Is the time right for preventive cardiology guidelines on sedentary behaviors and sitting time?

This review looks into sedentary behavior (SB) beyond its simplistic definition of "sitting" while also including sedentary activities. It explores the definition, physiological characteristics, prevalence, and guidelines of SB, contrasting it with physical activity (PA). The discussion encompasses: 1) the association between SB and mortality, with a specific focus on cardiovascular (CV) outcomes; 2) biological mechanisms linking SB to CV health, differentiating between the impacts of acute and chronic sitting additionally, 3) sex and gender differences in SB and, 4) SB as an independent CV risk factor are explored. The review concludes with an examination of the potential beneficial effects of PA on mitigating the detrimental impacts of SB and an analysis of evidence supporting the use of break-up strategies in preventive cardiology. This analysis sheds light on the significant CV health deleterious consequences of SB. It highlights the potential of incorporating strategies to reduce and interrupt prolonged sitting alongside existing guidelines promoting PA. These findings suggest considering SB as a major CV risk factor, emphasizing the importance of targeting SB reduction and interruption as a valuable approach for preventing and managing CV disease. However, further research is needed to determine the long-term effectiveness of SB interventions, informing the development of optimal guidelines for CV health management.