Fitness Tips

‘I’m a Cardiologist, and This Is What Walking Up 4 Flights of Stairs Can Tell You About Your Heart Health’

Zoe Weiner

Photo: Getty Images/ filadendron
One of the first questions that Arnold Meshkov, MD, a board-certified cardiologist based in Philadelphia, asks his patients is, “Can you walk up a flight of stairs?” Cardiologists, like Dr. Meshkov, have been using “step tests” to evaluate their patients’ heart health since the 1940s, thanks in large part to the fact that walking up stairs puts a measurable amount of demand on your heart. And now, according to a new study, there’s a way you can conduct this type of heart-health test at home with nothing more than a minute of free time and a few flights of stairs.

“Any kind of vigorous activity, like climbing up stairs, is going to cause a demand of blood and oxygen to your extremities,” says Dr. Meshkov. “And the body deals with that by increasing the output of [the blood the heart pumps] and supplying more blood and oxygen than would be required at rest.” He explains that this can happen in two different ways: Either by increasing the speed at which the blood is pumping (which accounts for the faster heart rate you tend to get during exercise) or by increasing the amount of blood that’s pumping out of the left ventricle. “When we’re young, these responses are automatic, but as we get older, that capacity decreases,” he adds.

So why have stairs become the go-to piece of “equipment” for testing heart health? “When exercising on an incline, your heart rate will be much higher than if you were working out on a level surface—your heart is working harder and becomes stronger,” says Satjit Bhusri, MD, a board-certified cardiologist and founder of Upper East Side Cardiology, previously told Well+Good. “It’s also a great way to lower your blood pressure, as your heart will strengthen over time to the point where it won’t need to work as hard to pump blood throughout the body. Your lungs will also work much harder than if you were on a level surface, and will become stronger and more conditioned,” he adds.

Researchers at the European Society of Cardiology put all of this to the test by recruiting 165 people with symptoms of coronary artery disease, such as chest pain or shortness of breath during physical activity, and challenging them to walk up four flights of stairs (or 60 steps) in under one minute. Then, they looked at their “METs,” (or “metabolic equivalents”), which are characterized by the amount of energy your body uses in a given activity. “The amount of oxygen the heart uses depends on the heart rate and the blood pressure, so the MET level has been used to determine the risk of a cardiac event in the next 10 years,” says Dr. Meshkov.

Through this “stairs test,” researchers found that participants who were able to climb the stairs in under 45 seconds achieved more than nine to 10 METS, and previous studies have shown that hitting 10 METS during an exercise test is linked to a low mortality rate (one percent or less per year, or 10 percent in 10 years). On the other hand, patients who took more than 1.5 minutes to climb the stairs maxed out at eight METs, which indicates a higher mortality rate (two to four percent per year, or 30 percent in 10 years). This comes on the heels of a 2018 study that required 12,615 participants to walk up three to four flights of stairs and found that those who weren’t able to do it quickly had nearly three times the death rate from heart disease over five years than those who were.

So what does that mean for those of us looking to test our cardiovascular health at home? “It’s a reasonably good approximation of cardiovascular fitness at one point in time,” says Dr. Meshkov. But, he adds, there are some limits to what the test can tell you, especially considering that the study only looked at people who had experienced symptoms of heart problems. “For someone who doesn’t have symptoms or shortness of breath and just wants to know how their heart is doing or how their cardiovascular health is, the stair test could certainly be a good assessment to their overall risk assessment,” he says. In other words? Walking up 60 steps in under a minute can tell you, to some extent, how your heart’s functioning, but shouldn’t stand in place of a regular stress test from a cardiologist.

Regardless of what the stairs test can or can’t tell you about your heart health, it’s still critically important to ensure you’re getting a solid dose of regular cardio. The American Heart Association recommends 150 minutes of moderate-intensity cardio exercise, like walking, per week or 75 minutes of vigorous-intensity exercise, like a dance cardio class, which pros say can improve your lung function, increase the strength of your heart and maximize the efficiency of your skeletal muscles—all of which make the body better at using oxygen. Work some cardio into your regular routine, and you’ll be flying up four flights of stairs in no time.

Need a little cardio inspiration? Follow along with the video below. 

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