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.

中文翻译：

---

日常步数与心血管疾病的前瞻性关联：一项统一的荟萃分析

背景：最近发现，少于广泛宣传的“每天 10000 步”与较低的全因死亡率风险相关。步数与心血管疾病 (CVD) 风险之间的关系仍然鲜为人知。检查每天步数与 CVD 之间剂量反应关系的荟萃分析有助于为临床和公共卫生指南提供信息。 CVD 事件遵循的步骤和参与者。研究量化了每天的步数，CVD 事件被定义为致死性和非致死性冠心病、中风和心力衰竭。使用研究特定的四分位数和风险比 (HR) 完成 Cox 比例风险回归分析，并使用逆方差加权随机效应模型对 95% CI 进行荟萃分析。结果：参与者的平均年龄为 63.2±12.4 岁，52% 为女性。平均随访时间为 6.2 年（123209 人年），共报告了 1523 起 CVD 事件（每 1000 名参与者年 12.4 起）。在老年人（即≥60 岁）和年轻人（即<60 岁）之间，每日步数与 CVD 的相关性存在显着差异。对于老年人，四分位数 2 的 HR 为 0.80（95% CI，0.69 至 0.93），四分位数 3 的 HR 为 0.62（95% CI，0.52 至 0.74），四分位数 4 的 HR 为 0.51（95% CI，0.41 至 0.63）最低的四分位数。对于较年轻的成年人，四分位数 2 的 HR 为 0.79（95% CI，0.46 至 1.35），四分位数 3 的 HR 为 0.90（95% CI，0.64 至 1.25），四分位数 4 的 HR 为 0.95（95% CI，0.61 至 1.48）最低的四分位数。受限三次样条显示了一种非线性关联，即更多步数与老年人 CVD 风险降低相关。结论：对于老年人，每天走更多步与 CVD 风险逐渐降低相关。监测和促进每天的步数是临床医患沟通和人口健康的一个简单指标，可降低 CVD 风险。