Grant: Operating Grant

Many people with diabetes and/or high blood pressure (hypertension) carry more weight than is healthy for them and are not very active. When people are more active, they can reduce the chances of having a heart attack or stroke. Walking more is a cheap and effective way to be more active and to lower the risk of heart attacks and strokes. The problem is that many people do not walk enough! We will study if people with diabetes and/or hypertension walk more when the doctor gives them a prescription with the number of steps they should be walking every day. We will compare this group, called 'active', to another group, called 'control', in which doctors and their patients do what they usually do, over a period of one year. We will measure the number of steps we walk everyday with a step counter or pedometer. In the step count prescription group, the doctors will give to the 'active' group a pedometer, a step count record book, and step count prescriptions. The overall goal is to gradually increase daily steps. The speed of the increase in step count will be slower for less active people. At each visit the doctor will look at the step count record book. The doctor will then give a new step count prescription to the patients. Patients of the two groups will see their doctor about four times during the year, which is how often they usually see their doctor. At the end of one year, we will see the difference in the hardness of the arteries between the 'active' and the 'control' groups, using simple and safe measurements, similar to ultrasound in pregnant ladies. People with hard arteries are more likely to have a heart attack or stroke. We suspect that patients who get the step count prescriptions will walk more and their arteries will be less hard than the control group. Our study will help decide if this is true. In that case, doctors should take the time to prescribe steps for all their patients with diabetes and/or hypertension.