Stair Climbing Tied to 39% Lower Cardiovascular Death Risk in Meta-Analysis of Nearly 500,000 Adults
核心洞察
A systematic review and meta-analysis of nine studies covering 480,479 participants found frequent stair climbing was associated with a 39% lower risk of dying from cardiovascular causes.
The same analysis reported a 24% lower risk of all-cause mortality among regular stair climbers compared with those who rarely took the stairs.
A sub-analysis suggested roughly six flights, or 60 to 70 steps per day, marked the point of greatest cardiovascular risk reduction, though researchers said more stairs yielded greater benefit.
Regular stair climbing is associated with a substantially lower risk of dying from cardiovascular disease (搜索), according to a systematic review and meta-analysis published in the American Journal of Cardiovascular Drugs by researchers at the University of East Anglia (UEA) and Norfolk and Norwich University Hospital (搜索) in the United Kingdom.
The analysis pooled nine studies involving 480,479 participants with a median follow-up of 14 years. Participants ranged in age from 35 to 84 years, included both people with a history of heart problems and otherwise healthy individuals, and were 53% female. Investigators found that people who frequently climbed stairs had a 39% lower risk of dying from heart-related issues and were 24% less likely to die from any cause compared with those who did not climb stairs often. Those who regularly took the stairs were also less likely to develop cardiovascular disease (搜索), including heart attacks, stroke (搜索), and heart failure (搜索).
"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.
Six Flights as a Practical Threshold
A specific sub-analysis included in the review suggested that approximately six flights of stairs — roughly 60 to 70 steps per day, taking less than three minutes — was the point at which participants saw a "sweet-spot" reduction in cardiovascular risk. The researchers reported that more stair climbing was associated with greater health benefits, but that even small changes had a measurable impact.
"Some of the studies we looked at showed that the more stairs climbed, the greater the health benefits," Paddock said. "But even small changes had a measurable impact."
The findings carry population-level implications given the scale of cardiovascular disease (搜索). "Cardiovascular disease is the leading cause of death worldwide, with cases nearly doubling between 1990 and 2019," said Prof. Vassilios Vassiliou, a study author from UEA. He noted that cardiovascular disease, including coronary artery disease and stroke (搜索), represents a total of 523 million cases worldwide, and 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 (搜索)."
Stair climbing is classified as vigorous physical activity, and prior research has indicated that adding it to a weekly routine can improve cardiorespiratory fitness. "With more than a quarter of adults worldwide failing to meet recommended activity levels, choosing to take the stairs offers a realistic, scalable intervention," Vassiliou said.
Observational Evidence and Methodological Limits
The authors and outside commentators emphasized that the observational nature of the underlying data limits causal inference. "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," Paddock said.
"It is important not to interpret this as proving that stair-climbing itself prevents heart disease," said Opel Baker, MBChB, a general practitioner at the Mayfield Clinic (搜索) who was not involved in the study. "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."
The researchers identified several limitations in the analyzed studies. Many relied on self-reports, meaning participant-reported activity may not accurately reflect actual behavior. Measurement of stair climbing also varied widely: some studies assessed only stair climbing at home and excluded activity in public or at work, while others examined participants' ability to climb stairs without difficulty rather than the amount climbed. No study in the analysis used wearable trackers.
"None of the studies included in our analysis utilized wearable trackers," Paddock said. "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."
Clinical Considerations and Alternatives
Paul Drury, MD, a board-certified cardiologist and associate medical director of electrophysiology at MemorialCare Saddleback Medical Center (搜索) in Laguna Hills, California, who was not involved with the study, said the results align with existing evidence on accumulated movement. "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. "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."
Stair climbing is not appropriate for all patients. It places pressure on the joints and could aggravate arthritis (搜索) or harm people with joint damage. Individuals with heart and lung conditions that can flare up, as well as those with balance or coordination issues, should also avoid it. Baker noted that alternatives exist for patients unable to climb stairs: "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."
The researchers were unable to determine an ideal amount of stair climbing for specific cardiovascular benefits, and they called for further work to define optimal amounts and forms of the activity. Vassiliou suggested that structural interventions could complement individual behavior change. "Encouraging people to take the stairs in workplaces, public buildings, and homes could form part of a wider strategy to reduce cardiovascular disease (搜索) at the population level," he said.
"I view this study as a reminder that cardiovascular exercise does not have to come exclusively from a structured workout," Drury said. "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."