Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis-Reference-Cited by-同舟云学术

Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis

Published:2023-01-10 Issue:2 Volume:147 Page:122-131
ISSN:0009-7322
Container-title:Circulation
language:en
Short-container-title:Circulation

Author:

Paluch Amanda E.¹^ORCID,Bajpai Shivangi¹,Ballin Marcel²^ORCID,Bassett David R.³,Buford Thomas W.⁴⁵,Carnethon Mercedes R.⁶^ORCID,Chernofsky Ariel⁷^ORCID,Dooley Erin E.⁸^ORCID,Ekelund Ulf⁹¹⁰^ORCID,Evenson Kelly R.¹¹,Galuska Deborah A.¹²,Jefferis Barbara J.¹³,Kong Lingsong¹,Kraus William E.¹⁴¹⁵^ORCID,Larson Martin G.⁷,Lee I-Min¹⁶^ORCID,Matthews Charles E.¹⁷,Newton Robert L.¹⁸^ORCID,Nordström Anna²¹⁹²⁰^ORCID,Nordström Peter²^ORCID,Palta Priya²¹,Patel Alpa V.²²,Pettee Gabriel Kelley⁸^ORCID,Pieper Carl F.¹⁵^ORCID,Pompeii Lisa²³,Rees-Punia Erika²²,Spartano Nicole L.²⁴,Vasan Ramachandran S.²⁵²⁶^ORCID,Whincup Peter H.²⁷,Yang Shengping¹⁸,Fulton Janet E.¹²,

Affiliation:

1. Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts Amherst (A.E.P., S.B., L.K.)

2. Departments of Community Medicine and Rehabilitation, Unit of Geriatric Medicine (M.B., A.N., P.N.), Umeå University, Sweden

3. Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville (D.R.B.), University of Alabama at Birmingham

4. Departments of Medicine, Division of Gerontology/Geriatrics/Palliative Care (T.W.B.), University of Alabama at Birmingham

5. Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, AL (T.W.B.)

6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.R.C.)

7. Department of Biostatistics, Boston University, MA (A.C., M.G.L.)

8. Epidemiology (E.E.D.‚ K.P.G.), University of Alabama at Birmingham

9. Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo (U.E.)

10. Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo (U.E.)

11. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill (K.R.E.)

12. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA (D.A.G., J.E.F.)

13. Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom (B.J.J.)

14. Duke Molecular Physiology Institute, Durham, NC (W.E.K.)

15. Department of Medicine, Duke University, Durham, NC (W.E.K., C.F.P.)

16. Brigham and Women’s Hospital, Harvard Medical School and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (I-M.L.)

17. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD (C.E.M.)

18. Pennington Biomedical Research Center, Baton Rouge, LA (R.L.N., S.Y.)

19. Public Health and Clinical Medicine, Section of Sustainable Health (A.N.), Umeå University, Sweden

20. School of Sport Sciences, UiT The Arctic University of Norway, Tromsø (A.N.)

21. Department of Medicine, Columbia University, New York (P.P.)

22. American Cancer Society, Population Science Department, Atlanta, GA (A.V.P., E.R-P.)

23. Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, TX (L.P.)

24. Departments of Endocrinology, Diabetes, Nutrition and Weight Management (N.L.S.), Boston University School of Medicine, MA

25. Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, MA

26. Department of Medicine and Epidemiology, Boston University School of Public Health, MA (R.S.V.)

27. Population Health Research Institute, St George’s‚ University of London, United Kingdom (P.H.W.).

Abstract

Background: Taking fewer than the widely promoted “10 000 steps per day” has recently been associated with lower risk of all-cause mortality. The relationship of steps and cardiovascular disease (CVD) risk remains poorly described. A meta-analysis examining the dose–response relationship between steps per day and CVD can help inform clinical and public health guidelines. Methods: Eight prospective studies (20 152 adults [ie, ≥18 years of age]) were included with device-measured steps and participants followed for CVD events. Studies quantified steps per day and CVD events were defined as fatal and nonfatal coronary heart disease, stroke, and heart failure. Cox proportional hazards regression analyses were completed using study-specific quartiles and hazard ratios (HR) and 95% CI were meta-analyzed with inverse-variance–weighted random effects models. Results: The mean age of participants was 63.2±12.4 years and 52% were women. The mean follow-up was 6.2 years (123 209 person-years), with a total of 1523 CVD events (12.4 per 1000 participant-years) reported. There was a significant difference in the association of steps per day and CVD between older (ie, ≥60 years of age) and younger adults (ie, <60 years of age). For older adults, the HR for quartile 2 was 0.80 (95% CI, 0.69 to 0.93), 0.62 for quartile 3 (95% CI, 0.52 to 0.74), and 0.51 for quartile 4 (95% CI, 0.41 to 0.63) compared with the lowest quartile. For younger adults, the HR for quartile 2 was 0.79 (95% CI, 0.46 to 1.35), 0.90 for quartile 3 (95% CI, 0.64 to 1.25), and 0.95 for quartile 4 (95% CI, 0.61 to 1.48) compared with the lowest quartile. Restricted cubic splines demonstrated a nonlinear association whereby more steps were associated with decreased risk of CVD among older adults. Conclusions: For older adults, taking more daily steps was associated with a progressively decreased risk of CVD. Monitoring and promoting steps per day is a simple metric for clinician–patient communication and population health to reduce the risk of CVD.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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