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Doing more than 40 push-ups shows you’re 96% less likely to get a heart attack (studyfinds.org)
72 points by kiddz 33 days ago | hide | past | web | favorite | 33 comments

Better summary "if you can do a push-up sprint and complete 41 pushups in less than 33 seconds without pausing you're in pretty good shape and btw you're 96% less likely to get heart disease in the next 10 years than someone that can't keep that pace up for even 10 pushups."

The most important sentence.

"For push-ups, the firefighter was instructed to begin push-ups in time with a metronome set at 80 beats per minute. Clinic staff counted the number of push-ups completed until the participant reached 80, missed 3 or more beats of the metronome, or stopped owing to exhaustion or other symptoms (dizziness, lightheadedness, chest pain, or shortness of breath)."

This was a combined strength/cardiovascular test. You had to book it. Only the firefighters that

"metronome set at 80 beats per minute ... until the participant reached 80, missed 3 or more beats of the metronome, or stopped"

This is literally a push-up sprint.

For comparison the US Army requires 42 pushups over 2 minutes (120 seconds) with any amount of pauses (to meet minimum standards) and maxes out at 71 push ups in 2 minutes.

The people I knew who were maxing out their PT tests weren't hitting anywhere near this pace and I suspect only a handful of them could.

The other detail is what they counted as a pushup. My understanding is the military is pretty strict and most gym-goers aren't. Having your arms out perpendicular to torso is noticeably easier than tucking then in towards your chest and there's a range of places one might stop at. At that pace, I think you'd be doing doing fairly shallow pushups.

Or maybe I'm just making excuses for not being able to do this.

I wonder about this too. During all of my PE classes in elementary and high school a pushup didn't count unless your nose touched the ground and you came all the way back up. Pushups I see all over the place now, from tv shows to YouTube videos to folks in the gym are incredibly shallow, often only dipping down a few inches from the top position.

Just as pullups and chin-ups are different things, perhaps these shallow pushups should have a different name to distinguish them from "to the floor" pushups.

I've never even tried to do pushups at that sort of pace, i was always taught that the lower should be slow/controlled and the raise fast/explosive.

It really does sound like something you would need to train pretty specifically for to complete when the reality is that just being fit is the metric for lower risk of heart disease

Another thing to remember is how this is a fact detached from reality. It seems to imply that if you manage to train hard enough, you will have lower chances of dying.

But in reality if you are in the "high chances of heart attack" group, the training might be the thing that kills you, which is why being able to do the push-ups is a good indicator of having low chances of heart attack...

This type of studies is just useless

You get more uprons if you say that doing 40 pushups cures Leukemia though.

99% of people who can't do 40 push-ups are going to fail because they don't have the strength. Firefighters are probably one of the only demographics where you are going to get a non-trivial percentage who have the strength but not the cardiovascular health required.

But the study also measured cardiovascular fitness via treadmill and didn't find the same correlation.

I mean it's not surprising that, in firefighters, pushups would be a better predictor of cardiovascular health than a VO2 max estimation. For the treadmill test, they cut participants off at 85% of their predicted max heart rate. Whereas with 40 push-ups you're pretty much guaranteed to be at your actual max heart rate after the first 10 or 15.

In other words, push-ups are probably a better measure of cardiovascular fitness than the treadmill test, but only for the tiny percentage of the population who isn't limited by strength.

Participants in the highest pushups-completed group were younger, weighed less, had lower blood pressure, and were likely to be non-smoking compared to the two lowest groups.

For a person who is 5ft10in, the BMI comparison in pounds would be 187lbs avg for the highest group vs 231 lbs, 211 lbs avg for the two lowest groups.

Look at the details from Table 1 in the Study (go to https://jamanetwork.com/journals/jamanetworkopen/fullarticle..., on the right hand side, click on 'Figures and Tables', then click on the 'View Large' link for Table 1):

BMI = Body Mass Index, BP = blood pressure, SD = Standard Deviation

Mean Avg Values for the two lowest groups of pushups (0-10, 11-20):

  Age: 48.4 (SD=10.1), 45.1 (SD=8.6)
  BMI: 33.1 (SD=5.8) , 30.3 (SD=4.9)
  BP:  136.9/89.4    , 129.96/86.5
  Smokers (Prev & Current): 54.7%, 58.8%
Value for the highest group of pushups (41+):

  Age: 35.1 (SD=7.1)
  BMI: 26.8 (SD=2.9)
  BP:  125.2/84
  Smokers (Prev & Current): 30.9%
from https://www.bmi3d.com/table.html

  BMI: 25-29.9: - overweight, >= 30: obese
from https://www.heart.org/-/media/data-import/downloadables/pe-a...

  BP: high blood pressure = 1st number >= 130 or 2nd number >= 80

Wait, this means that all groups had high blood pressure? (2nd number >= 80)

Isn't it generally more likely for someone who can do 40 push ups to be also living a more active life?

I mean the ability to complete 40 push ups could be a result of exercising in general.

"metronome set at 80 beats per minute ... until the participant reached 80, missed 3 or more beats of the metronome, or stopped"

To hit this top group that gives you less than 33 seconds to hit 41. You're not gonna hit those numbers just by exercising in general.

But someone with such a good performance in push ups is more likely to be more active in general.

I don't have training to make a formal argument, but this has got to be bullshit.

They take the few people that had some form of heart disease (37 out of 1104 over ten years) and noted that none of them except one could do 40 pushups. By some magic, this is translated into a 96% reduction in chance of a heart attack.

If that's really the reasoning, could I not just pick any metric (i.e. words typed per minute over 120, or IQ over 130) which is likely to eliminate almost all of the participants and conclude that it is reducing risk of heart disease?

Am I missing something? Is this kind of reasoning not complete bogus?

That's not how this sort of analysis is done. They separated people by push-up capacity, and compared the rate of heart disease in the low-capacity group versus the high-capacity group; those rates were 36 "cardiovascular events" for the 948 low-capacity guys (so, 3.7% of them), and 1 for the 155 high-capacity guys (0.6% of them.) I know which group I'd rather be in.

It is true that, with the small number of events, the precise "96% reduction" number shouldn't be taken too seriously- the study notes that the 95% confidence interval is 99% to 64%; essentially, there's a one-in-twenty chance that it's a 99% reduction, or likewise that it's only a 64% reduction. Science never grants absolute uncertainties- but sadly, that part never makes it into the news story.

Thank you for the explanation, that makes a lot more sense.

This study smells funny to me. Why did they divide pushup numbers into groups of 10 and test there, rather than use a continuous measure? I sense multiple comparisons/researcher degrees of freedom problems.

Considering how the test was actually run I feel like it's a nearly meaningless test. The bar they set was extremely high once you read the details.

I used to be able to do 40+ push ups, but at no where near the pace that the researchers required.

I find I can easily bust out 40 pushups at that rate, but if I try to go slower, it's harder to reach 40.

I'd expect that 40 push-ups are a proxy for good cardiovascular health rather than a cause of it. I.e. practicing push-ups in isolation is unlikely to improve cardiovascular health by itself.

Sure it is, IF you also literally make it a cardiovascular test.

"metronome set at 80 beats per minute ... until the participant reached 80, missed 3 or more beats of the metronome, or stopped"

hard to tell from the description of the study, it was done on firefighters, I would have though most would have reasonable cardio, I'm not sure if they did anything to isolate an overall lack of fitness from pushups

> I would have though most would have reasonable cardio

I don't know if there are any national standards. But I'm under the impression that at most places there is some baseline cardio component to the fitness test, but that the upper body strength standards are much more demanding.

I bet they could say the same about 20+ pull-ups (which is more difficult than 40 push-ups based on anecdotal evidence). Not too interesting of a study in that sense.

Most firefighters in the US face a significant physical test to become a firefighter - example: https://nationaltestingnetwork.com/publicsafetyjobs/cpat_inf...

Worth mentioning that all participants were firefighters - so not randomly selected individuals with variety of jobs.

Got to thirty-eight before I got total lactic burn in my biceps and deltoids. Then I got three more ticks and failed.

Better get your will in order. :-)

You probably mean triceps?

Strangely, no. Was the biceps, not triceps.

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