Step count tied to lower mortality and heart disease risk in older women

Step count is a key factor for reducing health risks in older women, according to a recent study by Mass General Brigham researchers.¹

The study evaluated how many steps women take and how often they reach their step target across the week.¹ In those with 4000 or more daily steps achieved 1 or 2 days per week, significant reductions in cardiovascular disease and death were reported, highlighting the protective effect of average steps.

“An important translational implication of these findings is that since step volume is the important driver of the inverse associations, there is no ‘better’ or ‘best’ pattern to take steps,” wrote investigators.¹

Measuring activity and outcomes

Participants included surviving Women’s Health Study patients aged at least 62 years wearing and returning devices to track physical activity.² At least 7 days of wearing the device for 10 or more hours were required for study inclusion.

There were 13,547 women aged a mean 71 years included in the analysis.¹ These patients were given accelerometers to track activity for 7 consecutive days between 2011 and 2015. Follow-up lasted for up to 11 years in these patients. Those with cardiovascular disease or cancer at baseline were excluded.

The device was only removed for sleep and water-based activities.² A step algorithm allowed researchers to determine steps per day, while death was identified based on based on reports from family members or postal authorities.

Dose-response relationship between steps and mortality

Death was reported in 13% of patients overall during follow-up, while cardiovascular disease was reported in 5%.¹ Overall, the odds of all-cause death and cardiovascular death were reduced by 26% and 27%, respectively, from at least 4000 steps per day on 1 to 2 days of the week vs not achieving this threshold.

A greater decline in the risk of overall death of 40% was reported when the step count was achieved for at least 3 days per week. However, the decline in cardiovascular death risk remained at 27%.¹

When increasing the daily step count to between 5000 and 7000 3 days per week, all-cause mortality risk declined by 32%. However, cardiovascular disease death risk leveled out in these patients to 16%.¹

Hazard ratios for all-cause mortality when reaching certain thresholds on 1 to 2 days included:²

• 0.66 for at least 4000 steps
• 0.67 for at least 5000 steps
• 0.62 for at least 6000 steps
• 0.54 for at least 7000 steps

Guildeline implications

This data indicated average steps as a key protector in older women.¹ Investigators concluded step volume is more important than the frequency of meeting daily step thresholds in this population.

“These findings can inform future [physical activity] guidelines, as well as clinical and public health practice,” wrote investigators.²

Additional benefits of physical activity have been reported, including reduced breast cancer risk, as highlighted by Neal Barnard, MD, FACC, president of the Physicians Committee for Responsible Medicine, in an interview with Contemporary OB/GYN.³ In the discussion, exercise was highlighted as part of the American Medical Association’s (AMA) guidelines to reduce breast cancer risk.

Broader health benefits

According to Barnard, engaging in regular physical activity can work in tandem with weight reduction, a plant-based diet, and minimizing alcohol use toward reducing breast cancer risk. However, barriers in clinical settings such as time constraints and reimbursement issues prevent many clinicians from counseling patients about these interventions.³

To combat these issues, Barnard highlighted the “Let’s Beat Breast Cancer” campaign. This effort aligns with the AMA guidelines to support women in reducing their cancer risk.³

“I’m hoping that when people put this [campaign] work, that families will have more power, less fear, and… will stay together longer,” said Barnard.³

References

1. Number of steps taken matters more for better health in older women than the frequency. BMJ Group. October 21, 2025. Accessed October 24, 2025. https://www.eurekalert.org/news-releases/1102390.
2. Hamaya R, Evenson KR, Lieberman D, et al. Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women. British Journal of Sports Medicine. 2025. doi:10.1136/bjsports-2025-110311
3. Barnard N. Neal Barnard, MD, FACC, highlights AMA's new breast cancer prevention guidelines. Contemporary OB/GYN. June 23, 2025. Accessed October 24, 2025. https://www.contemporaryobgyn.net/view/neal-barnard-md-facc-highlights-ama-s-new-breast-cancer-prevention-guidelines.