Effect of sedentary behavior interventions on vascular function in adults: A systematic review and meta-analysis

Sedentary behavior (SB) results in hemodynamic alterations within the vasculature, leading to vascular dysfunction that may be attenuated by various interventions. This systematic review and meta-analysis examined the effect of SB interventions on vascular function in adults using seven databases searched on December 17, 2020. All types of SB interventions were included such as short- and long-term interventions (≥7 days) in participants aged ≥18 years. The pooled effect (mean difference) of intervention on three outcomes, namely, flow-mediated dilation (FMD), shear rate (SR), and pulse wave velocity (PWV), was evaluated using random effects meta-analyses. The revised Cochrane risk-of-bias tool for randomized trials was employed to assess the quality of the included studies. Twenty-six studies (21 short-term and six long-term interventions) involving 669 participants from eight countries were included. Evidence from meta-analysis showed that short-term interventions targeting SB improved FMD by 1.50% (95% confidence interval [CI] 1.00-1.99) and increased SR by 12.70 S^-1 (95% CI 7.86-17.54); no significant pooled effect was found for PWV. Long-term SB interventions resulted in a 0.93% increase in FMD (95% CI 0.25-1.62) and had no significant effect on PWV. Findings of this systematic review and meta-analysis suggest that both short- and long-term SB interventions improved FMD but had no effect on PWV. Short-term interventions had a greater effect in improving lower extremity arterial function. Further studies targeting long-term SB interventions on vascular function in adults are warranted.