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The Association Between Daily Step Count and All-Cause and Cardiovascular Mortality: A Meta-Analysis

Banach, M, Lewek, J, Surma, S, Penson, PE, Sahebkar, A, Martin, SS, Bajraktari, G, Henein, MY, Reiner, Z, Bielecka-Dabrowa, A, Bytyçi, I, LBPMC, and ILEP, (2023) The Association Between Daily Step Count and All-Cause and Cardiovascular Mortality: A Meta-Analysis. European Journal of Preventive Cardiology, 30 (18). pp. 1975-1985. ISSN 2047-4873

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Aims There is good evidence showing that inactivity and walking minimal steps/day increase the risk of cardiovascular (CV) disease and general ill-health. The optimal number of steps and their role in health is, however, still unclear. Therefore, in this meta-analysis, we aimed to evaluate the relationship between step count and all-cause mortality and CV mortality.Methods and results We systematically searched relevant electronic databases from inception until 12 June 2022. The main endpoints were all-cause mortality and CV mortality. An inverse-variance weighted random-effects model was used to calculate the number of steps/day and mortality. Seventeen cohort studies with a total of 226 889 participants (generally healthy or patients at CV risk) with a median follow-up 7.1 years were included in the meta-analysis. A 1000-step increment was associated with a 15% decreased risk of all-cause mortality [hazard ratio (HR) 0.85; 95% confidence interval (CI) 0.81–0.91; P < 0.001], while a 500-step increment was associated with a 7% decrease in CV mortality (HR 0.93; 95% CI 0.91–0.95; P < 0.001). Compared with the reference quartile with median steps/day 3867 (2500–6675), the Quartile 1 (Q1, median steps: 5537), Quartile 2 (Q2, median steps 7370), and Quartile 3 (Q3, median steps 11 529) were associated with lower risk for all-cause mortality (48, 55, and 67%, respectively; P < 0.05, for all). Similarly, compared with the lowest quartile of steps/day used as reference [median steps 2337, interquartile range 1596–4000), higher quartiles of steps/day (Q1 = 3982, Q2 = 6661, and Q3 = 10 413) were linearly associated with a reduced risk of CV mortality (16, 49, and 77%; P < 0.05, for all). Using a restricted cubic splines model, we observed a nonlinear dose–response association between step count and all-cause and CV mortality (Pnonlineraly < 0.001, for both) with a progressively lower risk of mortality with an increased step count.Conclusion This meta-analysis demonstrates a significant inverse association between daily step count and all-cause mortality and CV mortality with more the better over the cut-off point of 3867 steps/day for all-cause mortality and only 2337 steps for CV mortality.

Item Type: Article
Uncontrolled Keywords: Humans; Cardiovascular Diseases; Walking; Cohort Studies; Health Status; All-cause mortality; Cardiovascular mortality; Daily step counts; Prevention; Humans; Walking; Cardiovascular Diseases; Cohort Studies; Health Status
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RB Pathology
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Oxford University Press
SWORD Depositor: A Symplectic
Date Deposited: 05 Apr 2024 14:21
Last Modified: 05 Apr 2024 14:30
DOI or ID number: 10.1093/eurjpc/zwad229
URI: https://researchonline.ljmu.ac.uk/id/eprint/22970
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