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  • Aldrin V. Gomes

Cardiovascular Disease and Walking: Does Walking Help You Live Longer?



With cardiovascular health issues being the leading cause of death in the United States and low cardiovascular fitness killing more people than obesity, high cholesterol, and diabetes combined – we must make some lifestyle modifications if we seek to live long, fulfilling lives (Blair et al., 2012). On top of our already sedentary lifestyles, as technology has become more advanced, even our modes of transportation are becoming increasingly effortless. From hoverboards to electric scooters, the accessibility to and ease of usage of these new modes of transportation are inevitably robbing us of our essential human patterns of movement. Luckily there’s a simple, low-cost, and natural solution that the overwhelming majority of people can implement:


Walking.


A lot of times when it comes to health and fitness, people seek to reinvent the wheel or adopt some new fad that is alleged to be the cure to all of people's problems. However, there is a reason fundamentals are so aptly named–and there is no movement more fundamental to life and health than walking. During the Paleolithic era, humans are estimated to have walked approximately 10,000 steps per day, however, due to the advent of technology, the average American only takes about 5,000 steps per day–and that was before the pandemic (Booth et al., 2012).


Recent studies demonstrate a significant negative relationship between walking and cardiovascular risk. A group of researchers came together to analyze 32 randomized controlled trials whose participants included both males and females from the ages of 30 to 83 years old. These subjects were previously inactive but otherwise healthy. During the studies, the subjects were randomly assigned to either a walking treatment group or a non-exercise control group for a period of 4 or more weeks. The protocols included walking for 20-60 minutes per day for 2-7 days a week. The majority of the walking protocols were deemed moderate intensity which for the majority of Americans is estimated around a pace of 2-3 miles per hour (a 20-30 minute mile time) while 3-4 miles per hour (15-20 minute mile time) starts to hit the threshold for vigorous intensity. Results showed significant improvements in several markers of cardiovascular risk including aerobic capacity, systolic and diastolic blood pressure, and adiposity (waist circumference, body mass, percentage body fat and body mass index) (Murtagh et al., 2015).


Another study sought to uncover the relationship between walking and cardiovascular incidents in women–specifically racially and ethnically diverse women. Historically, the earlier incidence and higher prevalence of cardiovascular disease in men have led to men being the main focus of cardiovascular disease research. However, it must be noted that the menopausal transition in women has been shown to increase their risk of cardiovascular disease significantly (Prabakaran et al., 2021). On top of that, previous research on the benefits of walking for women has looked at predominantly white women. Therefore, this observational study sought to break that pattern by looking at the association between the exercise habits of 73,743 postmenopausal women (between the ages of 50 to 79 years old) and the incidence of cardiovascular events. The study showed an inverse relationship between physical activity and cardiovascular incidents in the years following the start of the study meaning that a strong physical activity score led to a lower risk of coronary and cardiovascular events. The results did not vary substantially according to race, age, or body mass index. A faster walking pace and fewer hours spent sitting daily also predicted lower risk. For example, women who walked faster than 4 miles per hour had nearly ⅓ or 33% lower risk of cardiovascular disease than women who walked 2-3 miles per hour (Manson et al., 2002).



This information may come as some relief to a lot of women especially since walking is the most common form of exercise among women (Anderson et al., 1996). Another reassuring fact for all of us is that walking at a self-selected pace for most adults means walking at a moderate intensity while walking at a brisk pace results in walking at a vigorous intensity (Murtagh et al., 2002). According to the American College of Sports Medicine, moderate-intensity exercise can be colloquially thought of as a place where you can simultaneously hold a steady conversation while vigorous intensity exercise is represented by only being able to sustain a few words before pausing for breath (Zuhl). A moderate level of intensity provides a lot of benefits–as mentioned in the first study. However, as noted in the second study, a faster pace (i.e. higher intensity) leads to certain increased benefits.


The most prominent benefit that results from vigorous intensity exercise is increased aerobic fitness. Aerobic fitness is an independent risk factor for cardiovascular disease and a stronger risk factor than physical activity alone. Besides reduced cardiovascular disease, improved aerobic capacity leads to greater ease of performance of everyday physical activities and improved quality of life for the individual. From a population perspective, an improvement in aerobic fitness of approximately 10% leads to a 15% reduction in mortality, regardless of baseline fitness levels. Though it has been shown that some movement is better than no movement, keep in mind that walking needs to be at least moderate intensity to improve aerobic fitness. Additionally, even greater fitness improvements, and thus even lower risk of cardiovascular incidents can be obtained from walking at vigorous intensities (Murtagh et al., 2015).


Overall this information supports the general guidelines of exercise put out by the American College of Sports Medicine which recommends moderate intensity aerobic activity for a minimum of 30 minutes five times a week (150 minutes total per week) or vigorous intensity aerobic activity for a minimum of 20 minutes three times a week (60 minutes total per week) (Liguori). Again, moderate intensity is defined as being around a pace of 2-3 miles per hour (a 20-30 minute mile time) while vigorous intensity is around 3-4 miles per hour (a 15-20 minute mile time).


Some research-backed ways to increase your walking (Murtagh et al., 2010):

  • Step Trackers: easy, affordable, and effective in a wide range of the population especially when working towards reaching a goal like 10,000 daily steps.

  • Using public transit or walking for general transportation appears to be an effective long-term strategy to increase walking levels

  • Seeking opportunities in the workplace such as using break times for brief, brisk walks (as little as 6-10 minutes)

  • Electronic reminders such as text messages or emails have also been shown to effectively increase walking levels



Although cardiovascular exercise is dreaded by most and even demonized by some in the fitness community, the fact is that outer appearances can be deceiving. Despite looking physically good, a bodybuilder with poor cardiovascular fitness can have a higher risk of disease and death than someone who is overweight with great cardiovascular fitness. It’s time we resist the pressures of social standards and change our perspective to appreciate the opportunity we’ve been given to walk and improve the quality and length of our lives in the process. Although walking is great for your cardiovascular health, before starting any walking program, it is always best to consult with your doctor and seek guidance in regards to navigating any preexisting conditions.


Written by Massie Gardizi and edited by Aldrin V. Gomes, PhD


References

Anderson, Lynda A, et al. Physical Activity and Health: A Report of the Surgeon General. U.S. Department of Health and Human Services, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, The President’s Council on Physical Fitness and Sports, 1996.

Blair, S. N., et al. Exercise therapy - the public health message. Scandinavian Journal of Medicine & Science in Sports, vol. 22, no. 4, 2012.

Booth, Frank W, et al. Lack of Exercise Is a Major Cause of Chronic Diseases. Comprehensive Physiology, U.S. National Library of Medicine, Apr. 2012.

Manson, JoAnn E., et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine, vol. 347, no. 10, 2002, pp. 716–725.

Murtagh, Elaine M, Colin A.G. Boreham, et al. Speed and Exercise Intensity of Recreational Walkers. Preventive Medicine, Academic Press, 20 Nov. 2002.

Murtagh, Elaine M, Marie H Murphy, et al. Walking: The First Steps in Cardiovascular Disease Prevention. Current Opinion in Cardiology, U.S. National Library of Medicine, Sept. 2010.

Murtagh, Elaine M., et al. The effect of walking on risk factors for cardiovascular disease: An updated systematic review and meta-analysis of Randomised Control Trials. Preventive Medicine, vol. 72, Mar. 2015, pp. 34–43.

Liguori, Gary. ACSM’s Guidelines for Exercise Testing and Prescription, 11th Edition. Lippincott Williams & Wilkins, 2021.

Prabakaran, Sindhu, et al. Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: Risks, benefits, and current guidelines for use. Therapeutic Advances in Endocrinology and Metabolism, vol. 12, 30 Apr. 2021, p. 204201882110139.

Zuhl, Micah. Tips for Monitoring Aerobic Exercise Intensity. American College of Sports Medicine, 2020.







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