Target step count for the secondary prevention of cardiovascular disease

Background: Obtaining an accurate measure of physical activity energy expenditure (PAEE) can be difficult, so the simple measurement of steps per day has become widely promoted and accepted in the general population. However, the relationship between PAEE and steps per day has not been evaluated in patients with cardiovascular disease. Methods and Results: A total of 77 (53 men, 24 women) cardiac rehabilitation program participants aged between 46 and 88 years were enrolled. By means of an accelerometer the step count per day, amount of PAEE, as well as time per day spent in physical activity at light (<3 metabolic equivalents (METs)), moderate (3-6 METs) and vigorous (>6 METs) intensity were evaluated for each subject. The number of daily step counts strongly correlated with total PAEE (r=0.92, p<0.001) and time spent in moderate to vigorous intensity physical activity (r=0.85, p<0.001). The mean (95% confidence intervals) step counts associated with 214 and 314kcal/day (ie, 1,500 and 2,200kcal/week) were 6,470 and 8,496 steps/day, respectively. Conclusion: To achieve the total amount of PAEE generally recommended for the secondary prevention of cardiovascular disease, patients should be encouraged to accumulate 6,500-8,500 steps/day.