Loading...
Walking is a common form of physical activity that many people use to improve cardiovascular health. However, the optimal daily “step count” for cardiovascular disease (CVD) risk reduction is debated. To examine the dose-response association between step count and clinical outcomes, investigators performed a systematic review and meta-analysis of studies that quantified daily step count using objective methods (accelerometers and pedometers).
Data came from 111,309 individuals in 12 studies. Compared with 2000 or fewer steps/day, the researchers found statistically significant risk reductions for all-cause mortality at 2517 steps/day (adjusted hazard ratio, 0.92) and for incident CVD at 2735 steps/day (aHR, 0.89). Additional steps were associated with further risk reductions in a nonlinear fashion, up to a threshold of 8763 steps for reduction in all-cause mortality (aHR, 0.40) and 7126 steps for reduced CVD risk (aHR, 0.49). Increasing from a low to an intermediate cadence was associated with a further 33% decrease in all-cause mortality risk, and a 38% risk reduction from a low to high cadence.
Stens NA et al. Relationship of daily step counts to all-cause mortality and cardiovascular events. J Am Coll Cardiol 2023 Sep 6; [e-pub]. (https://doi.org/10.1016/j.jacc.2023.07.029)
Comment
This study found that taking fewer than 3000 steps/day was associated with statistically significant risk reductions in mortality and incident CVD. Maximal benefits were observed at about 8700 and 7100 steps/day, respectively. These findings suggest that health benefits from walking accrue at much lower step counts than the regularly cited threshold of 10,000 steps/day, which reinforces the message I give to my patients: “just keep moving.” Encouraging more daily steps is obviously desirable, but we should also counsel patients not to give up if they cannot reach a particular threshold.