Daily Dose: Walking More Reduced BP in Sedentary Older Adults with Hypertension

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in the Journal of Cardiovascular Development and Disease that examined the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure (BP) control among sedentary older adults with hypertension (HTN).

The study

Researchers recruited participants via email during September and October 2020 from the Physical Activity and Aging Study (PAAS), an ongoing prospective cohort study of more than 900 older adults in central Iowa, investigating associations of physical activity and fitness with chronic disease prevention and longevity in older adults. Among the exclusion criteria was the ability to walk >8000 steps/day, a level considered active enough to reap CV benefits.

The pilot study’s single arm, within-participant design included assessments at baseline, 10 weeks, and 20 weeks during the intervention period, each lasting 8 days.

Participants received a pedometer and were asked to increase daily steps to 3000 on 3 out of 5 days during the first week and then on 5 days/week from week 2 to week 20. Steps could be accumulated throughout the day in any manner that fit their lifestyle and all other lifestyle habits were to be maintained.

A health coach was assigned to each participant and during the first 10 weeks of the intervention each received scheduled weekly video or telephone call from the coach to answer questions, collect step counts, and assist with suggestions to help meet their goals.

The final cohort numbered 21 (13 women, 8 men) with mean age of 73 years. Nineteen participants (91%) completed both the 10- and 20-week assessments. Investigators reported that participants wore the study pedometer for more than 10 hours on nearly all (97%) of the days over the full 20-week study period.

Findings

Overall, the group significantly increased average steps/day from 3899 at baseline to 6512 at the 10-week point and 5567 at 20 weeks. At 20 weeks, there were significant improvements in both SBP (137 ± 10 to 130 ± 11 mm Hg; P<.001) and DBP (81 ± 6 to 77 ± 6 mm Hg, P=.01).

Authors' comment

"These results could have important implications for healthcare professionals looking for a simple yet effective strategy that can be delivered broadly via e-health technology to reduce blood pressure; however, future large-scale and sufficiently powered randomized, controlled trials are warranted and necessary to verify these results."

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