Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Robust evidence indicates an association of increased physical fitness with a lower risk of CVD events and improved longevity; however, few have studied simple, low-cost measures of functional status. To evaluate the association between push-up capacity and subsequent CVD event incidence in a cohort of active adult men. Retrospective longitudinal cohort study conducted between January 1, 2000, and December 31, 2010, in 1 outpatient clinics in Indiana of male firefighters aged 18 years or older. Baseline and periodic physical examinations, including tests of push-up capacity and exercise tolerance, were performed between February 2, 2000, and November 12, 2007. Participants were stratified into 5 groups based on number of push-ups completed and were followed up for 10 years. Final statistical analyses were completed on August 11, 2018. Cardiovascular disease-related outcomes through 2010 included incident diagnoses of coronary artery disease and other major CVD events. Incidence rate ratios (IRRs) were computed, and logistic regression models were used to model the time to each outcome from baseline, adjusting for age and body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared). Kaplan-Meier estimates for cumulative risk were computed for the push-up categories. A total of 1562 participants underwent baseline examination, and 1104 with available push-up data were included in the final analyses. Mean (SD) age of the cohort at baseline was 39.6 (9.2) years, and mean (SD) BMI was 28.7 (4.3). During the 10-year follow up, 37 CVD-related outcomes (8601 person-years) were reported in participants with available push-up data. Significant negative associations were found between increasing push-up capacity and CVD events. 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 (IRR, 0.04; 95% CI, 0.01-0.36). The findings suggest that higher baseline push-up capacity is associated with a lower incidence of CVD events. Although larger studies in more diverse cohorts are needed, push-up capacity may be a simple, no-cost measure to estimate functional status.
Highlights
Cardiovascular disease (CVD) remains the leading cause of death worldwide.[1]
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 (IRR, 0.04; 95% CI, 0.01-0.36)
The findings suggest that higher baseline push-up capacity is associated with a lower incidence of CVD events
Summary
Cardiovascular disease (CVD) remains the leading cause of death worldwide.[1]. In addition to longrecognized risk factors for CVD, such as smoking, hypertension, and diabetes, the unfavorable health consequences of physical inactivity on cardiovascular health have been well established.[2,3,4,5] Studies have suggested that physical activity provides cardiovascular benefits independent of other modifiable CVD risk factors associated with a lower incidence of multiple diseases, including CVD, diabetes, cancer, and Alzheimer disease.[3,6,7,8,9] A recent US study further suggested that moderate to vigorous physical activity could significantly reduce premature mortality and prolong life expectancy.[10]. The most commonly used physical activity assessments are the patient’s selfreported history and health and lifestyle questionnaires.[2] objectively measured CRF levels are often significantly lower than expected based on self-reported physical activity.[19,20] good performance on accurate and objective CRF assessment tools such as exercise tolerance tests has been inversely associated with future CVD,[21,22] these examinations are expensive, timeconsuming, and often require professional facilities and trained personnel to administer The use of these tools remains limited to particular occupations and targeted patient populations. We hypothesized that higher fitness levels would be associated with lower rates of incident CVD
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