Keywords
Sedentary behavior
Mechanism
Intervention
Review
Submitted : 2026-02-08
Accepted : 2026-02-23
Published : 2026-03-10
Abstract
This paper systematically reviews the concept and assessment methods of sedentary behavior, summarizes the current status of sedentary behavior in patients with chronic heart failure (CHF) and its impact on adverse health outcomes, and synthesizes the potential mechanisms linking sedentary behavior to CHF as well as current intervention strategies. It aims to provide a reference for future research on sedentary behavior in CHF patients in China.
References
Savarese G, Becher PM, Lund LH, et al., 2023, Global Burden of Heart Failure: A Comprehensive and Updated Review of Epidemiology. Cardiovasc Res, 118(17): 3272–3287.
Center for Cardiovascular Diseases, the Writing Committee of the Report on Cardiovascular Health and Diseases in China, 2024, Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary. Biomed Environ Sci, 37(9): 949–992.
Pandey A, Kitzman DW, 2021, Searching for the Optimal Exercise Training Regimen in Heart Failure With Preserved Ejection Fraction. Jama, 325(6): 537–539.
Ajugo E, Kany S, Rämö JT, et al., 2025, Accelerometer-Measured Sedentary Behavior and Risk of Future Cardiovascular Disease. J Am Coll Cardiol, 85(5): 473–486.
Letter to the Editor: Standardized Use of the Terms “Sedentary” and “Sedentary Behaviours,” 2012, Appl Physiol Nutr Metab, 37(3): 540–542.
Tremblay MS, Aubert S, Barnes JD, et al., 2017, Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act, 14(1): 75.
Owen N, Healy GN, Dempsey PC, et al., 2020, Sedentary Behavior and Public Health: Integrating the Evidence and Identifying Potential Solutions. Annu Rev Public Health, 41: 265–287.
Bauman A, Ainsworth BE, Sallis JF, et al., 2011, The Descriptive Epidemiology of Sitting. A 20-Country Comparison using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med, 41(2): 228–235.
Craig CL, Marshall AL, Sjöström M, et al., 2003, International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med Sci Sports Exerc, 35(8): 1381–1395.
Rosenberg DE, Norman GJ, Wagner N, et al., 2010, Reliability and Validity of the Sedentary Behavior Questionnaire (SBQ) for adults. J Phys Act Health, 7(6): 697–705.
Yavari M, Haykowsky MJF, Savu A, et al., 2017, Volume and Patterns of Physical Activity Across the Health and Heart Failure Continuum. Can J Cardiol, 33(11): 1465–1471.
Haedtke C, Smith M, Vanburne J, et al., 2017, The Relationships Among Pain, Depression, and Physical Activity in Patients With Heart Failure. J Cardiovasc Nurs, 32(5): E21–e25.
Schmidt C, Santos M, Bohn L, et al., 2020, Comparison of Questionnaire and Accelerometer-Based Assessments of Physical Activity in Patients with Heart Failure with Preserved Ejection Fraction: Clinical and Prognostic Implications. Scand Cardiovasc J, 54(2): 77–83.
Paterson C, Higgins S, Sikk M, et al., 2023, Acute Sedentary Behavior and Cardiovascular Disease Research: Standardizing the Methodological Posture. Am J Physiol Heart Circ Physiol, 324(1): H122–h125.
LaVie CJ, Ozemek C, Carbone S, et al., 2019, Sedentary Behavior, Exercise, and Cardiovascular Health. Circ Res, 124(5): 799–815.
Young DR, Hivert MF, Alhassan S, et al., 2016, Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association. Circulation, 134(13): e262–e279.
Doukky R, Mangla A, Ibrahim Z, et al., 2016, Impact of Physical Inactivity on Mortality in Patients With Heart Failure. Am J Cardiol, 117(7): 1135–1143.
Park LG, Dracup K, Whooley MA, et al., 2019, Sedentary Lifestyle Associated with Mortality in Rural Patients with Heart Failure. Eur J Cardiovasc Nurs, 18(4): 318–324.
Freene N, Lönn A, Carroll S, et al., 2024, Dose-Response Independent and Joint Associations of Physical Activity and Sedentary Behavior With Mortality Risk in 40156 Australian Adults With Coronary Heart Disease. J Am Heart Assoc, 13(21): e035803.
Boberska M, Szczuka Z, Kruk M, et al., 2018, Sedentary Behaviours and Health-Related Quality of Life. A Systematic Review and Meta-Analysis. Health Psychol Rev, 12(2): 195–210.
Edwards MK, Loprinzi PD, 2016, Sedentary Behavior & Health-Related Quality of Life Among Congestive Heart Failure Patients. Int J Cardiol, 220: 520–523.
Gao Y, Li Q, Yang L, et al., 2024, Causal Association Between Sedentary Behaviors and Health Outcomes: A Systematic Review and Meta-Analysis of Mendelian Randomization Studies. Sports Med, 54(12): 3051–3067.
Zahid I, Baig MA, Ahmed Gilani J, et al., 2018, Frequency and Predictors of Depression in Congestive Heart Failure. Indian Heart J, 70(Suppl 3): S199–s203.
Chen MF, Ke SR, Liu CL, et al., 2020, Associated Factors and Impacts of Sedentary Behaviour in Patients with Heart Failure: A Longitudinal Study. Eur J Cardiovasc Nurs, 19(7): 609–618.
Chen J, Hua S, Huang L, et al., 2025, Exploring Sedentary Behavior, Neutrophil-to-Lymphocyte Ratio, and Depression: Mediation Analysis in NHANES. Prog Neuropsychopharmacol Biol Psychiatry, 136: 111140.
Parsons TJ, Sartini C, Welsh P, et al., 2017, Physical Activity, Sedentary Behavior, and Inflammatory and Hemostatic Markers in Men. Med Sci Sports Exerc, 49(3): 459–465.
Nair N, 2020, Epidemiology and Pathogenesis of Heart Failure with Preserved Ejection Fraction. Rev Cardiovasc Med, 21(4): 531–540.
Li Z, Zhao H, Wang J, 2021, Metabolism and Chronic Inflammation: The Links Between Chronic Heart Failure and Comorbidities. Front Cardiovasc Med, 8: 650278.
Tunc Suygun E, Vardar Yagli N, Suygun H, 2025, Relationship Between Epicardial Adipose Tissue Thickness and Sedentary Time, Physical Activity Level, and Physical Performance in Patients with Hypertension. J Hum Hypertens, 39(4): 274–278.
Carter S, Hartman Y, Holder S, et al., 2017, Sedentary Behavior and Cardiovascular Disease Risk: Mediating Mechanisms. Exerc Sport Sci Rev, 45(2): 80–86.
Dunstan DW, Dogra S, Carter SE, et al., 2021, Sit Less and Move More for Cardiovascular Health: Emerging Insights and Opportunities. Nat Rev Cardiol, 18(9): 637–648.
Vahlberg BM, Jansson C, Åkerfeldt T, et al., 2024, Association Between Sedentary Time, Physical Activity, Biochemical Markers in the Blood (Heart and Muscles) and Heart Failure in Adults with Congenital Heart Disease: A Study Protocol of a Cross-Sectional Cohort Study in Sweden (the ACHD Trial Protocol). BMJ Open, 14(11): e087907.
Howden EJ, Carrick-Ranson G, Sarma S, et al., 2018, Effects of Sedentary Aging and Lifelong Exercise on Left Ventricular Systolic Function. Med Sci Sports Exerc, 50(3): 494–501.
Ahmadi-Abhari S, Sabia S, Shipley MJ, et al., 2017, Physical Activity, Sedentary Behavior, and Long-Term Changes in Aortic Stiffness: The Whitehall II Study. J Am Heart Assoc, 6(8): e005974.
LaMonte MJ, Larson JC, Manson JE, et al., 2020, Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women. Circ Heart Fail, 13(12): e007508.
Paterson C, Fryer S, Zieff G, et al., 2020, The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-Analysis. Sports Med, 50(11): 1929–1942.
Lemberg S, Brakenridge CJ, Dunstan DW, et al., 2025, Electromyography of Sedentary Behavior: Identifying Potential for Cardiometabolic Risk Reduction. Med Sci Sports Exerc, 57(1): 11–22.
Maasakkers CM, Melis RJF, Kessels RPC, et al., 2020, The Short-Term Effects of Sedentary Behaviour on Cerebral Hemodynamics and Cognitive Performance in Older Adults: A Cross-Over Design on the Potential Impact of Mental and/or Physical Activity. Alzheimers Res Ther, 12(1): 76.
Sanigatee K, Poochipakorn C, Huangsaksri O, et al., 2024, Comparison of Daily Heart Rate and Heart Rate Variability in Trained and Sedentary Aged Horses. J Equine Vet Sci, 137: 105094.
Muguerza-Rodríguez L, Mier A, Ponce-González JG, et al., 2025, Systematic Review on the Importance of Gut Microbiota in the Regulation of Type 2 Diabetes Through Physical Activity and Exercise. Curr Issues Mol Biol, 47(7): 505.
Brener A, Lorber D, Reuveny A, et al., 2023, Sedentary Behavior Impacts on the Epigenome and Transcriptome: Lessons from Muscle Inactivation in Drosophila Larvae. Cells, 12(19): 2333.
Lee H, Boo S, Yu J, et al., 2017, Physical Functioning, Physical Activity, Exercise Self-Efficacy, and Quality of Life Among Individuals With Chronic Heart Failure in Korea: A Cross-Sectional Descriptive Study. J Nurs Res, 25(2): 131–139.
Peachey MM, Richardson J, Tang A, et al., 2020, Environmental, Behavioural and Multicomponent Interventions to Reduce Adults’ Sitting Time: A Systematic Review and Meta-Analysis. British Journal of Sports Medicine, 54(6): 315–325.
Pratt M, 2021, What’s new in the 2020 World Health Organization Guidelines on Physical Activity and Sedentary Behavior? J Sport Health Sci, 10(3): 288–289.
Hannan M, Kringle E, Hwang CL, et al., 2021, Behavioral Medicine for Sedentary Behavior, Daily Physical Activity, and Exercise to Prevent Cardiovascular Disease: A Review. Curr Atheroscler Rep, 23(9): 48.