Related Experiment Video
Updated: Sep 10, 2026
Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
Published on: February 21, 2025
Combinations of stepping intensity and daily step counts against all-cause and cardiovascular disease mortality:
Le Wei1,2, Matthew N Ahmadi1,2,3,4, Nicholas A Koemel1,2,3,4
1School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Objective:
Understanding the joint role of stepping intensity and step counts could inform pragmatic step-based physical activity strategies for premature mortality prevention. We examined the joint association of stepping intensity and daily step counts with all-cause mortality (ACM) and cardiovascular disease (CVD) mortality.
Methods:
This prospective cohort study included the UK Biobank wrist-worn accelerometers subsample. We used peak 30-min cadence (PK30), the average steps/minute during the highest but not necessarily consecutive 30 minutes of the day, as a stepping intensity metric. We categorised daily steps into less than 5000, 5000-7500, 7500-10 000, above 10 000 steps/day group. We examined the multivariable-adjusted dose-response associations of PK30 and step counts with ACM/CVD mortality using Cox proportional and Fine and Gray subdistribution hazard models, respectively.
Results:
ACM analyses included 64 743 participants (mean age 61.5 (SD 7.8) years; female 37 497; 1697 events). Compared with the reference (fifth PK30 percentile and <5000 steps/day), both the <5000 and 5000-7500 steps/day groups showed a beneficial linear PK30-ACM risk association. Substantially lower ACM risk was observed at higher PK30 in the <5000 steps/day group (eg, 80 steps/min: HR 0.72 (95% CI 0.54 to 0.97)) and lower PK30 in the 5000-7500 group (eg, 60 steps/min: HR 0.70 (0.58 to 0.86)). Among all groups, 7500-10 000 steps/day had the lowest ACM risk, with a U-shaped pattern and the lowest risk was observed at approximately 100 steps/min (0.57 (0.47 to 0.69)). Higher PK30 was associated with lower ACM at 90 steps/min across all step-groups (eg, <5000 steps/day, 0.64 (0.32 to 1.32); above 10 000, 0.71 (0.59 to 0.87)). The CVD mortality results demonstrated similar dose-response patterns to those of ACM.
Conclusions:
Premature ACM/CVD mortality might be prevented through different combinations of stepping intensity and step counts.
