{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:34:43Z","timestamp":1753889683927,"version":"3.41.2"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:sec id=\"jah310912-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Limited data are available on sex\u2010specific associations between daily step counts and cardiovascular events in middle\u2010aged adults.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310912-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">This study used the KenCoM Healthcare Database to evaluate sex\u2010specific differences in cardiovascular event risk associated with daily step counts (DSC). The database incorporates DSC data from the KenCoM smartphone app, along with health checkup records and Japanese health insurance claims data. We recruited and enrolled participants using the KenCoM app, registering them in our database between January 2016 and September 2021. The primary outcome was the 5\u2010year cumulative incidence of composite cardiovascular events, including myocardial infarction, stroke, angina pectoris, heart failure, and atrial fibrillation. We compared event rates across quintiles of DSC. The quintiles were defined as follows: Group 1 (&lt;4000\u2009steps\/d), Group 2 (4000\u20135999\u2009steps\/d), Group 3 (6000\u20137999\u2009steps\/d), Group 4 (8000\u20139999\u2009steps\/d), and Group 5 (\u226510\u2009000\u2009steps\/d).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310912-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study included 73\u2009975 participants (55\u2009612 men and 18\u2009363 women) with a mean age of 44.1\u00b110.1\u2009years. The adjusted risk of 5\u2010year cardiovascular events was significantly lower in Group 5 compared with Group 1 in the entire cohort (adjusted hazard ratio, 0.87 [95% CI, 0.77\u20130.98];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.02). Sex\u2010specific analysis showed that the adjusted risk of cardiovascular events was significantly lower in Group 5 compared with Group 1 in men (adjusted hazard ratio, 0.82 [95% CI, 0.72\u20130.94];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004), but this effect was not observed in women.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310912-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The highest DSC was associated with a lower risk of cardiovascular events compared with the lowest DSC in men, but not in women, within a middle\u2010aged population.<\/jats:p>\n          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