Harris T, et al. - Since two 12-week pedometer-based primary care walking interventions (PACE-UP and PACE-Lift) discovered sustained objectively measured increases in physical activity (PA) at 3 and 4 years, respectively, in adults and elderly adults, researchers used primary care data to assess intervention impacts on long-term health outcomes applicable to walking interventions. For 1,001 PACE-UP participants (aged 45-75 years) and 296 PACE-Lift participants (aged 60-75 years) who gave written informed consent, they downloaded primary care data, masked to intervention or control status, for 4-year periods after randomization. For the PA intervention groups, significant reductions were observed in both cardiovascular events and fractures from over a four-year period, supporting and extending the benefits seen in long-term PA test results. The confidence intervals are wide, however, showing ambiguity about the precise degree of the impacts. They also verified that using routine primary care data to provide randomized controlled trials with long-term health results was feasible. Beneficial long-term health impacts can result from short-term, 12-week pedometer-based walking interventions and should be used more extensively to tackle the challenge of physical inactivity in public health.