Ljubljana, Slovenia – 20 April 2018: Faster walking patients with heart disease are hospitalised less, according to research presented today at EuroPrevent 2018, a European Society of Cardiology congress, and published in the European Journal of Preventive Cardiology.^1,2

The three-year study was conducted in 1,078 hypertensive patients, of whom 85% also had coronary heart disease and 15% also had valve disease.

Patients were then asked to walk 1 km on a treadmill at what they considered to be a moderate intensity.³ Patients were classified as slow (2.6 km/hour), intermediate (3.9 km/hour) and fast (average 5.1 km/hour). A total of 359 patients were slow walkers, 362 were intermediate and 357 were fast walkers.

The researchers recorded the number of all-cause hospitalisations and length of stay over the next three years. Participants were flagged by the regional Health Service Registry of the Emilia-Romagna Region, which collects data on all-cause hospitalisation.

Study author Dr Carlotta Merlo, a researcher at the University of Ferrara, Ferrara, Italy, said: “We did not exclude any causes of death because walking speed has significant consequences for public health. Reduced walking speed is a marker of limited mobility, which is a precursor of disability, disease, and loss of autonomy.” ^4,5

During the three year period, 182 of the slow walkers (51%) had at least one hospitalisation, compared to 160 (44%) of the intermediate walkers, and 110 (31%) of the fast walkers.

The slow, intermediate and fast walking groups spent a total of 4,186, 2,240, and 990 days in hospital over the three years, respectively.

The average length of hospital stay for each patient was 23, 14, and 9 days for the slow, intermediate and fast walkers, respectively (see figure).

Each 1 km/hour increase in walking speed resulted in a 19% reduction in the likelihood of being hospitalised during the three-year period. Compared to the slow walkers, fast walkers had a 37% lower likelihood of hospitalisation in three years.

Dr Merlo said: “The faster the walking speed, the lower the risk of hospitalisation and the shorter the length of hospital stay. Since reduced walking speed is a marker of limited mobility, which has been linked to decreased physical activity,⁴ we assume that fast walkers in the study are also fast walkers in real life.”

She continued: “Walking is the most popular type of exercise in adults. It is free, does not require special training, and can be done almost anywhere. Even short, but regular, walks have substantial health benefits. Our study shows that the benefits are even greater when the pace of walking is increased.”

Figure: Average length of hospital stay according to walking speed

References and notes

1. The abstract ‘Moderate walking speed predicts 3-years hospitalisation in hypertensive patients with cardiovascular disease’ will be presented during the Young investigator award session III – Exercise Basic & Translational Research (EBTR) which takes place on 20 April from 08:30 to 10:00 CEST in the room E3.
2. Merlo C, Sorino N, Myers J, et al. Moderate walking speed predicts hospitalisation in hypertensive patients with cardiovascular disease. Eur J Prev Cardiol. 2018. DOI: 10.1177/2047487318767463
3. Each patient was asked to gauge what they considered a moderate walking intensity using the Borg Scale of Perceived Exertion which ranks how hard you feel you are working from six to 20. Six is “no feeling of exertion” and 20 is “very, very hard”. Moderate activities are scored 11 to 14 and feel “fairly light” to “somewhat hard”.
4. Best JR, Liu-Ambrose T, Metti AL, et al. Longitudinal associations between walking speed and amount of self-reported time spent walking over a 9-year period in older women and men. J Gerontol A Bio Sci Med Sci, 2017. Jun 22. doi: 10.1093/gerona/glx129.
5. Granacher U, Voller H. Gait speed is not magic, but is prognostically important in older patients. Eur J Prev Cardiol. 2018;25(2):209–211. doi: 10.1177/2047487317744053.