A Cross-Sectional Examination of 10-Year Atherosclerotic Cardiovascular Disease Risk Among US Firefighters by Age and Weight Status

Abstract

Objective: Examine atherosclerotic cardiovascular disease (ASCVD) risk scores by age and weight status in career firefighters. Methods: Medical examinations for firefighters more than or equal to 40 years ( n = 644) were examined. ASCVD 10-year risk scores were calculated from sex- and race-specific equations and were reported by three age (40 to 44.9, 45 to 49.9, more than or equal to 50 years) and weight (normal, overweight, obese) categories. Results: Mean risk scores were 1.8%, 3.5%, and 6.2% for firefighters 40 to 44.9, 45 to 49.9, and more than or equal to 50 years, respectively. The association of weight status with increased ASCVD risk was higher ( P < 0.01) among older firefighters, where risk was 0.8% (95% confidence interval [CI]: 0.6 to 1.1) and 2.3% (95% CI: 2.0 to 2.6) among normal versus obese 40 to 44.9 year olds, and 4.1% (95% CI: 3.1 to 5.3) and 7.8% (95% CI: 6.7 to 8.9) among normal versus obese more than or equal to 50 year olds. Conclusions: While firefighters cannot avoid aging, physicians should counsel firefighters with weight-maintenance or weight-loss advice to prevent and manage elevated ASCVD risk.

Low testosterone and cardiometabolic risks in a real-world study of US male firefighters

“…Several integrating processes linking NAFLD to the complex network of cardiometabolic factors have been proposed, including low-grade inflammation due to increased secretion of deleterious hepatokines, hyperinsulinemia and hyperglycemia, atherogenic dyslipidemia, endothelial disfunction and thrombogenesis 29 . However, to our knowledge, there is no previous study on the prevalence of NAFLD in firefighters, which is remarkable considering the high prevalence of traditional CV risk factors among these men 17,18,21,22 .…”

“…A direct or reverse causality is yet to be clarified 12 due to complex interactions between TT and CV health, especially in firefighters. Testosterone deficiency (TD) and CV diseases share common risk factors, such as obesity and metabolic syndrome 13,14 , which are highly prevalent among firefighters [15][16][17][18] .Clinically, low testosterone is most commonly associated with increased visceral obesity, loss of muscle mass, fatigue, loss of bone strength, altered mood and low sex drive 8 . In regards to firefighters, the screening for testosterone deficiency is particularly relevant because: (a) firefighting independently induces a pro-coagulatory state 4,19,20 ; (b) firefighting can impair vascular function which may be further potentiated by testosterone imbalances; (c) firefighters commonly exhibit multiple risk factors that are associated with low testosterone levels, including obesity, metabolic dysfunction and sleep disturbance [21][22][23] .…”

“…A direct or reverse causality is yet to be clarified 12 due to complex interactions between TT and CV health, especially in firefighters. Testosterone deficiency (TD) and CV diseases share common risk factors, such as obesity and metabolic syndrome 13,14 , which are highly prevalent among firefighters [15][16][17][18] .…”

Rapid review of the literature on medical-occupational requirements for firefighters Working Paper

“…La causa principal de muerte en los bomberos son los eventos cardiacos repentinos. (13). Según el New England Journal of Medicine el 39 % de las muertes en los servicios de bomberos de EE.…”

Differences in 5-year weight change between younger and older US firefighters

“…Weight gain in older firefighters is also of particular concern, given that the risk of sudden cardiac death dramatically increases with age among firefighters [ 23 ]. The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event based on the pool-cohort equations [ 24 ] was 0.8 and 2.3% among normal versus obese 40–45 year old firefighters and 4.1 and 7.8% among normal versus obese ≥50 year old firefighters [ 25 ].…”