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Walking further and faster linked to reduced risk of heart attacks, heart failure, stroke in people with high blood pressure

Compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.  

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Analysis of over 36,000 people with high blood pressure has shown that taking more steps, even below the recommended daily target of 10,000 steps, and walking faster, is associated with a significant reduction in the risk of major problems of the heart and blood vessels. 

The study, published in the European Journal of Preventive Cardiology, found that compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.  

Approximately 1.28 billion people worldwide are living with high blood pressure, and it places them at increased risk of heart disease (49% increase), stroke (62% increase) and heart failure (77-89% increase). Until now, it has been unclear how much people with high blood pressure need to increase their physical activity in order to see a reduction in their risk of MACE. 

Professor Emmanuel Stamatakis, Director of the Mackenzie Wearables Research Hub at the University of Sydney, Australia, who supervised the study, said: “This study is one of the first to demonstrate a dose-response relationship between daily step count and major problems of the heart and blood vessels. In a nutshell, we found that, if you live with high blood pressure, the more you walk with greater intensity, the lower your risk for future serious cardiovascular events.  

“These findings support the message that any amount of physical activity is beneficial, even below the widely recommended daily target of 10,000 steps.”  

The study analysed data obtained from 32,192 people who had enrolled in a sub-study of the UK Biobank study. They had been diagnosed with high blood pressure and agreed to wear an accelerometer on their wrist for seven consecutive days to measure how far and how fast they walked. Data from the accelerometers was collected between 2013 and 2015. The average age was 64 and the participants were followed up for nearly eight years, providing the researchers with data for 283,001 person-years. During this time 1,935 cases of heart problems or stroke occurred. 

In addition to a 17% reduction in overall risk for every extra 1,000 steps a day, the researchers found a 22% reduction in heart failure, 9% reduction in risk of heart attack, and 24% reduction in risk of stroke. This means that every increase of 1,000 steps a day was associated with: 

  • an average reduction in the absolute risk of MACE of 31.5 events per 10,000 person-years 
  • an average reduction in the absolute risk of 7.2 heart failure events per 10,000 person-years 
  • an average reduction in the absolute risk of 9.9 myocardial infarctions (heart attacks) per 10,000 person-years 
  • an average reduction in the absolute risk of 10.4 strokes per 10,000 person-years. 

The average (mean) intensity of the 30 minutes of fastest walking per day was 80 steps a minute and this was associated with a 30% reduced risk of MACE. There was no evidence of harm in people whose 30 minutes of fastest walking or running was over 130 steps a minute.

The researchers found similar results when they looked at 37,350 people without high blood pressure. Every 1,000-step increase in daily step count led to an average lower risk of MACE, heart failure, myocardial infarctions and stroke of 20.2%, 23.2%, 17.9%, and 24.6%, respectively. 

Prof. Stamatakis said: “Our findings offer patients accessible and measurable targets for heart health, even below 10,000 steps daily. Clinicians should promote physical activity as standard care, especially in patients with high blood pressure. Our results can inform new, tailored public health recommendations for these patients. Future recommendations on walking in people with high blood pressure could consider promoting higher stepping intensity.” 

Strengths of the study include the large number of patients, the use of accelerometers to provide detailed information on numbers of steps and speed, and the use of data from national records in England, Wales and Scotland on deaths and causes of death.  

Limitations include the fact that physical activity was measured only when people first joined the study and did not include any subsequent changes in behaviour. In addition, the researchers point out that their findings can show only that there is an association between walking further and faster and better health outcomes, not that it causes these better outcomes. However, they conducted extensive analyses to minimise the risk of what is called ‘reverse causation’ (in which, in this case, health problems could be causing both a reduction in physical activity and an increase in heart disease events). Most UK Biobank participants are White, are less likely to be obese, to smoke or drink alcohol, and to be better educated, and so they may not be representative of the general UK population. 

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Wellness

Walking and weight training alone are not enough for strong bones – football and handball may be more effective

Bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

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When it comes to maintaining healthy bones, how intensely we exercise may matter more than how much we exercise, according to researchers at Semmelweis University.

Their study, published in Sports Medicine – Open, found that bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

Researchers at Semmelweis University analyzed the results of 24 clinical studies involving a total of 1,238 healthy adult participants. Rather than tracking changes in bone mineral density, the studies measured substances in the blood that indicate whether the body is actively building new bone tissue. These so-called biomarkers can reflect the effects of exercise within just a few weeks, providing feedback much earlier than bone density measurements.  

“What makes our study unique is that we examined not only the type of exercise – whether endurance, resistance, or combined training – but also exercise intensity, frequency, and duration. Our goal was to determine which forms of exercise stimulate bone metabolism most effectively and which appear to be less beneficial from this perspective,” said dr. Péter Ferdinandy, Vice-Rector for Science and Innovations at Semmelweis University and senior author of the study. 

The most effective activities were high-intensity sports involving frequent explosive movements, rapid changes of direction, and turning. Recreational football and handball, for example, were associated with increases of up to 45–46 percent in the levels of substances linked to bone formation. In contrast, walking, step aerobics, and traditional gym-based resistance exercises were generally less effective.  

What should you keep in mind?
It is important not to start a high-intensity exercise program suddenly or without proper preparation. This is particularly true for people with cardiovascular, musculoskeletal, or metabolic diseases, as well as those living with osteoporosis. Before beginning a new type of exercise or a more demanding training program, they should consult their treating physician, general practitioner, or a sports medicine specialist to ensure that the activity and its intensity are appropriate for their individual health status.

“The most surprising finding was that resistance training did not produce a significant effect on markers of bone metabolism, even though several professional guidelines recommend this type of exercise for maintaining bone health. Likewise, low- or moderate-intensity endurance exercise, such as walking or jogging, showed no meaningful long-term effect,” explained Viktória Barna, PhD student at Semmelweis University and first author of the study.

This, of course, does not mean that walking or lower-intensity physical activity is without health benefits. However, if the goal is to keep bones strong and healthy for as long as possible, they appear to require a greater mechanical stimulus. 

According to the World Health Organization, regular physical activity offers numerous health benefits. However, our findings suggest that low-intensity exercise alone is not sufficient to stimulate bone metabolism. High-intensity exercise may trigger early beneficial changes in bone formation, potentially helping to slow bone loss and support healthy ageing,” summarized dr. Nóra Sydó, clinical specialist and co-author of the study. 

According to the researchers, these findings could contribute to the development of evidence-based exercise programs aimed at maintaining bone health and preventing osteoporosis. 

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Move to quit: Exercise boosts smoking quit rates

Researchers found that people taking part in exercise programs were 15% more likely to achieve continuous abstinence and 21% more likely to report not smoking over a seven-day period, compared with control groups.

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A pack-a-day smoker can spend around $14,000 a year on cigarettes, yet despite the financial and health costs, quitting remains one of the most difficult changes many people will ever attempt.

Now, new research from Adelaide University shows that exercise can help people quit smoking by reducing cigarette consumption, easing cravings and improving their chances of quitting.

Researchers found that people taking part in exercise programs were 15% more likely to achieve continuous abstinence and 21% more likely to report not smoking over a seven-day period, compared with control groups.

They also found that exercise could reduce cigarette consumption by two cigarettes per day, and that a single bout of exercise immediately reduced cigarette cravings for up to 30 minutes after exercise.

The systematic review and meta-analysis examined 59 randomised controlled trials involving more than 9000 participants, exploring the effects of both single bouts of exercise and long-term exercise programs on smoking cessation, cravings, withdrawal symptoms and mood.

Globally, tobacco smoking remains the leading preventable cause of premature morbidity and mortality, accounting for about 7 million deaths, including an estimated 1.6 million non-smokers who are exposed to second-hand smoke.

Around the world, e-cigarette use has now reached more than 100 million people.

The researchers say exercise should be viewed as an additional tool that can be used alongside established smoking cessation support.

Lead researcher, Dr Ben Singh said the findings provide smokers with a practical, low-cost tool that can support their quitting journey.

“Quitting smoking is one of the best things a person can do for their health, but it’s also one of the hardest,” Dr Singh said.

“Many smokers want to quit, but the current approaches don’t work for everyone. That’s why we need more strategies that people can incorporate into their daily lives at little or no cost.

“Something as simple as regular exercise can make a meaningful difference to people trying to quit, helping them manage cravings, smoke less and improve their chances of quitting.”

While smoking rates have reduced over the past two decadesdemand for e-cigarettes and heated-tobacco products have risen, targeting the younger generation.

Today, 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, yet in contrast, vaping has risen across many OECD countries.

Senior researcher Adelaide University’s Professor Carol Maher said exercise could be used strategically to ward off tobacco cravings.

“Quitting smoking does not have to begin and end with willpower alone,” Prof Maher said.

“Cravings can be difficult to manage, but they often pass. Our review found that even a single bout of exercise can reduce cravings for up to 30 minutes, which may help people get through some of the hardest moments of a quit attempt.

“Exercise should not replace evidence-based quit supports such as counselling and smoking cessation medication, but it may be a practical, low-cost strategy that people can use alongside them.”

The researchers say the next step is to test how exercise can be built into real-world quit programs, including digital, community and clinical services, and to examine whether it can also support people trying to quit vaping, where evidence is currently lacking.

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Wellness

Midlife fitness linked to longer, healthier lives

Researchers note that improving fitness during midlife may be a key strategy for promoting healthy aging and preserving quality of life later on, even with modest increases in physical activity.

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How fit you are in midlife may help determine not just how long you live, but how many of those years are spent in good health, according to a study published in the JACC, the flagship journal of the American College of Cardiology.

The study found that adults with higher levels of cardiorespiratory fitness in midlife lived longer lives, developed fewer chronic diseases and spent more years free from serious illness compared with those who were less fit.

Cardiorespiratory fitness—how well the heart and lungs supply oxygen during physical activity—is known to reduce the risk of heart disease and early death. This study extends prior research by showing that fitness also plays a meaningful role in healthy aging, defined as years lived without major chronic disease.

The findings indicate that higher fitness in midlife is strongly associated with later onset of chronic disease, lower overall disease burden and longer life expectancy. These benefits were observed in both men and women.

Researchers followed more than 24,500 men and women who were healthy through age 65 and tracked their health outcomes later in life using Medicare data. Fitness was measured earlier in adulthood using a treadmill test, and researchers examined the development of 11 major chronic conditions, including heart disease, diabetes, kidney disease and cancer.

Compared with people who had low fitness levels, those with high fitness in midlife experienced clear benefits later in life. On average, they developed chronic diseases at least 1.5 years later, had fewer total conditions and lived longer overall. These patterns were seen in both men and women and across different ages, body weights and smoking histories.

Importantly, the study emphasizes health span—not just lifespan—highlighting that fitness helps people live more of their lives in good health, not simply live longer with disease.

The findings also underscore the public health value of physical activity, as cardiorespiratory fitness can be improved through regular movement such as brisk walking, cycling or other aerobic exercise.

Researchers note that improving fitness during midlife may be a key strategy for promoting healthy aging and preserving quality of life later on, even with modest increases in physical activity.

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