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Increased daily ambulatory activity may reduce CV events
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An additional 2,000 steps taken daily for a year may reduce the risk for CV events by 8%, according to findings in a large, international study of patients at risk for type 2 diabetes.
The prospective, multicenter NAVIGATOR trial included 9,306 patients who were recruited from 2002 to January 2004. All patients had impaired glucose tolerance and existing CVD (among patients aged at least 50 years) or one or more risk factors for CVD (among patients aged at least 55 years). The incidence of CV-related mortality, nonfatal stroke or MI was observed during a median follow-up of 6 years (45,211 person-years), with evaluable data for 9,018 patients.
The participants’ ambulatory activity was measured via pedometer at baseline and 1 year. Participants recorded their steps during the course of 7 consecutive days, 2 weeks after baseline and at 1 year.
In total, 531 CV events were recorded during follow-up. Ambulatory activity overall was similar at baseline (median, 5,892 daily steps) and at 1 year (median, 6,320 steps). However, the change in activity varied substantially among individuals (truncated range, –10,000 to 10,000 steps).
Researchers observed inverse associations between CV risk and ambulatory activity at baseline (HR=0.9; 95% CI, 0.84-0.96 per 2,000 daily steps) and change in ambulatory activity with time (HR=0.92; 95% CI, 0.86-0.99 per 2,000 additional steps). Adjustment for BMI changes and other potential confounders at 1 year did not affect the benefits of change in ambulatory activity. Exclusion of patients who experienced nonfatal CV events within the first 12 months, or of smokers at baseline, also did not significantly alter results.
“In the absence of randomized controlled studies assessing the effect of physical activity on morbidity or mortality outcomes, our findings strengthen the evidence underpinning the importance of physical activity in the promotion of CV health and have important implications for public health recommendations and the prevention of chronic disease,” the researchers concluded. “Implications extend to the importance of preventing a decline in physical activity levels in middle-aged and elderly populations.”
In a related editorial, Giuseppe Pugliese, MD, PhD, and Stefano Balducci, MD, of the department of clinical and molecular medicine, La Sapienza University of Rome, said the data strongly support the hypothesis that an active lifestyle reduces CVD burden among high-risk patients.
“We believe that the NAVIGATOR trial adds compelling and reassuring evidence for the benefits of physical activity on CV health, although further observational and intervention studies with rigorous and objective measurement of physical activity and fitness are needed.”
Disclosure: See the full study for a list of relevant financial disclosures.
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