An increase of just 2,000 steps a day cuts cardiovascular disease risk by 8 percent in those with a high risk of type 2 diabetes

December 19, 2013

"People with IGT have a greatly increased risk of cardiovascular disease", explains study leader Dr Thomas Yates from the University of Leicester in the UK in The Lancet. "While several studies have suggested that physical activity is beneficially linked to health in those with IGT, this is the first study to specifically quantify the extent to which change in walking behaviour can modify the risk of heart disease, stroke, and cardiovascular-related deaths."*

IGT affects about 7.9% of the adult population (344 million people worldwide), and this number is projected to increase to 472 million (8.4%) by 2030.

Data on 9306 adults from 40 countries with IGT and cardiovascular disease or at least one cardiovascular risk factor were taken from the NAVIGATOR trial**. All participants received a lifestyle modification programme aimed at reducing body weight and dietary fat intake while increasing physical activity to 150min a week. Using a pedometer, researchers recorded usual walking activity (average number of steps taken per day) over a week both at the start of the study and again 12 months later.

Statistical modelling was used to test the relationship between the number of steps taken per day and the risk of subsequent cardiovascular disease after adjusting for a wide range of confounding factors such as body-mass index, smoking status, diet, clinical history, and medication use. 531 cardiovascular events were recorded during 45 211 person-years of follow-up.

Both levels of walking activity at the start of the study and change in walking activity over 12 months had a graded inverse association with subsequent risk of cardiovascular disease.

Specifically, for every 2000 steps per day difference in walking activity at the start of the study there was a 10% difference in the risk of cardiovascular disease in subsequent years. On top of this, the risk of cardiovascular disease was further modified by 8% for every 2000 steps per day that walking activity changed between the start of the study and 12 months later.

For example, if subject A took 4000 steps per day at the start of the study and did not change their activity levels over the next 12 months, and subject B took 6000 steps per day at the start of the study and increased their activity levels to 8000 steps per day over the next 12 months, by the end of the study (other things being equal) subject B would have an 18% lower risk of cardiovascular disease.

According to Dr Yates, "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. Importantly, these benefits are seen regardless of bodyweight status or the starting level of activity. These novel 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."*

Writing in a linked Comment, Giuseppe Pugliese and Stefano Balducci from La Sapienza University in Rome, Italy say, "We believe that the NAVIGATOR trial adds compelling and reassuring evidence for the benefits of physical activity on cardiovascular health, although further observational and intervention studies with rigorous and objective assessment of physical activity and fitness are needed."
-end-
NOTES TO EDITORS:

*Quotes direct from author and cannot be found in text of Article.

**The NAVIGATOR trial tested whether treatments for diabetes and blood pressure could also prevent the onset of diabetes and cardiovascular events in patients aged 50 or more who had impaired glucose tolerance and cardiovascular risk factors or cardiovascular disease. Researchers analyzed data from 9306 adults from 806 centres in 40 countries who were randomised to the anti-hypertensive drug valsartan, the blood sugar lowering drug nateglinid, or placebo, and were tracked for an average of 6 years.

Lancet

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.