App-Recorded Daily Step Counts, Sex Differences, and Risk of Cardiovascular Outcomes Among Middle-Aged Population

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Limited data exist on sex-specific associations between daily step counts and cardiovascular events in middle-aged adults.
• Understanding these differences is crucial for targeted public health interventions.

Purpose of the Study:

• To investigate sex-specific differences in cardiovascular event risk associated with varying daily step counts (DSC) in middle-aged adults.
• To determine if higher physical activity levels, measured by DSC, correlate with reduced cardiovascular event incidence.

Main Methods:

• Utilized the KenCoM Healthcare Database, incorporating smartphone app DSC data, health checkups, and insurance claims from January 2016 to September 2021.
• Analyzed the 5-year cumulative incidence of composite cardiovascular events (myocardial infarction, stroke, angina pectoris, heart failure, atrial fibrillation).
• Compared event rates across five DSC quintiles: Group 1 (<4000 steps/day) to Group 5 (≥10,000 steps/day).

Main Results:

• Included 73,975 participants (55,612 men, 18,363 women) with a mean age of 44.1 years.
• The highest DSC quintile (≥10,000 steps/day) was associated with a significantly lower risk of cardiovascular events compared to the lowest quintile (<4000 steps/day) in the overall cohort (aHR, 0.87; P=0.02).
• Sex-specific analysis revealed this protective association was significant in men (aHR, 0.82; P=0.004) but not in women.

Conclusions:

• Higher daily step counts are linked to a reduced risk of cardiovascular events in middle-aged men.
• This association was not observed in middle-aged women, highlighting potential sex-specific differences in physical activity benefits for cardiovascular health.
• Public health strategies may need to consider sex-specific recommendations for physical activity to mitigate cardiovascular disease risk.