Reduced Diabetic, Hypertensive, and Cholesterol Medication Use With Walking
Abstract and Introduction
Purpose: To assess the relationships of walking distance, frequency, and intensity to the prevalence of antidiabetic, antihypertensive, and LDL cholesterol-lowering medications use.
Methods: Cross-sectional analyses of 32,683 female and 8112 male participants of the National Walkers' Health Study, of whom 2.8% and 7.4% reported antidiabetic, 14.3% and 29.0% reported antihypertensive, and 7.3% and 21.5% reported LDL cholesterol-lowering medication use, respectively.
Results: Weekly walking distance, longest walk, and walking intensity were inversely related to the prevalence of antidiabetic (males: P < 0.001, females: P < 0.0001), antihypertensive (males: P < 0.01, females: P < 0.0001), and LDL cholesterol-lowering medications (males: P < 0.01, females: P < 0.0001). Each medication remained significantly related to both walking intensity and longest weekly walk when adjusted for total weekly distance. Compared with men and women who walked at a speed of < 1.2 m·s, those who walked > 2.1 m·s had 48% and 52% lower odds for antihypertensive, 68% and 59% lower odds for antidiabetic, and 53% and 40% lower odds for LDL cholesterol-lowering medications, respectively, when adjusted for age, smoking, and diet. The longest usual weekly walk was a better discriminator of medication status than the total cumulative distance per week, particularly in men.
Conclusion: These results are consistent with the hypothesis that antidiabetic, antihypertensive, and LDL cholesterol-lowering medication use may be reduced substantially by walking more intensely and farther each week, and by including longer walks.
Diabetes, hypertension, and high cholesterol are common chronic conditions of modern society. These conditions increase risks for cardiovascular disease morbidity and mortality and require lifetime treatments, with no expectation of cure. The annual economic costs for medical treatments and of lost productivity from diabetes and cardiovascular disease are estimated at $130 billion and $368 billion, respectively. Although exercise is recommended for the prevention of all three maladies, 41% percent of women and 35% of men engaged in no leisure-time physical activity, and 73% of women and 66% of men are inadequately active.
Recent physical activity recommendations by governmental and nongovernmental organizations emphasize the accumulation of 30 min of moderately intense physical activity on most days of the week, which may be obtained from multiple activity bouts of at least 8-10 min each. In addition to being specifically recommended for meeting recent guideline levels, walking is also the most common exercise reported by Americans. There is substantial evidence from clinical trials and prospective studies relating walking and other physical activities to lower risks for diabetes, hypertension, and dyslipoproteinemia; however, the optimal dose, intensity, and frequency for reducing these risks remain less certain.
The National Walkers' Health Study was selected and surveyed specifically to assess the dose-response relationships of walking distance, intensity, and frequency to health. Previous analyses of this cohort have demonstrated that walking longer and faster are inversely related to body weight and regional body circumferences. The purposes of the current report are to 1) assess the dose-response relationships between the prevalence of antidiabetic, antihypertensive, and LDL-lowering medication use and walking distance, intensity, and frequency, and 2) assess whether these walking parameters are associated with disease prevalence independently of each other and independently of the lower body weight of faster, longer-distance walkers.