Increased Walking Intensity May Lower Cardiovascular Risks for Those with High Blood Pressure

A study involving over 36,000 individuals with high blood pressure demonstrates that walking more steps daily and increasing walking speed reduces the risk of significant cardiovascular issues.

The research, published in the European Journal of Preventive Cardiology, reveals that compared to a low daily step count of 2,300 steps, every additional 1,000 steps correlates with a notable reduction in major adverse cardiovascular events (MACE), up to 10,000 steps. Steps exceeding 10,000 are linked to decreased stroke risk.

Globally, around 1.28 billion people live with high blood pressure, elevating their heart disease (49% increase), stroke (62% increase), and heart failure (77–89% increase) risks. Until now, the required physical activity for these individuals to lower MACE risk remained uncertain.

Professor Emmanuel Stamatakis from the University of Sydney Australia, who led the study, commented, "Our findings demonstrate a dose-response relationship between daily step count and major cardiovascular events."

"For people with high blood pressure, more intense walking correlates with lower risks for future serious cardiovascular incidents.

"These results emphasize that even physical activity below the common 10,000-steps daily target yields significant health benefits."

The study sampled data from 32,192 participants of the UK Biobank sub-study who wore a wrist accelerometer for seven days to measure walking frequency and intensity. Data was collected between 2013 and 2015, with an average participant age of 64 and nearly eight years of follow-up. During this period, 1,935 cases of heart problems or stroke were documented.

Findings include a 17% reduced risk for each additional 1,000 daily steps: a 22% reduction in heart failure, 9% in heart attack risk, and 24% in stroke risk. Per day, every extra 1,000 steps leads to:

• an average absolute MACE risk reduction of 31.5 events per 10,000 person-years
• a 7.2 heart failure event reduction per 10,000 person-years
• a 9.9 myocardial infarction reduction per 10,000 person-years
• a 10.4 stroke risk reduction per 10,000 person-years.

The researchers also found similar results in 37,350 participants without high blood pressure. A daily increase of 1,000 steps resulted in MACE risk reductions of 20.2%, heart failure (23.2%), myocardial infarction (17.9%), and stroke (24.6%).

Prof. Stamatakis concluded that "Our findings provide accessible targets for improving heart health even below the common target of 10,000 steps daily. Clinicians should promote physical activity as routine care for patients with high blood pressure."

Study strengths include its large population sample, accurate accelerometer data, and national record data from England, Wales, and Scotland.

The limitations are that physical activity was only measured at study entry without accounting for subsequent changes in behavior. While the findings indicate association rather than causation, extensive analyses were conducted to minimize risks of 'reverse causation'.