A Conversation with Sheri Hartman, Ph.D., Professor and Assistant Dean of Research at Herbert Wertheim School of Public Health at the University of California San Diego

Sitting less may be tied to lower blood pressure in postmenopausal women, according to results from The Rise For Health Study, published in Circulation last month. Specifically, postmenopausal women who stood an average of 25 times a day decreased their diastolic blood pressure by 2.24 mmHg when compared with women in the control group.

Although this number is just shy of a clinically meaningful change of 3-5 mmHg, the change still demonstrates the value of even mild physical exercise, according to lead author Sheri Hartman, Ph.D., professor and assistant dean of research at the Herbert Wertheim School of Public Health at the University of California San Diego.

Hartman recently sat down with Managed Healthcare Executive to explain what these results reveal about cardiovascular health and what these findings mean for the future of postmenopausal research.

This interview has been edited for length and clarity.

Sheri Hartman, Ph.D.

MHE: Could you provide an overview of this study?

Hartman: We randomized three arms of postmenopausal women who also had a BMI of greater than 25, which put them in the obese category.

The study looked at how changing sitting patterns can improve different aspects of cardiovascular health for older women.

In arm one, we just asked participants to sit less.

The second arm was what we called our sit-to-stand transition arm, where we asked them to stand up for at least five seconds before sitting back down—not to change how much they were sitting, but just to break up the sitting by doing brief stands.

Our third group was our health and wellness comparison group. They had contacts with the health coaches in the same period, but we weren't asking them to change any of their behavior until we had everybody in the study for three months. We measured them at the start of the study and then again at the end of the three-month time point to look at if behavior changed and if there were any benefits using our measures of heart health.

MHE: Why were postmenopausal women the focus of this study?

Hartman: When women enter menopause, they have more risk for their heart health.

We often think about heart disease in men, but women, as they get older, also increase their risk for heart disease. We also focused on women who have higher BMI. As women go through menopause, they do gain weight, and when you have a higher weight, it can be harder to move your body. Not everybody is able to do moderate-intensity exercise.

We know that exercise is helpful for your heart, but as you get older, exercise can be harder to do, and we also know that even if people exercise the recommended 150 minutes a week or 30 minutes a day, they can still spend over 10 hours sitting, and all of that sitting time is not great for your heart.

Our recommendation right now is just to sit less, but what does that mean? Is it just about not sitting as much, or is it about breaking up sitting?

We wanted to look at what other ways we can encourage people to change their behaviors to improve their health.

MHE: In the study, neither sitting nor standing showed a significant improvement in blood sugar. Why is that?

Hartman: This was only a three-month study, which is too short to see some physiological changes. We didn't see any improvements in measures related to blood sugar because we weren't enrolling women who had elevated blood sugars.

Another longer study that also targets women who have some elevated blood sugars might be a great group to look at to see if this benefits them.

MHE: What was the most exciting finding for you from this study?

Hartman: The most exciting finding happened in the sit-to-stand transition group. We asked people to stand up for at least five seconds before they sit back down, and that's where we saw the biggest improvement in blood pressure. You use a whole lot of muscles to stand up, and your blood pressure rapidly changes, and those seconds might be an important part of why standing up is important. This is one of the first studies to really look at these very brief stands.

MHE: What is the next step for this research?

Hartman: The next step would ideally be doing a longer study. So doing a six-month study with a six-month follow-up to see if there's continued improvement. We’re also looking at including men to find out if they get as much benefit as women from sitting less.

MHE: How do the results of this study fit into the broader world of women's postmenopausal health?

Hartman: I think it gives women another health behavior to think about.

This was a home-based lifestyle intervention, where we help people set goals that fit in with their day-to-day.

It's hard to change behavior. People are creatures of habit, and giving them different ways to get up more is always important, because what works for one person might not work as well for another. The more tools we can get people, the better. They might not have time to go on a 30-minute walk but can find a half hour to stand up quickly and sit back down.