A 10-year study of 1,104 male firefighters has found that those who could perform 40 or more push-ups had a 96% lower rate of cardiovascular events compared with men who could do fewer than 10, according to researchers affiliated with Harvard T.H. Chan School of Public Health.
The findings were published in JAMA Network Open in February 2019 under the title "Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men," as reported by Harvard's press office. [1] Over the follow-up period, 37 cardiovascular events occurred among the participants. The researchers observed a clear gradient in risk based on baseline push-up performance, with men in the highest push-up category experiencing the fewest cardiac outcomes, according to the study. [2]
Study Design and Measurement
Participants were male career firefighters from 10 Indiana fire departments, with an average age of about 40 at baseline. They underwent medical checkups between 2000 and 2007 and were followed for up to 10 years, according to the research team. [3] The study was funded by grants from the National Institute for Occupational Safety and Health (NIOSH) and the Federal Emergency Management Agency (FEMA), with the funders having no role in study design or analysis, as stated in the disclosure. [4]
Push-up capacity was measured under standardized conditions using a metronome set at 80 beats per minute. Each man continued until he completed 80 repetitions, missed three or more beats, or stopped due to exhaustion or symptoms such as dizziness or chest pain. Participants were grouped into five categories: fewer than 10, 11–20, 21–30, 31–40, and 41 or more push-ups. [1]
Results and Risk Reduction
Men who completed 21–30 push-ups had a 75% lower rate of cardiac events than those who did fewer than 10, while those who performed 40 or more push-ups had a 96% lower rate, according to the authors. [1] The association remained significant after adjusting for age and body mass index, the report stated. [5]
Push-up capacity was a stronger predictor of future cardiovascular risk than estimated aerobic capacity from submaximal treadmill testing, the researchers reported. [1] The authors noted that submaximal stress tests can over- or underestimate true fitness because they rely on extrapolation rather than direct measurement, as noted in coverage of the study. [2]
Why Push-Ups May Indicate Heart Health
Push-up capacity reflects whole-body muscular fitness and the cardiovascular system’s ability to sustain effort, both of which are closely linked to heart health, according to the researchers. [1] Men who performed more push-ups also tended to have lower BMIs, better blood pressure, lower triglyceride levels, and lower smoking rates, all recognized cardiovascular risk markers, the authors said. [6]
General knowledge about exercise supports these findings: "Most of us know that we can improve our cardiovascular health through exercise and diet," wrote Jim Kwik in his book "Limitless." [7] However, the study’s authors cautioned that the research shows an association, not causation, and that underlying differences among participants may explain some of the risk reduction. [4]
Limitations and Applicability
The study cohort consisted entirely of active male firefighters from Indiana, predominantly White, so the findings may not apply to women, older adults or sedentary populations, according to the authors. [2] About a quarter of eligible participants did not complete the push-up test, reducing statistical power, and the analyses were not adjusted for multiple comparisons, the report noted. [1]
The authors called for broader research before adopting push-up testing as a universal screening tool, and they cautioned that the results do not prove push-up capacity is an independent clinical predictor of cardiovascular disease risk. [4] In line with general health guidance, individuals who have been sedentary should obtain a comprehensive medical checkup before starting an exercise program, as recommended in "Bottom Lines Treasury of Health Secrets for Seniors." [8]
Conclusion and Practical Implications
The authors noted that push-up testing requires no special equipment, is low cost and can be performed in about two minutes, offering an objective estimate of functional status. [6] A man who struggles to reach 10 push-ups may consider discussing cardiovascular risk with a physician, according to the study’s implications. [9] The study ultimately adds to evidence that simple, strength-based exercises can serve as pragmatic indicators of overall health, particularly for middle-aged men in physically demanding occupations.
References
- Harvard T.H. Chan School of Public Health. "Push-up capacity linked with lower incidence of future cardiovascular disease events among men."
- NaturalNews.com. "Worried about your heart? How many pushups you can do indicates cardiovascular health status." July 11, 2019.
- Mercola.com. "Mercola Staff Takes the Pushup Challenge." April 5, 2019.
- J Yang et al. "Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men." JAMA Network Open. February 2019.
- National Institutes of Health. "How Many Push-Ups Can You Do?" (Research News).
- Mercola.com. "Take the Pushup Test to Help Gauge Your Risk for Heart Disease." March 1, 2019.
- Jim Kwik. "Limitless."
- Unknown. "Bottom Lines Treasury of Health Secrets for Seniors."
- Harvard Health Publishing. "More push-ups may mean less risk of heart problems." May 1, 2019.
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