Walking an extra 2000 steps a day reduces cardiovascular events in people at high risk of type 2 diabetes

Walking an additional 2000 steps each day reduces the risk of cardiovascular events by 8% in people with impaired glucose tolerance, shows a large international study.1

Researchers analysed prospective data concerning 9306 adults with impaired glucose tolerance and pre-existing cardiovascular disease or at least one additional cardiovascular risk factor. They were taking part in the international NAVIGATOR trial, which assessed the potential for drug treatment to reduce the onset of diabetes and cardiovascular events, but the research group also used the opportunity to assess the effect of walking.

All study participants took part in a lifestyle modification programme aiming to reduce body weight and dietary fat intake and to increase physical activity to 150 minutes each week.

The researchers recorded usual walking activity with a pedometer, counting the number of steps taken each day for one week at baseline and again 12 months later, and then followed participants for an average of six years.

They used statistical modelling to test the relation between the number of steps taken each day and the risk of subsequent cardiovascular disease, after adjusting for confounding factors such as body mass index, smoking status, diet, clinical history, and drug use. There were 531 cardiovascular events during a total of 45 211 person years of follow-up.

Their results showed that walking activity at the start of the study and change in walking activity over 12 months were inversely associated with the subsequent risk of cardiovascular events.

Every 2000 additional steps a day at the start of the study translated into a 10% lower risk of cardiovascular events in subsequent years (hazard ratio for each 2000 steps a day 0.90 (95% confidence interval 0.84 to 0.96)). In addition, the risk of cardiovascular disease was further reduced by 8% for every 2000 steps a day that walking activity increased between the start of the study and 12 months later (hazard ratio 0.92 (0.86 to 0.99)).

The study’s lead author, Thomas Yates, of the University of Leicester, said, “Our results provide novel evidence that changing physical activity levels through simply increasing the number of steps taken can substantially reduce the risk of cardiovascular disease, such as heart attack and stroke.” He pointed out that the benefits were seen regardless of body weight or starting level of activity.

“These findings provide the strongest evidence yet for the importance of physical activity in high risk populations and will inform diabetes and cardiovascular disease prevention programmes worldwide,” he concluded.

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