Heart Failure Patients Can Improve Their Health With Just 1,000 Extra Steps a Day

• Heart failure patients who took between 1,000 and 5,000 steps a day reported fewer symptoms and physical limitations, according to new research published in JACC: Heart Failure.
• A decline in steps, however, did not worsen health outcomes.
• Though the new study focused solely on people with heart failure, experts agree that walking benefits most people.

Wearable devices, such as fitness trackers and smartphones, have grown in popularity in recent years, allowing many people more precise monitoring of habits that could affect their health.

Now, researchers from the University of Michigan have used data from wearables to glean insights into how physical activity levels impact health outcomes.

Their study, published July 26 in the journal JACC: Heart Failure, found that people with heart failure who walked just 1,000 steps a day reported fewer symptoms and physical limitations. Participants who took more steps appeared to have even better outcomes, the research showed.

“Our research demonstrated that increases in step count over time were associated with improved health status,” lead study author Jessica R. Golbus, MD, a heart failure cardiologist at the University of Michigan Health Frankel Cardiovascular Center, told Health. “This is one of the first studies to look at the relationship between wearable device-measured physical activity and health status.”

She said inspiration for the study came from her patients, who often ask her to interpret wearable device data and explain its relationship to health—something that she said "has historically been challenging" to do. This research is a first step in helping patients like hers "understand what their data means in terms of their health," she added.

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Health Insights From Smartwatches

The study included 425 people with heart failure enrolled in a clinical trial.

Researchers asked participants to wear a Fitbit Versa 2 for twelve weeks and use a smartphone app to complete the Kansas City Cardiomyopathy Questionnaires (KCCQs), which is a survey designed to measure a patient’s perception of their health status. The questionnaire has previously been found to be a predictive measure of health for people with heart failure, said Golbus.

The team then examined the relationship between daily step counts, floors climbed, and questionnaire scores relating to "physical limitations" and "total symptoms," such as swelling and shortness of breath. Scores were taken at baseline and between two and 12 weeks.

Researchers found a link between a baseline daily step count between 1,000 and 5,000 and questionnaire scores indicating improved symptoms and fewer physical limitations. Participants who walked 2,000 steps a day had even fewer symptoms and physical limitations, as reflected by their questionnaire scores, than those who walked just 1,000 steps a day.

People who increased their step counts throughout the study had clinically significant health improvements, the research showed.

Notably, the researchers found that a decline in steps, however, didn't worsen health status. This “finding surprised me,” said Dr. Golbus, noting that life circumstances that reduce physical activity but "do not impact upon health status" could have played a role.

"I would certainly, however, still encourage clinicians to discuss decrementing physical activity levels with their patients—though an intervention may not necessarily be warranted," she said.

While the new research provides a more nuanced understanding of how movement could help people with heart failure manage their health, Dr. Golbus noted that more research needs to be done outside the clinical trial setting to paint a more comprehensive picture of how changes in physical activity could benefit people with heart failure.

"Future research will also need to focus on whether the observed findings persist in extended follow-up beyond 12 weeks and whether these results pertain to patients with chronic diseases other than heart failure," she said. Using wearables to measure health outcomes in people without chronic disease could also be another future research avenue, she added.

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How To Add More Steps to Your Day

While this study focused solely on people with heart failure, experts agree that walking benefits most people.

Physical activities, such as walking, engage and strengthen skeletal muscles and thus improve “cardiac efficiency,” Tajinderpal Saraon, MD, a heart failure cardiologist at NYU Langone Heart who is unaffiliated with this research, told Health. In other words, your heart doesn’t have to work as hard to pump more blood to the muscles.

To add more daily steps, Saraon suggested thinking about them in terms of flights of stairs or other measurements, which can make goals feel more manageable. (He said that in New York City, where he works, 2,000 steps equate to about 10 blocks.)

He also recommended developing a walking routine with a friend or family member, which can make exercise more enjoyable. “Many patients have been receptive to this,” he said.