- Researchers say how quickly a person can walk up four flights of stairs may be an indicator of their heart health.
- Experts note that cardiologists use stair climbing in some physical exams, but the exercise shouldn’t be a substitute for regular checkups.
- They also say there are other tasks, such as carrying a bag of groceries to a car, that can be used as a preliminary gauge of heart health.
A simple and free test of your heart health is as close as your nearest high-rise building.
Researchers from Spain say that being able to climb four flights of stairs in under a minute is an accurate indicator of good cardiac health.
“The stairs test is an easy way to check your heart health,” said Dr. Jesús Peteiro, a cardiologist at University Hospital a Coruña and a study author. “If it takes you more than one and a half minutes to ascend four flights of stairs, your health is suboptimal and it would be a good idea to consult a doctor.”
The study presented at a recent scientific meeting of the European Society of Cardiology compared the results of the stair-climbing test to those obtained from exercise testing conducted in a lab.
The research hasn’t yet been peer reviewed or published in a scientific journal.
The 165 study participants each walked or ran on a treadmill until exhaustion with their exercise capacity measured as metabolic equivalents (METs).
After a rest period, the study group climbed four flights of stairs (60 steps) at a fast but non-running pace, then had their METs measured again.
Participants who climbed the stairs in less than 40 to 45 seconds achieved more than 9 to 10 METs.
Past studies have shown that achieving 10 METs during an exercise test is linked with a low death rate (1 percent or less per year, or 10 percent over a 10-year span).
Participants who took 1.5 minutes or longer to climb the stairs achieved less than 8 METs, which translates to an anticipated death rate of 2 to 4 percent per year, or 30 percent in 10 years.
Imaging of heart function during the tests revealed that 58 percent of the participants who took more than 1.5 minutes to climb the stairs had abnormal heart function during exercise.
That compared to 32 percent of those who climbed the stairs in less than a minute.
Nearly 1 in 3 study participants who climbed the stairs quickly still demonstrated abnormal heart function — a possible marker for coronary heart disease.
That fact demonstrates why the stair-climbing test shouldn’t be viewed as a substitute for more comprehensive evaluations, said Dr. Renee Bullock-Palmer, a cardiologist and director of the Women’s Heart Center and director of noninvasive cardiac imaging at the Deborah Heart and Lung Center in New Jersey.
“Based on the study, the ability to climb stairs can be used as a crude way to assess one’s physical function that may be predictive of overall heart health,” Bullock-Palmer told Healthline.
“However, I believe that this crude self-assessment cannot take the place of a proper physical exam, and history by a physician, and a proper, appropriately indicated stress test,” she said.
Dr. Nicole Harkin, founder of the online heart health practice Whole Heart Cardiology, agreed.
“During a more typical stress test, sometimes we see evidence of heart problems (like changes in the EKG or the sonogram), even if a patient doesn’t have symptoms,” she told Healthline. “Other times we pick up other issues, like dangerous blood pressure changes or heart rhythm issues, that would be missed with this kind of test.”
All study participants had symptoms associated with coronary artery disease, such as chest pain or shortness of breath during exercise.
“The idea was to find a simple and inexpensive method of assessing heart health,” Peteiro told Healthline. “This can help physicians triage patients for more extensive examinations.”
Doctors often use stair climbing to assess heart health, noted Harkin.
“It’s an exercise that gets your heart rate up relatively quickly,” she said. “Typically, if there’s an issue like a blocked heart artery, people tend to get symptoms (like chest pain or shortness of breath) at higher heart rates. We often use a person’s ability to climb a flight or two of stairs without issue as a sign that they should probably do OK during surgery,” she said.
Dr. Oyere K. Onuma, a cardiologist at Yale Medicine and assistant professor of medicine at Yale, told Healthline that the stair-climbing test is useful but has its limitations.
“The big advantage of this method is its ease. It can be done almost anywhere with very little requirement in terms of equipment or personnel. It is also much cheaper and faster to do than the traditional stress tests and can be repeated multiple times to track any progress or changes in functional ability,” Onuma said.
“However, the flip side of this is that the test is not standardized… the type of stairs, speed of climbing the stairs, timing of effort can differ,” she said. “This method also significantly limits the evaluation of patients with limited mobility and elderly patients, who may have more mechanical difficulty with climbing stairs.”
“As a physician, it’s important to evaluate each patient and assess his or her current capabilities and state of health,” said Dr. Jeremy Pollock, a cardiologist with the University of Maryland St. Joseph Medical Center.
“As an example, a frail 80-year-old, mostly sedentary patient should never be asked to walk up a flight of stairs,” he said. “Being able to complete a short duration of strenuous exercise is a nice predictor that a patient is relatively low risk in the short term from a cardiovascular perspective.”
Fortunately, stair climbing isn’t the only way to do a cardiac self-assessment, Pollock said.
“Factors such as whether or not they can walk two city blocks or carry grocery bags to their car, or numerous other regular activities of daily living, can be used as indicators of cardiovascular health,” Pollock said.
“Exercise ability is always a great indicator of overall heart health,” Harkin said. “If your ability to complete a moderate- to vigorous-intensity exercise program ever changes, that’s a good sign something may be going on, and you should contact your doctor.”
“You can also monitor for things like heart rate recovery (how long it takes for your heart rate to decrease after intense exercise) as an indicator of how your heart is doing,” she added.
“Also, as wearables and health tech continue to improve and become more mainstream, we will increasingly be able to use data gathered at home, like heart rate variability, to inform us about our heart health,” Harkin said.
Dr. Deane Waldman, a professor emeritus of pediatrics, pathology, and decision science as well as a former director of the Center for Healthcare Policy at the Texas Public Policy Foundation, cautioned that many older adults and people with diabetes have joint issues.
“Climbing stairs is hard on the knee joint,” he told Healthline.
Those people may or may not be able to perform the stair-climbing stress test. But they should generally avoid stair climbing as a form of regular exercise, said Waldman.
“The problem with using stairs for workouts is the descent,” said Paul Johnson, founder of Complete Tri, which provides training advice for fitness enthusiasts.
“Climbing downstairs puts significant force on the knees. Be sure that you walk down carefully, taking care of your joints, after going upstairs,” he said.
