Frequent sit-to-stand transitions reduce diastolic blood pressure in postmenopausal women

Frequent sit-to-stand transitions reduce diastolic blood pressure in postmenopausal women | Image Credit: © Chinnapong - stock.adobe.com.

A randomized controlled trial published in Circulation has found that increasing daily sit-to-stand transitions led to modest reductions in blood pressure among postmenopausal women with overweight or obesity. The 3-month Rise for Health Study evaluated 2 sedentary behavior interventions, reducing sitting time and increasing sit-to-stand transitions (STSTs), in comparison with a control condition.^1,2

“Public health messaging urges us to sit less but doesn’t tell us the best ways to do that,” said Sheri Hartman, PhD, lead author and professor at the University of California San Diego. “Our findings suggest that while sitting less was helpful, interrupting sitting with brief standing breaks—even if you don't sit less—can support healthy blood pressure and improve health.”

The study enrolled 407 postmenopausal women (mean age, 68 years) with body mass index ≥25 kg/m² and daily sitting time of ≥7 hours. Participants were randomized into 3 arms: a “sit less” group aimed at reducing total daily sitting time, a “sit-to-stand” group instructed to increase the frequency of standing transitions, and a “healthy living” control group. Each group received 7 coaching sessions over 12 weeks.

Behavioral outcomes showed that the “sit less” group reduced total sitting time by 58 minutes per day compared with the control (P < .001) but did not significantly increase STSTs. Conversely, the “sit-to-stand” group increased STSTs by 26 per day (P<.001) without significantly reducing sitting time. Both intervention groups reduced the duration of long sitting bouts (>30 minutes), but only the “sit-to-stand” group significantly reduced average sitting bout length (P<.01).

Physiologically, the sit-to-stand intervention led to a statistically significant reduction in diastolic blood pressure compared with the control group. The estimated intervention effect was –2.24 mm Hg (95% CI, –4.08 to –0.40; P=.02). Systolic blood pressure also declined in the sit-to-stand group by –3.33 mm Hg (95% CI, –6.32 to –0.33; P = .03), although it did not meet the predefined significance threshold of P < .025. No statistically significant changes in blood pressure were observed in the “sit less” group.

Neither intervention had a significant impact on glucose regulation markers, including fasting plasma glucose, insulin, glycated hemoglobin (HbA1c), or homeostatic model assessment of insulin resistance (HOMA2-IR). The composite glucose outcome remained unchanged in both groups (P > .05).

The authors emphasized that sitting time and sit-to-stand transitions are distinct behaviors and require separate intervention strategies. “What excites me most about this study is that women set their own goals and made a real difference in their sitting behaviors,” said co-author Andrea Z. LaCroix, PhD. “With a little coaching, we can teach ourselves to sit less and it makes a tangible difference to our short- and long-term health.”

Although the average decrease in diastolic blood pressure did not reach the clinically meaningful range of 3 to 5 mm Hg, the authors note that a 2.24–mm Hg drop achieved in only 3 months suggests potential for larger population-level benefits with longer interventions. Exploratory analyses adjusting for moderate-to-vigorous physical activity (MVPA) did not materially change the results, indicating that the blood pressure effects were attributable to increased STSTs rather than increased exercise.

Additional adverse events were minimal, with mild skin irritation from wearable devices being the most common. Musculoskeletal complaints were infrequent and generally resolved during the study period.

The authors suggest that brief, frequent sit-to-stand movements may be an accessible behavioral strategy for older women to improve cardiovascular health. The research team has submitted a grant proposal to investigate the long-term impact of these behaviors in a broader cohort that includes older men and clinical populations at elevated cardiometabolic risk.

“Adapting real-world interventions that are easy, realistic, and aligned with our personal goals—such as stand up from sitting 25 extra times per day, like 2 times per hour over 12 hours—may be doable for so many of us,” LaCroix said.

Hartman and colleagues conclude that targeting sit-to-stand transitions may offer a feasible, low-barrier intervention to help mitigate cardiovascular risk in sedentary older women.

References:

1. Hartman SJ, LaCroix AZ, Sears DD, et al. Impacts of Reducing Sitting Time or Increasing Sit-to-Stand Transitions on Blood Pressure and Glucose Regulation in Postmenopausal Women: Three-Arm Randomized Controlled Trial. Circulation. Published online July 25, 2025. doi:https://doi.org/10.1161/circulationaha.124.073385
2. University of California - San Diego. Just rise: Study finds frequent standing may boost heart health after menopause. Eurekalert. August 5, 2025. Accessed August 7, 2025. https://www.eurekalert.org/news-releases/1093550