Push-ups and the Risk of Cardiovascular Death

Cardiovascular Risk and Push-Ups

I was scrolling through the most read articles through the JAMA group this year and the top one was the following:

Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men

It is kind of a cool study looking at the link between push-up capacity in firefighters in Indiana 18 years of age and older who had no job restrictions at the time of the initial assessment.  They divided the group based on the number of push-ups they could complete into the following categories:

  • 0-10 push-ups
  • 11-20 push-ups
  • 21-30 push-ups
  • 31-40 push-ups
  • ≥ 41 push-ups

They followed this group for 10 years and found that the push-ups capacity was related to survivability.  What’s interesting is that it was also significantly inversely associated with key cardiovascular risk factors:

  • Age, P < .001
  • BMI, P < .001
  • Systolic blood pressure, P < .001
  • Diastolic blood pressure, P < .001
  • Total cholesterol level, P = .02
  • Low-density lipoprotein cholesterol level, P = .04
  • Triglycerides, P < .001
  • Glucose level, P < .001
  • Smoking status, P < .001

The figure from this trial shows that people that had the lowest push-ups capacity had the highest 10-year mortality.

Image source: Yang J, Christophi CA, Farioli A, et al. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Netw Open. 2019;2(2):e188341-e188341. doi:10.1001/jamanetworkopen.2018.8341

What does this mean to practice?

  • The benefits of physical activity on cardiovascular disease risk has been known for years.  This study clearly demonstrated the benefits of resistance exercise (push-ups) on 10-year cardiovascular mortality.
  • This study provides a way of accessing functional and fitness status with a simple test.  It also provides a goal for patients as well.
  • Looking at the figure, it also contributes to the common notion that the most benefits of exercise are seen in people with the lowest fitness level becoming more active.
  • This study is early but it is a simple assessment test that can be used in practice.

Reference

Yang J, Christophi CA, Farioli A, et al. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Netw Open. 2019;2(2):e188341-e188341. doi:10.1001/jamanetworkopen.2018.8341

2 thoughts on “Push-ups and the Risk of Cardiovascular Death”

  1. Very practical Mike. Thanks for this.
    Do you have any thoughts on how clinicians could use this learning to set therapeutic pushup thresholds for female patients and populations who were never professional athletes (as all firefighters are from try-outs until they shift to management roles).

    1. Thanks Jim,

      Not a ton of data. The issue here is they wanted a relatively consistent baseline of patients. It was a small study, but the results were pretty compelling. From other groups, I would feel pretty comfortable saying that the more active a person is, the lower overall cardiovascular risk. I just wish we could see more long-term data on the different non-pharmacological interventions for disease prevention. I am hoping with more EMR’s, health data collected by patients (fit-bit, Apple watch) and registries we will be able to make stronger and evidence-based recommendations to patients.

      Thanks for reading

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