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September 4, 2026Frontiers in Cardiovascular Medicine0 citationsOpen Access

Effects of breaking up prolonged sitting on vascular endothelial function in adults: a systematic review

JHJun HeTianjin University of SportXXXinyu XuJiangnan UniversityYZYanan ZhaoTianjin University of Sport

Key Result

Short-term breaks from prolonged sitting, particularly 2-3 minute lower-limb dynamic or resistance exercises every 20-30 minutes, improved peripheral hemodynamics such as lower-limb blood flow and shear-rate responses, whereas flow-mediated dilation responses were heterogeneous.

Study Design

Type

Systematic Review (n=454)

Structured PICO

Does breaking up prolonged sitting improve vascular endothelial function in adults?

P
Population
454 adults aged 18 years and older, including healthy individuals and those with cardiovascular risk factors, across 24 randomized crossover trials evaluating the vascular effects of interrupting prolonged sitting.
I
Intervention
Breaking up prolonged sitting (e.g., frequent 2-3 min lower-limb dynamic or simple resistance breaks every 20-30 min)
C
Comparator
Prolonged sitting
O
Outcome
Vascular endothelial function (flow-mediated dilation, blood flow, shear-rate outcomes)surrogate

Frequent short breaks from prolonged sitting improve peripheral hemodynamics and may protect vascular endothelial function.

Limitations

  • Most studies were short-term, acute trials, with a lack of long-term follow-up data.
  • The majority of studies were conducted in controlled laboratory settings, lacking real-world occupational or daily-life environment evaluation.
  • Heterogeneity in intervention modalities, exercise doses, participant characteristics, and measurement locations precluded uniform calculation of standardized effect sizes.

Abstract

Objective Sedentary behavior contributes to vascular endothelial dysfunction and elevated cardiovascular disease risk. Because endothelial responses may differ by vascular bed, this review systematically evaluated the effects of breaking up prolonged sitting on adults' vascular endothelial function, focusing on flow-mediated dilation (FMD), blood flow, shear-rate outcomes, and the artery or measurement location reported in each study. Methods Based on the PRISMA guidelines, literature searches was conducted in PubMed, Web of Science, CNKI, VIP, and Wanfang databases using English search terms “sedentary, sitting, sedentary behaviour, sitting position, standing, exercise, endothelial function, endothelial dysfunction, endothelium” and Chinese search terms “sedentary, sitting, sedentary behaviour, sitting position, standing, exercise, endothelial function, endothelial dysfunction, endothelium”. The search period spanned from January 2000 to November 2025. The PEDro scale was used to assess the quality of the literature, and a review analysis was conducted on the 24 included articles. Results Interrupting prolonged sitting generally improved peripheral hemodynamics, especially lower-limb blood flow and shear-rate responses, whereas FMD responses were heterogeneous and depended partly on the artery examined (e.g., brachial, superficial femoral/femoral, or popliteal artery), participant characteristics, and interruption dose. Across the included studies, frequent 2–3 min lower-limb dynamic or simple resistance breaks every 20–30 min appeared most consistently beneficial for hemodynamic outcomes. Conclusion Short-term breaks from prolonged sitting may protect vascular function by improving blood flow and shear-rate profiles, particularly in lower-limb arteries. Because FMD findings are site-specific, brachial, femoral/superficial femoral, and popliteal artery results should be interpreted separately when applying these findings to practice. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261332434 , PROSPERO CRD420261332434.

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Cite This Study

He et al. (2026) conducted a systematic review in Prolonged sitting (n=454). Breaking up prolonged sitting vs. Uninterrupted prolonged sitting was evaluated on Peripheral hemodynamics (blood flow, shear rate) and flow-mediated dilation (FMD). Short-term breaks from prolonged sitting, particularly 2-3 minute lower-limb dynamic or resistance exercises every 20-30 minutes, improved peripheral hemodynamics such as lower-limb blood flow and shear-rate responses, whereas flow-mediated dilation responses were heterogeneous.

synapsesocial.com/papers/6aa1114d25b16df10966775ahttps://doi.org/10.3389/fcvm.2026.1780316
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