Walking Lowers CVD Risk in Patients With Impaired Glucose Tolerance

December 23, 2013

LEICESTER, UK — Walking just 2000 steps per day lowers the risk of CVD by 10% in those with impaired glucose tolerance (IGT), according to the results of a new study. In addition, the study also showed that, regardless of baseline walking habits, each 2000-step increase per day resulted in an 8% reduction in cardiovascular risk[1].

Two-thousand steps per day is the equivalent of approximately 20 minutes of walking at a moderate pace.

"These findings support both the promotion of increased ambulatory activity and the avoidance of decreased ambulatory activity, irrespective of the starting level, as important targets in the prevention of chronic disease," report Dr Thomas Yates (Leicester General Hospital, UK) and colleagues in the paper, published online December 20, 2013 in the Lancet.

The findings are from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study, which included 9306 randomized patients from 40 countries. All patients had IGT, defined as plasma glucose >140 mg/dL but <200 mg/dL after an oral glucose load and at least one cardiovascular risk factor if aged 55 years or older (or known CVD if 50 years or older).

Results from the NAVIGATOR trial, previously reported by heartwire , showed that neither valsartan (Diovan, Novartis) nor nateglinide (Starlix, Novartis) had any significant effect on CV risk compared with placebo in separate randomizations. The trial also required patients to participate in a lifestyle-modification program designed to reduce the risk of diabetes through weight loss, dietary fat reduction, and increased exercise.

After a mean follow-up of five years, baseline walking habits and a change in walking activity were both inversely associated with the risk of a CV event. From baseline, each additional 2000 steps of daily walking at 12 months was associated with a 10% lower risk of a CV event. Similarly, each 2000-step increase or decrease in daily walking from baseline to 12 months was associated with an 8% decrease or increase in CV risk, respectively.

The results were unaffected when adjusted for potential confounding factors, including body-mass index, as well as a previous history of CVD, sex, age, or geographic region.

"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," conclude Yates et al.

Novartis Pharmaceuticals provided funding for the study. Yates has no conflicts of interest; disclosures for the coauthors are listed in the paper.

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