Ability to do more than 40 push-ups linked to dramatically lower risk of heart disease

The more push-ups you can do, the lower your risk of cardiovascular disease

What about women?

How to do push-ups

References

The more push-ups you can do, the lower your risk of cardiovascular disease

A 2019 study of middle-aged men found that the more push-ups they could do in one go, the lower their risk of cardiovascular disease over the following ten years. (1)

The study's results were really significant. Those men who completed more than 40 push-ups in one go at the start of the study had a 96% reduction in cardiovascular events such as coronary artery disease, heart failure and sudden cardiac death, compared to those who could do fewer than 10 push-ups. Those who completed somewhere between 10 and 40 push-ups also enjoyed a significant reduction in risk. Even those who could only do a few more than 10 push-ups still had significantly reduced risk of subsequent cardiovascular disease events.

The study analysed 1,104 active male firefighters, all aged more than 18 years and with an average age of 40. Their average BMI was 28.7, which means they were on the chubby side. They completed both push-up and treadmill exercise tolerance tests. For the next ten years the men had an annual physical exam and completed a health questionnaire.

In the study, the participants had to complete their push-ups all at one time, as opposed to doing them a few at a time with rests in between. They had to do them in time with a metronome set at 80 beats per minute. The test stopped when the participant missed three or more beats of the metronome or felt exhausted, dizzy, lightheaded, chest pain or shortness of breath.

Heart disease is the leading cause of death worldwide, and push-ups are a simple activity that anyone can do, so this is information well worth acting on. Push-ups are incredibly beneficial because they rapidly develop your muscle strength and bulk, and serve as an indicator of your overall fitness level. (4) Exercise tolerance tests using a treadmill or stationary cycle while hooked up with tubes and wires can also assess your risk of cardiovascular disease, but they require you to visit a professional to administer the test which may take an hour and is expensive too. This study suggests that the number of push-ups you can complete may be a comparable and accurate way to measure your cardiovascular health, at home, in just a couple of minutes.

What about women?

This particular study examined middle-aged men. The researchers concluded that more study is needed to determine if the results apply to other populations, such as women, older adults or people who are less active than the firefighters. I don't doubt that a similar outcome would be found for active middle-aged women. However, with a healthy, normal woman having less muscle bulk and more fat than a healthy normal man, the number of push-ups required to measure the risk and to increase protection would be lower for women than for men. However, we don't know how much lower.

How to do push-ups

Push-ups are an exercise you can do virtually anywhere, and they take only a few minutes. When you first start doing them, do as many as you safely can in one go. This is your baseline, which you can use to keep track of how you improve each week.

The normal position for a push-up (which was used in the study) places your hands under the outer edges of your shoulders with your fingers facing forward. You knees, hips, back, shoulders and head should be straight as a plank. Avoid tensing your shoulders or moving them up toward your ears. To do a push-up, bend your elbows until the "plank" virtually touches the ground, and then lift up again with your elbows extending fully. Ideally, the tip of your nose lightly touches the ground.

Push-ups exercise your chest muscles, shoulders, backs of your arms, abdominals and the serratus anterior (the muscles under your armpits) simultaneously. Placing your hands slightly closer together increases the strain on your chest muscles. Placing your hands further apart puts more strain on your triceps. (3)

You are lifting 50% to 75% of your body weight while building strength in your core and upper body muscles. They are a weight-bearing exercise that also raises your metabolic rate and increases cardiovascular fitness. This means they build stronger bones and prevent osteoporosis.

Earlier research found that a higher level of muscular strength protects against death from any cause and reduces blood pressure in men. Muscle bulk and strength is also linked to a lower risk of cancer mortality, metabolic syndrome, and age-related weight and fat gain. (2, 4, 5)

If it's been awhile since you've tried to do push-ups, you may find you can't even do one. In this case start your training by pushing against a wall. Stand about one metre (three feet) from a wall, and then lean against it with your palms flat on the wall. Slowly come forward, bending your elbows to do a push-up against the wall. After you find you are stronger, again try doing push-ups on the floor, but with your knees bent and on the floor. Eventually you should be strong enough to do push-ups with your knees off the floor.

References

1. Justin Yang, Costas A. Christophi, Andrea Farioli, Dorothee M. Baur, Steven Moffatt, Terrell W. Zollinger, Stefanos N. Kales. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Netw Open. 15 February 2019;2(2):e188341. doi:10.1001/jamanetworkopen.2018.8341

2. Hu G, Tuomilehto J, Borodulin K, Jousilahti P. The joint associations of occupational, commuting, and leisure-time physical activity, and the Framingham risk score on the 10-year risk of coronary heart disease. Eur Heart J. 2007;28(4):492-498. doi:10.1093/eurheartj/ehl475.

3. You-Sin Kim, Do-Yeon Kim, Min-Seong Ha. Effect of the push-up exercise at different palmar width on muscle activities. J Phys Ther Sci. 2016 Feb; 28(2): 446-449. Published online 29 February 2016. doi: 10.1589/jpts.28.446. PMCID: PMC4792988. PMID: 27064571.

4. Artero EG, Lee DC, Lavie CJ, Espana-Romero V, Sui X, Church TS, Blair SN. Effects of muscular strength on cardiovascular risk factors and prognosis. J Cardiopulm Rehabil Prev. 2012 Nov-Dec;32(6):351-8. doi: 10.1097/HCR.0b013e3182642688.

5. Naoki Kikuchi, Koichi Nakazato. Low-load bench press and push-up induce similar muscle hypertrophy and strength gain. J Exerc Sci Fit. 2017 Jun; 15(1): 37-42. Published online 29 June 2017. doi: 10.1016/j.jesf.2017.06.003. PMCID: PMC5812864. PMID: 29541130.