7500 steps per day is associated with lower cardiovascular risk in rural residents with a high prevalence of sedentary lifestyle

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sedentary lifestyle is one of the modifiable risk factors that account for the high prevalence of cardiovascular diseases (CVD) in the rural areas.1,2 Daily step counting, using wearable devices, is increasingly used to monitor physical activity levels in interventions targeting CVD risk reduction in the rural areas.3,4 However, there is a lack of evidence to support a daily step count threshold that may reduce CVD risk among rural residents. The purpose of this study was to examine the relationship between daily step count cut-points and CVD risk. Methods This secondary analysis included 312 adults living in the rural areas in the southern United States. Daily step counts from pedometers were collected for 14 consecutive days. Established cut-points were used to categorize participants into groups based on mean daily step count as sedentary (≤ 5000 steps/day), less active (5000 -7499 steps/per), and physically active (≥7500 steps/day).5-7 CVD risk was measured with the Framingham risk score. Generalized additive models were used to examine differences among the 3 activity groups in Framingham risk score, controlling for educational level, perceived physical health status, depressive, marital status, and years of residence in a rural county. Results Among the participants (75% female, mean age 50.1 (±13.6) years), 40.7% were sedentary, 35.2% were less active, and 24.0% were physically active. The average Framingham risk score was 11.2% (±9.4%). Framingham risk scores were 1.7% lower in the less active compared to the sedentary group, but the effect was not significant (p <  .11), and 2.6% lower in the physically active compared to the sedentary group (p < .04). The model accounted for 22% of the variation in Framingham risk scores. Conclusion These findings indicate that rural residents who averaged 7500 steps or more per day had lower CVD risk, and the difference is clinically significant.