Disclosures: The authors report no relevant financial disclosures.
July 12, 2021
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CVD risk factors rise with age, BMI for US firefighters

Disclosures: The authors report no relevant financial disclosures.
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Firefighters who have a higher BMI and are older are more likely to have a higher prevalence of cardiovascular disease risk factors, according to a study published in Obesity.

Cardiovascular events are the leading cause of duty-related events in the fire service,” Denise L. Smith, PhD, director of the First Responder Health and Safety Laboratory and professor of health and human physiological sciences at Skidmore College, told Healio. “Firefighters show up to work every day with the goal of protecting their communities. To do that effectively, they must also protect their own health. Everyone needs to be attentive to cardiovascular health to decrease the risk of early death or disability, but firefighters must also be attentive to cardiovascular health to ensure they can perform their public safety duties effectively and safely.”

Smith is director of the First Responder Health and Safety Laboratory and professor of health and human physiological sciences at Skidmore College.

Smith and colleagues analyzed data from 4,453 U.S. career firefighters who underwent annual medical evaluations between 2015 and 2018. The firefighters attended clinics in southern Arizona, northern Virginia, central Florida and the capital region of Indiana. Data on height, weight, blood pressure, fasting blood glucose, cholesterol and use of prescription medications were collected. The data were cross-sectionally analyzed by BMI and age groups.

There were 4,225 male firefighters (82% white) and 228 female firefighters (84% white) included in the study. Among men, 49% had overweight, 37% had obesity and 14% had normal weight. For women, 39% had overweight, 34% had normal weight and 27% had obesity. Among female firefighters with obesity, 58% had high BP and 10% had metabolic syndrome. For male firefighters, 80% had high BP and 21% had metabolic syndrome.

For male firefighters, older age and a higher BMI were associated with a higher likelihood for high BP, high cholesterol, high blood glucose and metabolic syndrome. A significant quadratic relationship was also observed with older age and a higher likelihood for high BP and high cholesterol.

“The prevalence increases with both age and BMI; 60% of firefighters 20 to 29 years old with obesity had hypertension and about 80% of 40- to 49-year-old firefighters with obesity had hypertension,” Smith said. “Among 40- to 49-year-olds with overweight, almost 70% had hypertension. Hypertension often goes unnoticed because it does not produce noticeable symptoms, but it can lead to significant coronary artery damage and can cause the heart to increase in size due to the need to produce more pressure. This greatly increases the risk of fatal arrhythmias. It is critical that firefighters receive screening for hypertension and that programs be put in place to detect and manage high blood pressure.”

When stratified by age group, having a higher BMI was associated with a higher likelihood for high BP, low HDL cholesterol, high triglycerides and metabolic syndrome for all groups. For those aged 40 to 49 years and 50 to 59 years, having a higher BMI was associated with a higher likelihood for high cholesterol and high blood glucose.

Smith said the findings reveal the importance of having strategies and programs in place to help firefighters improve and maintain their CV health.

“It is critical that we investigate the effectiveness of different programs, like fitness program and comprehensive wellness programs, to better understand what type of programming is most effective in ensuring that firefighters have the necessary cardiovascular health to do their work,” Smith said. “We also need additional research to understand how occupational factors affect cardiovascular health and how to detect early markers of disease.”

For more information:

Denise L. Smith, PhD, can be reached at dsmith@skidmore.edu.