European Journal of Cardiovascular Medicine

The rapid evolution of digital infrastructure and the global shift in work modalities, particularly since the COVID-19 pandemic, have dramatically transformed the nature of professional environments. A major by-product of this shift has been the normalization of remote work, particularly in the IT, customer support, academic, administrative, and financial sectors. While working from home offers flexibility and reduces commuting stress, it has inadvertently reinforced sedentary behavior as a default mode of living. The term “sitting is the new smoking” underscores the growing concern among health professionals regarding the underestimated but potentially devastating effects of prolonged sitting on human health, especially cardiovascular outcomes.

Sedentary behavior is defined as any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents (METs) while in a sitting, reclining, or lying posture [1]. Work-from-home (WFH) professionals often engage in long hours of uninterrupted sitting, ranging between 8 to 12 hours daily, either due to online meetings, task completion, or lack of dedicated breaks. This behavior pattern significantly limits opportunities for physical activity and contributes to metabolic dysfunction, obesity, impaired glucose tolerance, and systemic inflammation—all of which are known precursors of cardiovascular disease (CVD) [2].

Numerous studies have indicated that sedentary time is independently associated with adverse cardiovascular outcomes, irrespective of physical activity levels. Even among individuals who meet the recommended 150 minutes of moderate-intensity activity per week, extended sitting hours have been linked to increased all-cause and cardiovascular mortality [3]. The underlying mechanisms include decreased lipoprotein lipase activity, reduced insulin sensitivity, endothelial dysfunction, and increased arterial stiffness—all pathophysiological processes strongly associated with atherosclerosis and cardiac events [4].

In the Indian context, this concern becomes particularly relevant. India is already burdened with a high prevalence of non-communicable diseases (NCDs), especially hypertension and ischemic heart disease, which contribute to a significant portion of premature mortality and morbidity [5]. The National Health Profile and ICMR reports indicate an upward trend in cardiovascular risk factors among the urban working population, with lifestyle changes during the pandemic likely exacerbating the situation [6]. The WFH model, while initially adopted as a protective measure during the pandemic, has continued in many organizations even post-lockdown, thereby extending the sedentary lifestyle for large segments of the workforce [7].

Furthermore, the home environment may lack the ergonomically designed workstations found in office settings, leading to poor posture, muscular fatigue, and compounded vascular strain. Studies have also shown that working from home often blurs the boundary between professional and personal time, reducing the likelihood of scheduled physical activity or exercise breaks [8]. Psychological stress, another significant risk factor for cardiovascular disease, is also known to be higher among individuals with inadequate work-life balance, irregular sleep cycles, and limited social interaction—all common characteristics of prolonged WFH settings [9].

Therefore, this study aims to examine the relationship between prolonged sedentary behavior among WFH professionals and their cardiovascular health profile, with a focus on identifying patterns in physical activity, biometric markers, self-reported symptoms, and perceived health status. Understanding these associations will enable the development of evidence-based recommendations and workplace health policies to mitigate the risks posed by sedentary workstyles in the evolving digital work culture [10].

Study Design and Setting

This was a cross-sectional, observational study conducted for 6 months among work-from-home professionals residing in metropolitan and tier-1 cities across India. The study was approved by the Institutional Ethics Committee, and informed digital consent was obtained from all participants prior to data collection.

Study Population

Eligible participants included adult men and women aged between 25 and 55 years who had been working remotely from home for at least 6 months. Inclusion criteria required participants to be engaged in a desk-based job involving a minimum of 6 hours of continuous computer use per workday. Exclusion criteria included known cardiovascular disease, chronic kidney or liver disease, pregnancy, or those engaged in regular intensive physical training (e.g., athletes).

Sample Size and Sampling Method

Based on an estimated sedentary lifestyle prevalence of 65% among urban Indian professionals, a minimum sample size of 80 was calculated with 95% confidence interval and 10% margin of error. Participants were recruited through targeted email campaigns, professional network groups, and social media platforms using purposive sampling.

Data Collection Tool

A structured and pre-validated digital questionnaire was designed in Google Forms and distributed via email and messaging platforms. The questionnaire comprised four major domains:

Demographics: Age, gender, location, occupation, and working hours.

Sedentary Behavior: Average hours of sitting per day, number of breaks taken, posture habits.

Physical Activity: Daily and weekly activity frequency (using the Global Physical Activity Questionnaire – GPAQ).

Cardiovascular Health Indicators: Self-reported blood pressure, resting heart rate, history of elevated blood sugar or lipid levels, and presence of symptoms such as palpitations, fatigue, or breathlessness.

A subset of participants (n=40) who consented to biometric monitoring were provided with wearable fitness trackers to record real-time heart rate, step count, and sedentary intervals for 7 consecutive days.

Data Analysis

Data were exported to Microsoft Excel and analyzed using SPSS version 25. Descriptive statistics (mean, standard deviation, percentage) were calculated for all variables. Chi-square tests were used for categorical variables, and independent t-tests were applied for continuous variables. Correlation analysis (Pearson’s r) was conducted to evaluate the association between sedentary duration and cardiovascular parameters. A p-value <0.05 was considered statistically significant.

Ethical Considerations

Participant confidentiality was maintained throughout the study. All responses were anonymized, and access to data was restricted to the research team. The study adhered to the ethical guidelines of the Indian Council of Medical Research (ICMR).

Summary of Findings

A total of 120 participants were enrolled in the study, out of which 112 completed the full questionnaire and were included in the final analysis. The mean age of participants was 36.4 ± 7.9 years, with a slight female predominance (56%). The average daily sitting duration reported was 9.3 ± 2.1 hours. Nearly 68% of participants took fewer than 2 breaks per workday, while only 18% met the WHO guidelines for moderate physical activity.

A significant proportion (39%) reported at least one cardiovascular symptom, such as palpitations, fatigue, or elevated blood pressure readings during routine checks. Chi-square analysis showed a statistically significant association between prolonged sitting (>9 hours/day) and the presence of cardiovascular symptoms (p = 0.02). Wearable tracker data (n=40) revealed that those with >70% sedentary time had higher resting heart rates (mean 84 bpm) compared to those with <60% sedentary time (mean 76 bpm; p = 0.01).

Table 1: Demographic and Occupational Characteristics of Participants (n = 112)

Table 2: Sedentary Behavior and Physical Activity Patterns

Table 3: Self-Reported Cardiovascular Health Indicators

Table 4: Association Between Sedentary Time and Cardiovascular Symptoms

*Statistically significant (Chi-square test)

This study aimed to evaluate the impact of prolonged sedentary behavior among work-from-home (WFH) professionals on cardiovascular health outcomes. The findings suggest a strong association between increased daily sitting duration and the occurrence of cardiovascular (CV) symptoms, such as elevated blood pressure, fatigue, palpitations, and abnormal heart rate. The majority of participants (39%) reported at least one cardiovascular symptom, and those who sat for more than 9 hours per day had a significantly higher prevalence of these symptoms compared to those with less sedentary time. These results are consistent with global trends emphasizing the health risks posed by prolonged sitting, especially in professional settings that limit physical movement [6].

Several pathophysiological mechanisms explain the adverse cardiovascular effects of sedentary behavior. Physical inactivity leads to impaired endothelial function, reduced nitric oxide availability, and increased arterial stiffness—all of which are precursors to hypertension and atherosclerosis [7]. Furthermore, inactivity reduces muscle contractions that otherwise promote venous return and glucose metabolism, contributing to insulin resistance and dyslipidemia—established risk factors for cardiovascular disease [8]. In this study, participants with higher sitting time were also more likely to report elevated fasting glucose levels and higher resting heart rates, supporting the metabolic link between inactivity and cardiovascular dysfunction.

The observation that only 18% of participants met the WHO-recommended levels of physical activity is particularly concerning. It reflects the challenge of integrating movement into daily routines when working from home, especially in urban settings where space may be limited. Research has shown that even short but regular interruptions in sitting time—such as standing or walking for a few minutes each hour—can improve cardiometabolic outcomes [9]. However, the data from our study indicate that such breaks were infrequent, with nearly 39% of respondents taking only one or no break during working hours. This behavioral pattern may contribute to the observed prevalence of fatigue and reduced cardiovascular efficiency.

Moreover, the wearable tracker subset revealed a notable disparity in heart rate metrics between high-sedentary and low-sedentary groups. Participants with over 70% sedentary time had a mean resting heart rate of 84 bpm, significantly higher than those with under 60% sedentary time (mean 76 bpm). Elevated resting heart rate is a well-established predictor of cardiovascular events and mortality [10]. This supports the hypothesis that continuous sitting, even in the absence of overt disease, contributes to measurable physiological stress.

In the Indian context, the implications of these findings are profound. India already carries one of the highest burdens of premature cardiovascular deaths globally, with lifestyle factors playing a significant role [11]. The post-pandemic rise of remote work, while beneficial in many ways, may inadvertently accelerate sedentary-related cardiovascular risks, especially among young professionals unaware of their vulnerability. National surveys have identified a significant gap in awareness and screening practices among working populations regarding lifestyle-induced non-communicable diseases [12].

The current study also highlights the psychosocial dimensions of sedentary behavior. While not directly measured, several participants indicated through open comments that their work-from-home schedules often extended into personal time, further reducing opportunities for structured exercise. Such work-life imbalance has been linked to stress-induced autonomic dysregulation and increased cardiovascular risk, especially when combined with poor sleep and irregular eating habits [13].

From a preventive standpoint, the findings underscore the urgent need for workplace health policies that address sedentary risks. Employers should be encouraged to implement scheduled microbreaks, virtual exercise reminders, and ergonomic assessments for remote employees. There is emerging evidence that workplace interventions—including standing desks, active break reminders, and digital health coaching—can significantly reduce sedentary time and improve cardiovascular markers [14]. However, these strategies remain underutilized in the WFH setup, especially in small- and medium-sized enterprises in India.

It is also important to consider the limitations of this study. The cross-sectional nature of the design restricts causal inferences. While associations between sedentary time and cardiovascular symptoms were observed, prospective studies are needed to confirm temporal relationships. Additionally, self-reported data on symptoms and lifestyle behaviors are subject to recall and social desirability bias. Although wearable data provided objective insights, it was limited to a subset of participants and may not reflect the broader sample’s behavior accurately. Despite these limitations, the findings offer a meaningful contribution to the limited body of research on sedentary risks in the Indian work-from-home population [15].

The study highlights a significant association between prolonged sedentary behavior among work-from-home professionals and adverse cardiovascular symptoms, including elevated blood pressure, fatigue, and increased resting heart rate. A majority of participants exceeded 9 hours of sitting daily, with insufficient physical activity and minimal work breaks. These findings underscore the urgent need for targeted interventions, such as structured movement breaks, ergonomic awareness, and virtual wellness programs. Promoting active work habits, even within remote settings, is essential to mitigate the rising burden of lifestyle-related cardiovascular risks in India’s digitally connected workforce.

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