Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events

Stens, NA ORCID: 0000-0001-7487-151X, Bakker, EA, Mañas, A, Buffart, LM, Ortega, FB, Lee, DC, Thompson, PD, Thijssen, DHJ ORCID: 0000-0002-7707-5567 and Eijsvogels, TMH ORCID: 0000-0003-0747-4471 (2023) Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. Journal of the American College of Cardiology, 82 (15). pp. 1483-1494. ISSN 0735-1097

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Abstract

Background: The minimal and optimal daily step counts for health improvements remain unclear. Objectives: A meta-analysis was performed to quantify dose-response associations of objectively measured step count metrics in the general population. Methods: Electronic databases were searched from inception to October 2022. Primary outcomes included all-cause mortality and incident cardiovascular disease (CVD). Study results were analyzed using generalized least squares and random-effects models. Results: In total, 111,309 individuals from 12 studies were included. Significant risk reductions were observed at 2,517 steps/d for all-cause mortality (adjusted HR [aHR]: 0.92; 95% CI: 0.84-0.999) and 2,735 steps/d for incident CVD (aHR: 0.89; 95% CI: 0.79-0.999) compared with 2,000 steps/d (reference). Additional steps resulted in nonlinear risk reductions of all-cause mortality and incident CVD with an optimal dose at 8,763 (aHR: 0.40; 95% CI: 0.38-0.43) and 7,126 steps/d (aHR: 0.49; 95% CI: 0.45-0.55), respectively. Increments from a low to an intermediate or a high cadence were independently associated with risk reductions of all-cause mortality. Sex did not influence the dose-response associations, but after stratification for assessment device and wear location, pronounced risk reductions were observed for hip-worn accelerometers compared with pedometers and wrist-worn accelerometers. Conclusions: As few as about 2,600 and about 2,800 steps/d yield significant mortality and CVD benefits, with progressive risk reductions up to about 8,800 and about 7,200 steps/d, respectively. Additional mortality benefits were found at a moderate to high vs a low step cadence. These findings can extend contemporary physical activity prescriptions given the easy-to-understand concept of step count. (Dose-Response Relationship Between Daily Step Count and Health Outcomes: A Systematic Review and Meta-Analyses; CRD42021244747)

Item Type:	Article
Uncontrolled Keywords:	exercise; health outcomes; physical activity; population; public health; walking; 1102 Cardiorespiratory Medicine and Haematology; 1117 Public Health and Health Services; Cardiovascular System & Hematology
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Elsevier
Date of acceptance:	24 July 2023
Date of first compliant Open Access:	6 September 2024
Date Deposited:	07 Nov 2023 10:23
Last Modified:	04 Jul 2025 16:00
DOI or ID number:	10.1016/j.jacc.2023.07.029
URI:	https://researchonline.ljmu.ac.uk/id/eprint/21803

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