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Assessing cardiovascular disease risk with push-ups

Posted: June 13, 2019

Can a simple exercise like a push-up be an inexpensive way for fire departments to assess cardiovascular disease (CVD) risk in firefighters?

A study1 published this year evaluated push-ups as a simple, no-cost measure of CVD risk. It's the first study to identify a relationship between push-up capacity at a baseline exam and CVD risk over an extended period.

While the results suggest that being able to perform more push-ups at baseline is associated with lower incidence of CVD events among active men, more research is needed about its potential use as a clinical assessment tool.


Researchers looked at the records of 1,562 male firefighters aged 21-66 from Indiana who had medical screenings between Jan. 1, 2000 and Dec. 31, 2010.

  • The firefighters' initial screening and follow-up exams included push-up capacity testing.
  • Clinic staff counted the number of completed push-ups in time with a metronome set at 80 beats per minute.
  • Staff counted push-ups until each participant reached 80, missed three or more beats of the metronome, or stopped due to exhaustion.
  • Researchers looked for any CVD-related events among the participants during the 10-year period.


  • Those firefighters who completed fewer than 10 push-ups at their initial exam were at significantly higher risk of CVD over the course of the 10-year period.
  • Participants who did 11 or more push-ups at their initial exam were at significantly reduced risk of experiencing a CVD event.
  • Push-ups, as a simple, no-cost, fitness estimate, have the potential to improve physical fitness assessments in workplace settings.
  • Medical personnel should recommend ways to reduce CVD risk for those who complete a low number of push-ups, especially those only capable of 10 or fewer push-ups.
  • Research results may not apply to women or to men of other ages since this study group was middle-aged, active men.

Assessing CVD risk in firefighters: background

CVD is a leading cause of on-duty death among firefighters. Recent studies show that even moderate physical activity can significantly reduce CVD risk factors.

Despite these research findings, very little emphasis is placed on assessing cardiorespiratory fitness. Physicians often rely on a patient's self-assessment and lifestyle questionnaires.

Current forms of exercise tolerance tests are expensive and require special equipment and trained personnel to administer them. Many career and volunteer fire departments do not have the means to conduct exercise stress tests for their firefighters.

Learn more about this research

Summary information for this article was provided by the NETC Library. You can find this article in our library.

1 Yang, J., Christophi, C., Farioli, A., Baur, D., Moffatt, S., Zollinger, T., Kales, S. (2019). Association between push-up exercise capacity and future cardiovascular events among active adult men. JAMA Network Open: 2 (2):e188341. doi:10.1001/jamanetworkopen.2018.8341

This summary is for informational purposes only. As such, the content does not reflect any official positions, policies or guidelines on behalf of the sender, the U.S. Fire Administration, Federal Emergency Management Agency, the Department of Homeland Security, nor any other federal agencies, departments or contracting entities. Similarly, this summary does not represent in any manner an official endorsement or relationship to any private or public companies, organizations/associations, or any authors or individuals cited or websites associated within the article.

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