Pedometer step counts predict cardiac risk factors at entry to cardiac rehabilitation

Walking exercise favorably affects cardiac risk factors (CRF) and reduces total and cardiovascular disease-related mortality. The purpose of this study was to describe walking levels, prospectively measured by pedometer, in individuals commencing phase II cardiac rehabilitation (CR) and to correlate step counts with CRF.

Participants (n = 107) wore a pedometer for 7 consecutive days starting the day after their first formal phase II CR exercise training session. Primary outcome was total steps taken, with CR and non-CR days analyzed separately. We examined the relationship between daily step counts and CRF.

Participants achieved significantly higher step counts on CR versus non-CR days (7,387 +/- 3,387 vs 5,315 +/- 3,336, P < .0001). Total daily step count correlated significantly, in descending order, with peak oxygen uptake, the number of days since the index cardiac event, diagnosis of diabetes mellitus, physical function score, waist circumference, body mass index, age, and high-density lipoprotein cholesterol (HDL-C). By multivariate analysis, peak oxygen uptake, HDL-C, and the diagnosis of diabetes mellitus independently correlated with daily non-CR step count (cumulative total r = 0.62, adjusted R2 = 0.35, P < .0001). Regression analysis, using step counts on CR days, produced similar results.

Daily steps taken by patients during the first week of phase II CR are quite low. Despite the low step counts, significant correlations between steps taken and CRF were found including fitness, centrally distributed adiposity, and HDL-C. Our results suggest that, even early after a coronary event, higher levels of walking are favorably related to CRF.