The Push-Up Test: What Your Number Says About Your Heart

Forty is a number that sticks. In a 2019 study of 1,104 firefighters in Indiana, men who could do more than 40 push-ups had far fewer heart problems over the following decade than men who managed 10 or fewer. All the test needs is a patch of floor, so it’s tempting to try on yourself.

The push-up test is a count of how many full push-ups you can do with good form at a steady pace. A higher count went with fewer heart problems in that study, but age, body weight and other risk factors may explain much of the link. The number works best for tracking your own strength over time, not as a heart score.

The Firefighter Study Behind the Push-Up Test

A Harvard-led team reviewed the records of male firefighters examined at one clinic in Indiana between 2000 and 2007. The 1,104 men with a push-up result were aged 21 to 66, 39.6 on average, with an average body mass index (BMI) of 28.7. Each man did push-ups in time with a metronome set at 80 beats per minute. Staff counted until he reached 80, missed three or more beats, or had to stop.

The men were sorted into five groups, from 0 to 10 push-ups up to 41 or more, and followed until the end of 2010. There were 37 cardiovascular events, defined as a new diagnosis of coronary artery disease or another major event such as heart failure or sudden cardiac death. Only one of them happened among the 155 men in the top group. Their event rate was 96% lower than that of the 75 men who managed 10 or fewer.

Yang, J. et al. (2019). “Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men.” JAMA Network Open, 2(2), e188341.

What the Headline Number Leaves Out

That 96% is a raw comparison, and the two groups differed in more than push-ups. The men who managed 10 or fewer were on average 13 years older than those who did more than 40, had a much higher BMI (33.1 versus 26.8) and were more than three times as likely to smoke (24% versus 7%). Once the researchers adjusted for age and BMI, the top group’s advantage shrank and was no longer statistically significant. Only the men doing 21 to 30 push-ups still had a clearly lower risk than the bottom group, about 70% lower.

The authors were candid. They wrote that their results “do not support push-up capacity as an independent predictor” of cardiovascular risk, and that differences in blood pressure, blood fats and smoking may explain much of the remaining gap. The study also included only middle-aged men in a physically active job, so it may not apply to women, older adults or people who are less active.

A broader study points the same way. In the 1981 Canada Fitness Survey, 8,116 men and women aged 20 to 69 did push-ups, sit-ups, a grip test and a flexibility test, and 238 of them died over the next 13 years. After accounting for age, smoking, body mass and estimated aerobic fitness, push-up results showed no pattern with the risk of dying, though people in the bottom quarter for sit-ups had more than twice the risk of those in the top quarter. This was observational too, and it counted deaths from any cause.

Katzmarzyk, P.T. & Craig, C.L. (2002). “Musculoskeletal fitness and risk of mortality.” Medicine & Science in Sports & Exercise, 34(5), 740-744.

Why Strength Still Matters

None of this makes strength unimportant. A 2018 meta-analysis pooled 38 cohort studies with about 1.9 million adults and 63,087 deaths. People with higher grip strength had a 31% lower risk of dying from any cause than those with lower grip strength, and stronger legs, measured with a knee-extension test, went with a 14% lower risk. Those were grip and leg tests, not push-ups, and associations rather than proof, but they suggest the muscle behind a push-up is worth keeping.

García-Hermoso, A. et al. (2018). “Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women.” Archives of Physical Medicine and Rehabilitation, 99(10), 2100-2113.e5.

A push-up works your chest, shoulders and triceps, and your trunk has to hold a straight line. Body weight counts too, since a heavier body gives the same arms more to lift, which likely explains part of why the lowest counts came with the highest BMI.

How to Do the Push-Up Test at Home

Use a non-slip floor or a rug that won’t slide, and test at the same time of day each month.

1. Warm up for three to five minutes: march on the spot, circle your arms and do a few easy push-ups against a wall.
2. Start at the top of a push-up with your hands about shoulder-width apart and your body straight from head to heels.
3. Set a metronome app to 80 beats per minute: down on one beat, up on the next, which is 40 push-ups a minute.
4. Lower until your chest is about a fist’s height from the floor, then press back up to straight arms, breathing out as you push.
5. Count only full reps. Stop when your hips sag or pike, when you fall behind the beat three times, or when you can’t do another.
6. Write down the number, the version you used and the date.

If a full push-up isn’t possible yet, test from your knees or with your hands on a sturdy bench or kitchen counter, and use the same version next time. Retest about once a month.

The firefighters’ test stopped for dizziness, light-headedness, chest pain or shortness of breath, and yours should too. Those symptoms are a reason to see a doctor, not to push through. If you have heart disease, have been told to avoid strenuous exercise, or have shoulder, elbow or wrist pain, check with your doctor or a physical therapist before testing to your limit.

How Many Push-Ups Should You Be Able to Do?

No evidence-based target fits everyone. The firefighter study’s authors recommended that men with low counts, especially 10 or fewer, work on their heart risk factors, so a low count is a good prompt to book a check-up. The study didn’t include women or older adults, and charts that rank you by age and sex only show how you compare with other people. The comparison that means most is your own count against last month’s.

To raise your number, practice push-ups two or three times a week on non-consecutive days. Choose the hardest version you can do for about 8 to 12 clean reps (hands on a counter, a sturdy chair or the floor) and do three sets, stopping each one when you have a rep or two left. When three sets of 12 feel steady, move your hands one step lower. The monthly retest tells you whether it’s working.

Lamplit’s free Fitness Check, in the workout tracker, includes a push-up round (“As many quality reps as you can”) plus squats, a plank and a wall sit, with 30 seconds of rest between. Push-ups score one point at 5 reps and two at 15, and the four tests add up to a score out of 8 and a fitness level from “Getting started” to “Strong foundation.” Comparing checks over time needs Lamplit Pro, but you can log today’s test as a workout for free, with your count and version in the notes, and repeat it next month.

Do the push-up test today and log it as a workout in Lamplit, with your count in the notes. It’s free.