Being able to do more than ten push-ups slashes the risk of getting heart disease، heart attacks and strokes.
Middle-aged men who can do more than 40 push-ups in one go had a 96 percent reduced risk of cardiovascular disease events compared with those able to do fewer than 10.
And dropping to the floor and showing your GP how many you can do is a better indication of your risk than treadmill tests.
First author occupational medicine resident Dr Justin Yang at Harvard TH Chan School of Public Health in Boston said: '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. Surprisingly، push-up capacity was more strongly associated with cardiovascular disease risk than the results of submaximal treadmill tests.' While there is growing evidence for objectively assessing cardiorespiratory fitness (CRF) as a vital sign for health risk، it has been neglected by researchers.
Senior author Professor Stefanos Kales explained: 'The most commonly used physical activity assessments are the patient's self-reported history and health and lifestyle questionnaires.
'However، objectively measured CRF levels are often significantly lower than expected based on self-reported physical activity.
'Although good performance on accurate and objective CRF assessment tools such as exercise tolerance tests has been inversely associated with future CVD، these examinations 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. '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.
'In this study، we examined baseline performance on commonly performed physical fitness assessments (push-up capacity and submaximal treadmill tests) and its association with subsequent incident CVD events in a cohort of occupationally active men.
'We hypothesised that higher fitness levels would be associated with lower rates of incident CVD.'
The study involved 1،104 firefighters over 18 in Indiana with a mean age of 39.6 and mean body mass index (BMI) of 28.7 recruited to a retrospective longitudinal cohort study between 2000 and 2010.
At the start and at periodic physical fitness examinations their push-up capacity and exercise tolerance were assessed between February 2000 and November 2007.
They were followed for 10 years and results showed 37 CVD-related outcomes.
All but one occurred in men who completed 40 or fewer pushups during the baseline exam.
Prof Kales said: 'This study found that push-up capacity was inversely associated with 10-year risk of CVD events among men aged 21 to 66 years.
'Thus، push-up capacity، a simple، no-cost measure، may provide a surrogate estimate of functional status among middle-aged men.
'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.
'Our retrospective cohort study provides further insights into the association of greater fitness، specifically muscular strength، with CVD-related outcomes in an occupationally active cohort across 10 years of follow-up.
'This study emphasises the importance of physical fitness on health، and why clinicians should assess fitness during clinical encounters.'