Taking a walk is an easy way to move your heart to better health. Some studies recommend walking as many as 10,000 steps a day; however, this may not be realistic for everyone. How many steps should you walk each day for optimal heart health, and what are some alternatives?

In this Q&A, Mary Ann McLaughlin, MD, Associate Professor of Medicine (Cardiology), and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, explains how much you need to walk each day to keep your heart beating strong. Dr. McLaughlin is also Director of Cardiovascular Health and Wellness, Mount Sinai Heart, and Co-Director of the Women’s Cardiac Assessment and Risk Evaluation Program at the Mount Sinai Health System.

Do people need to walk 10,000 steps a day for optimal health? And if so, why?
There are studies showing that overall risk of death or heart attacks is reduced in people who walk at least 10,000 steps a day. More recently, in the Journal of the American Medical Association, there was an article looking at those who walked 8,000 steps or more, and it showed that in 3,000 adults followed for over 10 years, those who exercised at least 8,000 steps a day had reduced death rates. They found that even exercising 8,000 steps or more just one to two days a week had a significant reduction in dying from cardiovascular disease or dying period. This study supports that idea that you can—by step counting—have very good effects on cardiovascular health.

Is there a lower number of steps people can aim for that would still allow them to achieve good heart health?
We now know that 8,000 steps a day actually is very effective, even just one to two times a week. In addition, being active at least five hours a week does have health benefits. Anything more than being a true couch potato definitely can incrementally improve cardiovascular health, and those people who work very long hours during the week and are weekend warriors, those who exercise vigorously on weekends alone, can still reduce their risk of cardiovascular bad outcomes. You don’t have to do 10,000 steps a day, per se. Any bit of exercise is better than none at all.

What are the cardiovascular risks of being too sedentary, and how does walking reduce these risks?
When we look at the risk of heart attack, we look at some major risk factors. Diabetes is one; hypertension is another; high cholesterol is another; family history of premature coronary disease is another. When we look at what exercise does, it improves the vascular health—the blood vessels are more effectively exchanging oxygen to the muscles and to the brain; it reduces obesity and the effects of diabetes on the heart. Both of those—by reducing excess weight and sugar—can improve the risk of cardiovascular disease.

What walking speed should I aim for to get the best cardiovascular health results?
When we look at intensity of exercise, we actually have different scales that we use in cardiac testing. We know that two and a half to three miles per hour is considered moderate intensity—that’s what we say is equivalent to three metabolic equivalents of exercise, or three “mets.” When people are walking more vigorously—up to four miles per hour—that’s considered vigorous exercise

What other exercises will give me similar health results?
If you don’t particularly love to walk all the time, things like bicycling at 6 to 12 miles per hour can reduce cardiovascular events; jogging around seven miles per hour; swimming 50 yards per minute; tennis, especially singles tennis, pickleball, and even doubles tennis, can be very vigorous exercise.

What are some other health benefits of walking?
Recently, the Journal of American Medical Association—Neurology, showed that those who had a higher number of steps at 9,000 steps per day, had a lower risk of dementia. For those who dislike  exercise, when we talk to them about what the real benefits are—prolonging life, reducing risk of heart attacks and now, dementia—that will have a very big impact.

How many minutes per week should I be walking or exercising?
The American Heart Association guidelines have recommended at least 150 minutes per week of moderate intensity exercise, or 75 minutes a week for vigorous aerobic activity for those who want to be weekend warriors. We also recommend adding resistance or weight muscle strengthening. For overall health, that helps balance, reduces risk of falls as we age, and anything that reduces time sitting is important. Many people are using standing desks, and that is actually shown to be a little healthier than sitting all day. Anything that gets everyone off the couch has excellent health benefits.

What else can I do to improve my heart health?
The other important part of that is eating healthy. You want a healthy diet, one that’s lower in saturated fat, higher in vegetables, more of a plant-based diet, with healthy meats, including fish and chicken, less of the red meat and saturated fats. I hope you found this helpful and go out and take a good walk this weekend.

Get more exercise and focus on healthy eating. That’s the message cardiologists from Mount Sinai Heart are promoting to lower the risk of heart attack and stroke during American Heart Month in February. This is especially important among high-risk groups.

As the COVID-19 pandemic continues, doctors continue to see increased sedentary behavior, unhealthy eating habits, and weight gain among patients—putting them at higher risk for heart conditions, including some that are potentially serious.

“It is so important for all, but especially the high-risk groups, to watch their diet and exercise more for heart disease prevention. We need to focus on how the pandemic is contributing to worsening habits,” says Icilma Fergus, MD, Director of Cardiovascular Disparities for The Mount Sinai Hospital. “There are simple ways to get moving, not just going to the gym, but simply walking or doing housework to avoid being sedentary.”

Nearly half of adults in the United States—more than 121 million people—have some type of cardiovascular disease. The Centers for Disease Control and Prevention says it is the leading cause of death among men and women in the United States; nearly 650,000 die from it every year and, heart disease is preventable 80 percent of the time.

Certain minority groups, including Blacks and Latinos/Latinas, are also at higher risk due to genetic predisposition, diet, lifestyle factors, and socioeconomic factors. However, illness in any population can be prevented by taking simple steps towards a healthier lifestyle.

Tips for Lowering Your Risk of Heart Disease

• Know your family history
• Manage your blood pressure
• Control your cholesterol
• Maintain a healthy diet, eating nutrient-rich food and eliminating sweets
• Limit alcohol consumption to no more than one drink per day for women and two drinks per day for men
• Quit using tobacco or other inhaled substances, including both smoking and electronic cigarettes or vapes
• Watch your weight and exercise regularly
• Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in your arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness

COVID-19, Heart Disease, and Vaccinations

Adults with heart disease are also at increased risk of severe illness from COVID-19. According to the American Heart Association, COVID-19 patients with underlying conditions including cardiovascular disease are six times more likely to be hospitalized and 12 times more likely to die than patients without any chronic health problems. About one in three people with COVID-19 has cardiovascular disease, making it the most common underlying health condition.

Mount Sinai cardiologists encourage people in these high-risk groups to get their full dose of the COVID-19 vaccine, including the booster.

 “People with heart disease and with risk factors including diabetes, hypercholesterolemia, and obesity are at higher risk of contracting a severe COVID-19 infection and having complications due to COVID-19 infection. Thus, we strongly recommend these patients get vaccinated. I know some patients have been reluctant; however, vaccines have been proven to be safe and to prevent severe infections and for the most part, are well tolerated,” says Johanna Contreras, MD, Director of the Ambulatory Heart Failure Network for the Mount Sinai Health System.

It is also important that you not put off getting regular medical care.

“The current pandemic environment has added stress in everyone’s life, and led to added work for many. However, it’s critical for patients to check in with their doctors and continue to schedule and keep their doctor appointments, along with following up on medications and taking them as prescribed,” says Dr. Contreras. “If you have any issues do not be afraid to call your doctor. It is important to see medical attention.”