Something is definitely better than nothing: simple strategies to prevent vascular dysfunction

Abstract

Understanding the negative health consequences of a physical inactivity has been the topic of much investigation as an alarming number of adults have adopted a sedentary lifestyle. With the rise in sedentarism the field of inactivity physiology has emerged. The goal of inactivity physiology is to identify the impact in inactivity on health and develop strategies that effectively minimize the risk of a sedentary lifestyle. Arising from this field is the finding that excessive sitting is linked to increased cardiovascular and metabolic disease and all-cause mortality. Most importantly, these relationships exist even in individuals that are physically active. Clearly, excessive sitting is an occupational hazard with significant health consequences. Through a series of investigations, including research published this issue of Clinical Science, Padilla and colleagues have identified that prolonged sitting evokes vascular dysfunction and that this dysfunction is caused by reduced shear stress. This commentary highlights this series of investigations and culminates with an overview of how prior exercise and standing are effective strategies to circumvent vascular dysfunction that is caused by excessive sitting. Excessive sitting is now considered by many to be an occupational and societal hazard due to the alarming evidence linking this sedentary behavior to increased cardiovascular and metabolic disease and all-cause mortality [1][2][3][4]. Strategies to circumvent these negative health outcomes are critical as sedentarism continues to rise in the workplace and leisure time physical activity continues to decline. Longitudinal and epidemiological investigations provide evidence that even in individuals meeting the recommended levels of moderate-to-vigorous physical activity, excessive sitting is independently associated with negative health outcomes [1,[4][5][6][7][8][9]. The recognition of these negative outcomes has led to the emergence of the field of inactivity physiology in order to better understand the mechanisms leading to disease progression as a result of sedentary behavior and to provide recommendations to mitigate the deleterious impact of sedentary behavior and in particular, excessive sitting [2,10]. In this issue of the Clinical Science, Padilla and colleagues expand upon their previous work and explore how prior exercise and standing affect sitting-induced endothelial dysfunction [11]. Before diving head first into the findings of the present study, we must first appreciate the link between atherosclerosis, endothelial dysfunction, and shear rate. Endothelial dysfunction presents prior to the onset of overt cardiovascular disease (CVD) and is an established risk factor for the development of future CVD [12