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Push-up capacity can predict future heart events for men

Heart disease is the leading cause of death worldwide, precipitated through smoking, high blood pressure and diabetes, becoming out of control. Added to this list of offensive agents is physical inactivity — sedentary living — which predisposes an individual to excessive visceral fat gain (around the midsection), coupled with a high fat and sugar Western-type diet.

According to research, which appears in the JAMA Network Open — Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Men — a recent study suggests that moderate to vigorous physical activity could significantly reduce premature mortality and prolong life expectancy.

The American Heart Association (AHA) added physical activity to its “My Life Check — Life’s Simple 7” campaign to reduce the burden of CVD (cardiovascular disease) and improve overall health.”

The AHA has recommended that an assessment of physical activity take place in clinical and workplace environments — with the most common assessment being a person’s self-reported history and lifestyle questionnaires versus anthropomorphic (height, weight, and BMI) and blood values.

The JAMA website noted that “although good performance on accurate and objective CRF (cardiorespiratory fitness) assessment tools, such as the exercise tolerance tests, has been inversely associated with future CVD, these examinations are expensive, time- consuming and often require professional facilities and trained personnel to administer.”

Researchers from Harvard T.H. Chan School of Public Health, Cyprus International Institute for Environmental and Public Health, Department of Medical and Surgical Sciences, University of Bologna, and the Richard M. Fairbanks School of Public Health, Indiana University, point out that no study has examined the association of push-up capacity, “a simple, no-cost, surrogate measure of functional status, with future cardiovascular events.”

Recruiting from 10 active duty fire departments in Indiana, 1562 career firefighters underwent baseline and periodic physical examinations — including push-up capacity and exercise tolerance, which were conducted between January 1, 2000, and December 31, 2010.

Over a 10-year follow-up period, cardiovascular disease-associated outcomes, such as diagnosis of coronary artery disease and other major CVD events, were included in the assessment process, along with anthropometric data, laboratory results, blood pressure, resting heart rate and complete physical examinations.

“This study found that push-up capacity was inversely associated with 10-year risk of CVD events among men aged 21 to 66 years,” noted the researchers, which led to the conclusion that “push-up capacity, a simple, no-cost measure, may provide a surrogate estimate of functional status among middle-aged men.”

Participants, who were able to perform 11 or more push-ups at baseline had significantly reduced risk of subsequent CVD events, the study reported.

Having been part of the Ochsner Heart and Vascular Institute during my prior seven year tenure with the Ochsner Health System, I was quite surprised when the researchers reported “in the present study, push-up capacity was more strongly associated with future CVD risk than was V O2max, as estimated by submaximal stress tests.”

The cardiopulmonary stress test — a measurement of VO2 max (maximum endurance capacity) — is an integral part of my cardiorespiratory assessment. To find that push-up capacity was more strongly associated with adverse cardiovascular events in middle aged men, raises questions, as to appropriate risk stratification.

Being able to perform a greater number of push-ups, more than 40, should not only be a wake-up call to police and fire departments, as a simple way to reduce heart disease in their employees, but also to men in general.

Baseline assessment at the training academy level — with periodic, yearly reassessment of career employees in their respective first responder departments, will reduce health care costs, along with increasing life expectancy and work capacity.

From a general population perspective, push-up capacity should also be part of a young man’s physical education assessment at the high school level.

Time to man up and push up.

Article and photo originally appeared on

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