseases, every 30-minute increment over two hours of daily standing was associated with a higher risk.

“When you keep standing without moving around to increase your heart rate, the blood is not moving from the legs into your heart due to gravity. That’s how you get varicose veins,” Mukarram Siddiqui, MD, an electrophysiologist and chief of Cardiology at Detroit Medical Center Sinai Grace Hospital, told Health. “And when you are sitting down, your veins are crunched up, and the blood is not able to get back to the heart to keep recirculating.”

The finding that standing didn’t improve cardiovascular disease outcomes was “not very surprising,” Ahmadi said. “To improve cardiovascular health, we need to engage the cardiovascular system, and standing by itself doesn’t engage the system as efficiently as other forms of activity that get the body moving.”

It’s important to note that the study only showed correlations but doesn’t prove that sitting and standing increased or lowered the risk for cardiovascular or circulatory diseases, Abhayjit Singh, MD, a cardiologist at the Cleveland Clinic, told Health.  

“The main takeaway should be the dangers of a sedentary lifestyle, not necessarily the difference in specific hazard ratios from sitting versus standing,” Singh said. “We should be encouraging our patients to move, not just stand, and maintain an active lifestyle.”

While standing is better than sitting, standing is still a stationary behavior and needs to be mixed with movement to optimize cardiovascular health and lower the risk of circulatory conditions related to standing, Ahmadi explained.

If you have a job that involves sitting or standing for prolonged periods, Siddiqui suggests: