Daily step counts of 4,000 or more tied to reduced risk of heart disease, mortality in older women: Study

“In countries like the United States, advances in technology have made it such that we don’t really move very much, and older individuals are among those least active,” said senior author I-Min Lee, MBBS, ScD, an epidemiologist in the Mass General Brigham Department of Medicine and the Division of Preventive Medicine at Brigham and Women’s Hospital (BWH). “Because of today’s low step counts, it’s increasingly important to determine the minimum amount of physical activity required to improve health outcomes, so that we can offer realistic and feasible goals for the public.”

In this federally funded study, Mass General Brigham researchers conducted a prospective cohort study of 13,574 older women (71.8 years old on average) without cardiovascular disease or cancer from BWH’s Women’s Health Study. The women wore ActiGraph GT3X+ accelerometers to track their steps over seven days between 2011 and 2015. For the next 10 years, the researchers monitored mortality and cardiovascular disease incidence.

Participants were sorted by how many days per week they achieved step thresholds at or above 4,000, 5,000, 6,000, or 7,000. Those that got 4,000 steps one or two days per week had 26% lower mortality risk and 27% lower cardiovascular disease risk compared to those that never hit 4,000 on any day. What’s more, reaching 4,000 steps three or more days in a week decreased mortality risk further to 40%. As for women that reached the higher step thresholds, cardiovascular disease risk leveled out.

Interestingly, the health benefits seem to be associated with the total volume of steps taken, rather than how many days per week a particular threshold was achieved. This suggests that there isn’t a “better” way to get steps—women with similar total volume of steps, either achieved by consistent steps throughout the week or sporadic steps in just a few days, had similar health benefits.

Future research will need to explore whether these effects hold in populations beyond older, American, mostly white women. Additionally, the researchers are curious to analyze even lower step count thresholds to determine whether less than 4,000 steps can produce similar health benefits.

“I hope our findings encourage the addition of step count metrics to physical activity guidelines, including the upcoming 2028 U.S. Physical Activity Guidelines,” said lead and corresponding author Rikuta Hamaya, MD, of Mass General Brigham’s Department of Medicine and the Division of Preventive Medicine at BWH. “If we can promote taking at least 4,000 steps once per week in older women, we could reduce mortality and cardiovascular disease risk across the country.”

Reference:

Hamaya R, Evenson KR, Lieberman D, et alAssociation between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older womenBritish Journal of Sports Medicine Published Online First: 21 October 2025. doi: 10.1136/bjsports-2025-110311