New research could help people who have to decide between using an elevator and taking the stairs. A study reports that regularly climbing stairs could significantly reduce the risk of dying from cardiovascular disease.
Researchers from the University of East Anglia (UEA) and Norfolk and Norwich University Hospital in the United Kingdom carried out the study, published in the American Journal of Cardiovascular Drugs.
Their findings are of particular note, given the rising prevalence of cardiovascular disease.
“Cardiovascular disease is the leading cause of death worldwide, with cases nearly doubling between 1990 and 2019,” explained Prof. Vassilios Vassiliou, one of the study authors from UEA, in a press release.
“[Cardiovascular disease] is largely preventable through a healthy lifestyle — including regular physical activity, a heart-healthy diet, not smoking, maintaining a healthy weight, and managing blood pressure, cholesterol, and diabetes.”
— Prof. Vassilios Vassiliou, study author
This rise in cardiovascular disease, including coronary artery disease and stroke, represents a total of 523 million cases worldwide, according to the study authors.
As physical activity is a known risk factor for cardiovascular disease, and previous research has linked it to prevention, the researchers were keen to investigate a form of exercise that might help adults meet physical activity recommendations.
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“Taking the stairs is a practical and often overlooked way to build physical activity into daily life,” said Prof. Vassiliou in the press release. “We wanted to better understand how this everyday activity could have life-saving potential.”
Stair-climbing is a form of vigorous physical activity. Previous research has indicated that adding stair-climbing to a weekly routine can lead to improvements in cardiorespiratory fitness, among other health benefits.
“With more than a quarter of adults worldwide failing to meet recommended activity levels, choosing to take the stairs offers a realistic, scalable intervention,” said Prof. Vassiliou.
As a result, the researchers set out to see how stair-climbing might affect the incidence of cardiovascular disease — including heart attacks, stroke, and heart failure — and deaths from cardiovascular disease.
The researchers conducted a systematic review and meta-analysis of 9 studies involving 480,479 participants with a median follow-up of 14 years.
The pool of study participants was:
“After pooling results from over 450,000 participants, we found a consistent association between stair-climbing and lower risk of both cardiovascular death and overall mortality,” said Sophie Paddock, one of the study authors from UEA, in the press release.
Specifically, the review found that people who often climbed stairs had a 39% lower risk of dying from heart-related issues and 24% less likely to die from any cause compared with those who did not climb stairs often.
A specific sub-analysis included in the review suggested that around 6 flights (or ~60–70 steps per day) was when participants saw a sweet-spot reduction in cardiovascular risk. The researchers also reported that people who regularly climbed stairs were less likely to develop cardiovascular disease.
“Some of the studies we looked at showed that the more stairs climbed, the greater the health benefits,” said Paddock. “But even small changes had a measurable impact.”
Medical News Today asked Paddock what was already known about people who frequently took the stairs.
“We know that habitual stair-climbing may co-occur with other health-seeking behaviors, so those that tend to take the stairs may well have overall higher physical activity levels or fitness levels compared to those that don’t,” she explained.
MNT also spoke to Paul Drury, MD, a board certified cardiologist and associate medical director of electrophysiology at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was not involved with the study. Drury was not surprised by the findings.
“Even one- to two-minute bursts of movement performed several times throughout the day can add up and may be associated with a lower risk of cardiovascular events and death,” he said.
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“Climbing stairs is a practical example of this type of higher-intensity activity, so these findings are consistent with the broader evidence supporting the benefits of incorporating movement into daily life,” he added.
The researchers noted a few limitations in the studies they analyzed for their review, suggesting that further research will be useful in supporting their conclusions.
One key issue was that many of the studies in the review relied on self-reports, meaning that what participants reported may not accurately reflect what happened.
Another shortcoming was that many of the studies measured stair-climbing in different ways. Some looked only at stair-climbing at home and excluded any that occurred in public or at work. Others investigated participants’ ability to climb stairs without difficulty rather than how much they climbed. This inconsistency makes the overall picture less clear.
“It is important not to interpret this as proving that stair-climbing itself prevents heart disease,” said Opel Baker, MBChB, general practitioner at the Mayfield Clinic, who was not involved in the study, in an interview with MNT.
“Much of the evidence is observational, so people who climb stairs regularly may also be healthier or more physically active in other ways. The findings therefore support, rather than fundamentally change, our knowledge of the relationship between physical activity and cardiovascular health.”
— Opel Baker, MBChB
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The researchers suggest that future research will be needed to determine exactly what amounts and forms of stair-climbing are best for improving cardiovascular health.
“None of the studies included in our analysis utilized wearable trackers,” Paddock told MNT. “This represents an exciting opportunity for further research into this area as it will provide a more objective measure of stair-climbing and other physical activity behaviors rather than relying on self-reported data.”
Although there are some limitations in what the review can confirm, it is another piece of evidence showing how beneficial taking the stairs can be.
“Unlike going to the gym or doing a workout, climbing the stairs is something you can easily fit into your day at home, at work, or when you’re out,” said Paddock.
“[Climbing stairs is] a good option for people who don’t have much time or easy access to exercise. So if you have the choice of taking the stairs or the elevator, go for the stairs as it will help your heart.”
— Sophie Paddock, study author
The present research was unable to determine an ideal amount of stair-climbing to achieve specific cardiovascular benefits. Still, the researchers state that any additional physical activity is likely to be useful.
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“Even brief bursts of physical activity have beneficial health impacts, and short bouts of stair-climbing should be an achievable target to integrate into daily routines,” said Paddock.
The researchers note, however, that stair-climbing is not an exercise suitable for everyone. Due to the additional pressure it places on the leg joints, it may not be appropriate for people with osteoarthritis, musculoskeletal disorders of the legs, or impaired mobility.
“For people unable to climb stairs, there are plenty of alternatives. Brisk walking, cycling, swimming, water-based exercise, rowing, and adapted seated exercises can all raise the heart rate and provide cardiovascular benefits. Strength exercises such as sit-to-stands can also help replicate the muscular demands of stair-climbing.”
— Opel Baker, MBChB
Otherwise, the researchers believe that taking the stairs could play a role in the ongoing issue of cardiovascular disease in public health.
“Encouraging people to take the stairs in workplaces, public buildings, and homes could form part of a wider strategy to reduce cardiovascular disease at the population level,” suggested Prof. Vassiliou.
“I view this study as a reminder that cardiovascular exercise does not have to come exclusively from a structured workout,” said Drury. “The important message is to find safe ways to move more and sit less. Even brief periods of activity can be a meaningful part of an overall strategy for protecting cardiovascular health.”
