Increased step count linked to better health for people with heart failure

The results may inform interpretation of wearable device data in clinical and research settings, investigators say

4:23 PM

Author | Noah Fromson

woman checking watch orange shirt outside
Getty Images

More often, people are turning to consumer wearable devices, such as smartwatches, to monitor their health and physical activity.

Using these wearable devices, a study led by Michigan Medicine and the University of Missouri with Saint Luke’s Mid America Heart Institute finds that taking more daily steps is associated with improved health, including fewer symptoms and physical limitations, for people with heart failure.

The results are published in JACC: Heart Failure.

Clinicians are increasingly presented with their patients’ wearable device data though interpretation has been challenging given a lack of normative data in different populations, says first author Jessica R. Golbus, M.D., clinical instructor of internal medicine-cardiology at University of Michigan Medical School.

“This is one of the first studies to provide context to wearable device data from heart failure patients and helps us to understand what physical activity data from a wearable device means at a population level as well as at the individual level,” Golbus said.

SEE ALSO: A Consumer Sleep Tracker Researchers Can Actually Use (

As part of a national, randomized clinical trial for heart failure, over 400 patients were given activity monitors to evaluate the relationship between daily step count, floors climbed, and their symptoms and physical limitations over 12 weeks.

The CHIEF-HF trial used the Kansas City Cardiomyopathy Questionnaires (KCCQ) to gauge total symptoms and physical limitations.

Baseline step counts between 1,000 and 5,000 steps were associated with significantly improved symptoms and fewer physical limitations reflected by KCCQ scores, with little association seen beyond 5,000 steps.

People who walked 2,000 steps per day had total symptoms scores 3.11 points higher, and physical limitation scores 5.36 points higher, than those who walked 1,000 steps a day.

Participants who increased their step counts by 2,000 steps per-day during the 12 weeks experienced a clinically important greater than 5-point increase in physical limitation scores compared to those who did not change their step counts. While increases in step counts over time showed better symptom control and physical function, declines showed no relationship with these outcomes.

This study design provides unique insights for both researchers and clinicians, says co-senior author Brahmajee Nallamothu, M.D., professor of internal medicine-cardiology at U-M Medical School.

“Up until this point, it has been tough to collect data from patients outside of office visits,” Nallamothu said. “By collecting data from wearable devices, we can now examine folks in their home environments and over time. That’s something special about this work. We will have much more to learn as we consider things that can affect step counts like travel, weather and holidays.”

SEE ALSO: Can a wearable device make an impact on your heart health? | Michigan Medicine

Consumer wearable devices are consistently mentioned in clinical care as possible tools to interpret functional performance and activity, and mobile health technology is increasingly used for recruitment, data collection and outcomes assessments in clinical trials.

For heart failure, the United States Food and Drug Administration has endorsed the use of patient-reported measures to support regulatory approval but not data from wearable devices.

The latest findings, researchers say, highlight the importance of understanding whether and how data from consumer wearables is clinically meaningful.

Given the growing interest in using measures of patients’ ‘real-world’ activity, the clinical and research community need to understand how to interpret the data shared by patients, says co-senior author John Spertus, M.D., Professor and Lauer/Missouri Endowed Chair at the University of Missouri-Kansas City School of Medicine.

“These data provide the first insight into how changes in activity relate to changes in patients’ health status, suggesting that we should interpret improvements in activity as indicating better health status but that we need not necessarily be as concerned about reductions in activity,” Spertus said.

Additional authors include Kensey Gosch, Mikhail L. Kosiborod M.D., both of University of Missouri – Kansas City, Mary C. Birmingham, PharmD., C.V. Damaraju, Ph.D., both of Janssen Scientific Affairs, L.L.C., Javed Butler, M.D., Baylor Scott and White Research Institute, Ildiko Lingvay, M.D., University of Texas Southwestern Medical Center, David E. Lanfear, M.D., Henry Ford Hospital, Antonio Abbate, M.D., University of Virginia Health, and James L. Januzzi, M.D., Harvard Medical School and Baim Institute for Clinical Research.

This study was funded by Janssen Scientific Affairs, L.L.C. See the full paper for additional disclosures.

Paper cited:Association Between Wearable Device Measured Activity and Patient-Reported Outcomes for Heart Failure,” JACC: Heart Failure DOI: 10.1016/j.jchf.2023.05.033

More Articles About: Cardiovascular: Diseases & Conditions Heart Failure Heart disease Cardiovascular: Preventive Cardiology Heart Disease Risk Factors Exercise Wellness & Prevention Emerging Technologies
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories bandaid on arm after shot yellow shirt
Health Lab
Yes, you should get a COVID shot this year
The newest COVID vaccine was approved by the Food and Drug Administration and recommended by the Centers for Disease Control and Prevention in September and is rolling out in pharmacies and clinics across the country.
doctor checking heart on patient
Health Lab
Leading experts release new guidelines to improve congenital heart surgery care for children
For the first time in more than 20 years, dozens of pediatric cardiologists, surgeons and other health professionals have come together to develop new guidelines intended to improve heart surgery care for this population of children and teens.
woman older with provider
Health Lab
Should older adults, with fewer years to live, keep getting cancer screenings?
Cancer screening guidelines increasingly factor in how long a person has left to live, to guide whether to continue or stop screening. A new poll explores older adults’ attitudes toward this approach.
watch on hand
Health Lab
Tailored text messages not enough to improve mobility after heart issues
A Michigan Medicine report shows that adding a mobile health application to such devices yields mixed results. Tailored text messages to encourage high-risk people to move more may improve some short-term outcomes but doesn’t always improve physical activity levels for everyone.
man smiling sitting
Health Lab
A unique collaboration helps one patient better manage aortic disease
MI-AORTA is a donor-funded initiative that facilitates collaboration within the Frankel Cardiovascular Center, U-M Health and referring provider networks, creating value for the patients, families, and communities they serve and allows them to continue to pioneer advanced therapies for aortic diseases.
kids on the floor
Health Lab
Protecting children from poor air quality: 6 things to know
As smoke from Canada's historic wildfires triggers poor air quality alerts across the country, many parents worry about the impact on their child’s health, a national poll suggests. Here, a Michigan Medicine expert provides six ways to help reduce exposure.