What push-ups can tell about your heart

Can you do 40 push ups? No, not over the course of a month, but in a row? If not, can you do at least ten?

The answers to these questions may help you determine your risk of heart problems over the next decade, according to a study recently published in JAMA Network Open

The study did focus on 1104 male firefighters who were on average 39.6 years old with a standard deviation in age of 9.2 years. Therefore, before you try to get your babies to do push ups, keep in mind that any conclusions from this study came from a fairly specific group of people. Most babies are not firefighters and are terrible at doing push-ups. Although the thought of babies trying to do push-ups with their little arms could be adorable.

Also, keep in mind that this was a retrospective cohort study, which basically means looking at what has happened in the past and trying to determine if there were any associations and correlations based on the available data. As a result, any analyses are limited by what data has already been collected and may overlook many different factors.

For the study, a team from the Harvard T.H. Chan School of Public Health, the University of Bologna, Public Safety Medical in Indianapolis, Indiana and Indiana University analysed data on firefighters who had visited an outpatient clinic in Indiana that served 10 different fire departments from February 2, 2000, to November 12, 2007.

Although 1562 male firefighters had undergone physical exams during this time period, only 1104 had undergone a push-up test. The push-up test involved starting a metronome at a rate of 80 beats per minute and then having the firefighter try to do push-ups at this rate. The firefighter would continue until he reached 80, missed three or more beats of the metronome, or could not go any further. Hence, one hour latte breaks between push-ups wouldn’t have worked.

The firefighters also had completed exercise tolerance tests. This involved seeing how long they could walk or run on a treadmill while measuring their heart rates and rhythms and oxygen consumption. Exercise tolerance tests are the more standard way of testing a person’s risk for having cardiovascular problems. But, of course, purchasing and maintaining a treadmill and doing the testing is a lot more involved and expensive than asking someone to drop and give you 80 or 60 or 40 or 20 or one or one-third of a push-up.

For each of the 1104 firefighters, the research team had data on whether the firefighter was eventually diagnosed with coronary artery disease or had a major cardiovascular disease event, such as heart failure or sudden cardiac death, in the years after the push-up test up till December 31, 2010.

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The researchers then tried to determine if there was an association between how the firefighters did on the push-up test and these cardiovascular outcomes.

The push-up study focused on a very specific population that did not include women.

Call the results more than a push for the push-up test. Those who did more than 40 push-ups were 96% less likely to have had a cardiovascular problem in the subsequent years compared to those who could do no more than 10 push-ups.

For all of the other groups, the research team found a rough association between being able to more push-ups and a reduced likelihood of having a cardiovascular problem. For example, compared to those who did 10 or fewer push-ups, those who did between 11 and 20 push-ups were 64 per cent less likely, those who did between 21 and 30 were 84 per cent less likely, and those who did between 31 and 40 were 75 per cent less likely to have eventually developed cardiovascular problems.

The researchers found that these associations seemed to roughly follow the risk associations seen with exercise tolerance testing. This prompted the researchers to wonder if a push-up test could be “a simple, no-cost measure, [which] may provide a surrogate estimate of functional status among middle-aged men.”

In other words, when a treadmill and exercise tolerance testing is not available, can you just see how many push-ups a person can do as a quick and dirty way (really dirty if the floor is very dirty) to determine a person’s cardiovascular health status and risk for future bad events?

Potentially. Having a quick-and-dirty test could be helpful, especially when there is no ready access to an exercise testing laboratory. Just make sure the clinic floor is cleaned regularly and often.

However, there are caveats. The study did focus on a very, very, very specific group: male firefighters in their 30’s and 40’s and from Indiana who went to a particular clinic. That’s pretty darn specific.

The findings may not apply if your are different from this population, such as if you are a male firefighter in your 40’s and from Nebraska. The same thresholds may be very different for different people.

After all, not everyone is created equal when it comes to doing push-ups. As the late comedian Mitch Hedberg once said, “Dogs are forever in the push up position.” So if you are a dachshund, don’t get too overconfident. You may just be built to do push-ups.

If you are human, results of the push up test could still be misleading if the top part of your body looks like Mr. Incredible on steroids while the bottom part of you looks like toothpicks. Being able to do lots of push-ups but barely being able to run to the bathroom would not bode well for your cardiovascular health.

Conversely, just because relatively weaker arms and shoulders prevent you from doing too many push ups, doesn’t necessarily mean that you are in bad cardiovascular shape.

What this study suggests is that push-up capacity could be one (just one) possible measure that must take into account multiple other measures. A single measure will never be able to fully assess your cardiovascular risk, unless it is perhaps “did you just have a heart attack” or “did that man from Indiana Jones and The Temple of Doom just remove your heart from your chest?”

But even after a heart attack, different people may have different risks of future cardiovascular problems. Having your heart removed from your just chest is a different story.

—Healthcare