Never Too Fit Nor Too Healthy

"Our findings provide evidence that pushup capacity could be an easy, no-cost method to help assess cardiovascular disease risk in almost any setting. Surprisingly, pushup capacity was more strongly associated with cardiovascular disease risk than the results of submaximal treadmill tests."
"Using push-ups could be a no-cost and simple method to assess one’s functional capacity and predict future cardiovascular event risk. For clinicians this is really important since a lot of tests vary in their results and are very expensive and time consuming. This can be done within a minute."
"With firefighters pictured on calendars as muscular and very fit, we tend to think of them as different from everyone else, but this group is pretty much the same as the rest of the population. Half of them were overweight or obese." 
Justin Yang, occupational medicine resident, Harvard University

"It's one snapshot assessment, but the fact that you can do less than 10 push-ups doesn't necessarily mean you're at high risk for heart disease. There could be other factors at work.:
"And the fact that you can do more than 40 doesn't mean you're at low risk."
Dr. Stefanos N. Kales, co-author, Harvard study

Master Sgt. Jesse Lawhorn, 49th Maintenance Squadron, completes 289 push-ups during the annual Push up-a-thon held at the Domenici Fitness and Sports Center here Dec. 11. Sergeant Lawhorn won the category for having the most push-ups for males over the age of 30. (U.S. Air Force photo by Airman 1st Class Veronica Stamps)

"You have to be pretty fit to do that many push-ups."
"You would probably have to do a good amount of exercise on a regular basis to get to the level of 40 or more."
Kerry Stewart, professor of medicine, director, clinical and research exercise physiology, Johns Hopkins School of Medicine, Baltimore, Maryland 

"We have long known that physical inactivity constitutes a risk factor for cardiovascular disease and is associated with worse [health] outcomes."
"Conversely, physical activity decreases cardiovascular risk."
Dennis Bruemmer, associate professor of medicine, cardiologist, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pennsylvania

Men, able to produce 40 pushups at a time, are recognized through a new study appearing in JAMA Network Open as less likely to experience a heart attack or any cardiovascular problem in following years, than those men who manage to complete ten or fewer pushups in a single exercise session.
Although the medical community has long recognized the utility of exercise in keeping a body healthy, what is meaningful about this study and its conclusions is that pushup capability might present as a simple method of assessing heart health.

It is universally acknowledged that cardiovascular disease represents the most common cause of global death events. Surviving heart attacks and strokes leads invariably to disability, a lapse in work capability and a considerable diminution of quality of life. The issue here is to recognize the presence or impending signals of cardiovascular disease onset and while there are medical tests to diagnose heart health such as treadmill exercise-stress testing or heart scans, they tend to be complicated and are expensive to prescribe.

These are not tests that are predictive in nature, picking up alerts that heart health is being compromised; what they mostly do is recognize heart disease once it has developed. This very fact spurred Harvard University researchers and those at Indiana University along with other related institutions to study the health and fitness of a group of over 1,500 Indiana firefighters who were instructed to report annually to a single clinic in the state for a medical check, including standard assessments of weight, cholesterol, blood sugar and allied health data.

Part of the annual report included a submaximal treadmill stress test to estimate their current endurance capacity. It was that last measurement of endurance capacity that piqued the interest of researchers, building on past studies that have linked high aerobic fitness with a reduced risk for heart disease onset. The purpose was for the researchers to compare stress test results to cardiovascular problems in the future for a sense of how prescient the treadmill testing might turn out. It then came to the notice of the researchers that over 1,100 of the firefighters had as well completed pushup tests as part of their yearly exams.

Taking advantage of the pushup data available, the researchers included that information as a second set of data, to categorize the men in groups reflecting the number of pushups they were able to complete. Then they discovered that pushup capacity proved to be a more statistically accurate predictor of future heart problems than the treadmill tests. This was a strictly observational study, showing that a greater number of pushups are linked with fewer heart problems, but not that arm strength directly improves heart health or whether ability to perform more pushups would drop the risk for heart problems over time.

However, according to Dr. Stefanos Kales, professor of medicine at Harvard Medical School, and senior author of the new study, "muscular strength is one component of good fitness". A further takeaway from the proficiency in performing pushups is that those who demonstrated that ability are assumed to have an interest in consuming nutritionally healthful food, to indulge in regular exercise and to maintain a normal weight, all of which contribute to healthier hearts.

RossHelen / Getty Images