Walking more means less cardiovascular risk

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Individuals with impaired glucose tolerance and other risk factors for heart disease who exercise more can help walk off their chances of having a cardiovascular event, according to a study published online Dec. 20 in The Lancet.

Investigators led by Thomas Yates, PhD, of the University of Leicester in Leicester, U.K., used data from the 2002-2004 NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research) trial to determine the relationship between walking and the risk of a cardiovascular event. The NAVIGATOR trial evaluated the effects of nateglinide (Starlix, Novartis) and valsartan (Diovan, Novartis) on the risk of cardiovascular events in people with impaired glucose tolerance who already had cardiovascular disease or had one or more risk factors. Researchers defined cardiovascular events as cardiovascular death, nonfatal stroke or nonfatal heart attack.

Yates and colleagues looked at data from 9,306 NAVIGATOR participants with impaired glucose tolerance. They were also evaluated for other cardiovascular risk factors and received full clinical assessments.

All participants took part in a lifestyle modification program that involved a goal of 5 percent weight loss, lower saturated and overall fat intake and 150 minutes of ambulation per week. Physical activity was measured using a pedometer and participants recorded their daily step counts at baseline and at 12 months.

Analysis revealed an inverse relationship between ambulation and risk of a cardiovascular event (hazard ratio [HR] 0.92). At baseline, about 20 minutes a day of walking at a moderate pace was associated with a 10 percent lower risk of a cardiovascular event. Between baseline and 12 months, a change in ambulatory activity of about 20 minutes a day was associated with an 8 percent difference in the rate of cardiovascular events. Sex, age, level of activity at baseline and cardiovascular disease history had no impact on the relationship between the two variables.

The investigators acknowledged that among the study’s limitations were issues related to the use of the pedometer, such as the reliance on self-reporting. Nevertheless, they argued that their study offers evidence of the need to encourage physical activity.

“Implications extend to the importance of preventing a decline in physical activity levels in middle-aged and elderly populations,” they wrote.

Novartis provided the funding for this study.