Men who can do more than 40 push-ups have 96 per cent lower risk of heart disease

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How many push-ups can you do in a row? The number says a lot about your health — with doctors urging people to aim for at least 40.

Men who can do more than 40 push-ups in a row have a 96 per cent lower risk of heart disease than those who can do fewer than 10, according to new research.

The Harvard study, published in JAMA Network Open on Friday, suggests dropping to the floor and showing your doctor how many you can do may be a better predictor of heart disease, heart attacks and strokes than traditional treadmill tests.

"Surprisingly, push-up capacity was more strongly associated with cardiovascular disease risk than the results of submaximal treadmill tests," lead author Dr Justin Yang, occupational medicine resident at the Harvard TH Chan School of Public Health, said in a press release.

"Our findings provide evidence that push-up capacity could be an easy, no-cost method to help assess cardiovascular disease risk in almost any setting."

The researchers analysed the health data of 1104 active male firefighters aged between 21 and 66 over a 10-year period. Their push-up capacity and treadmill exercise tolerance were measured at the start of the study in 2000, with each man then taking annual physical examinations and health questionnaires.

During the study period, 37 of the men developed some type of cardiovascular disease, with "all but one" occurring in men who completed 40 or fewer push-ups in the baseline exam.

"Participants able to complete more than 40 push-ups were associated with a significantly lower risk of incident CVD event risk compared with those completing fewer than 10 push-ups," the study says.

"Participants able to perform 11 or more push-ups at baseline had significantly reduced risk of subsequent CVD events. To our knowledge, this is the first study to report the inverse relationship between push-up capacity at baseline and subsequent CVD-related outcomes in an occupationally active male cohort."

Heart disease is the leading cause of death worldwide, and despite the growing evidence for "objectively assessing cardiorespiratory fitness as a vital sign in health care settings", the authors warn physical activity and CRF assessments "have largely been neglected by clinicians".

"The most commonly used physical activity assessments are the patient's self-reported history and health and lifestyle questionnaires," it says. "However, objectively measured CRF levels are often significantly lower than expected based on self-reported physical activity."

Traditional cardiorespiratory fitness tests are "expensive, time-consuming, and often require professional facilities and trained personnel to administer".

"The use of these tools remains limited to particular occupations and targeted patient populations," it says. "To our knowledge, no study has examined the association of push-up capacity, a simple, no-cost, surrogate measure of functional status, with future cardiovascular events."

The authors noted that because the study population consisted of middle-aged, occupationally active men, the results may not be generalisable to women or to men of other ages or who are less active.

"This study emphasises the importance of physical fitness on health, and why clinicians should assess fitness during clinical encounters," said senior author Stefanos Kales, professor in the Department of Environmental Health at Harvard Chan School and chief of occupational medicine at Cambridge Health Alliance.