Cardiovascular Disease Risk Factor Changes Over 5 Years Among Male and Female US Firefighters

Smith, Denise L.; Graham, Elliot; Stewart, D. Scott; Mathias, Kevin C.

doi:10.1097/jom.0000000000001846

Cited by 36 publications

(71 citation statements)

References 17 publications

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“…Hypertension prevalence has been shown to increase with age in the general population [27], and in 2002, using the hypertension cut-off values of that time (≥140/90 mmHg), Davis and colleagues reported a hypertension prevalence of 12.0% among young firefighters and 31.6% in older firefighters [24]. While not formally tested in our study, female firefighters had lower blood pressure values than male firefighters on average, which is consistent with previous findings [22,23]. The results of this study, however, extend previous research by showing that female firefighters' blood pressure reached values more similar to male firefighters at older ages.…”

Section: Discussionsupporting

confidence: 90%

“…To date, studies on hypertension and other CVD risk factors in firefighters have generally reported on small sample sizes, limited geographical regions, a select group of firefighters, and mainly males [17][18][19][20][21][22][23]. Currently, only one study has investigated blood pressure and hypertension across different age groups of firefighters [24], and studies that have compared hypertension in the fire service to the general population have found mixed results and were based on small samples [17,19,20,24].…”

Section: Introductionmentioning

confidence: 99%

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Hypertension in the United States Fire Service

Khaja

Mathias

Bode

et al. 2021

IJERPH

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Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Hypertension in the United States Fire Service

Khaja

Mathias

Bode

et al. 2021

IJERPH

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“…Obesity is highly prevalent among US firefighters (24–35%) [ 1 – 5 ] and is associated with impaired work performance [ 6 ], increased risk of injury [ 7 , 8 ] and duty-related sudden cardiac events [ 9 ]. Sudden cardiac events are the leading cause of duty-related deaths in the fire service [ 10 ], and coronary heart disease and structural heart changes (cardiomegaly and LVH) have been identified in over 80% of cardiac cases [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several longitudinal studies have shown that, on average, firefighters gain weight as they age (~ 0.5 kg/yr) [ 5 , 18 , 19 ] and that firefighters who gained weight over a 5-year period had adverse changes in cardiovascular health [ 20 ]. Previous studies, reporting on data from the 1980s and 1990s, suggests that while both age groups gain weight over time, younger firefighters gain more weight each year than older firefighters [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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

Mathias

Stewart³

et al. 2021

BMC Public Health

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Background Research consistently finds that, on average, firefighters gain weight over time and some data indicate that younger firefighters are more likely to gain weight than older firefighters. The purpose of this study was to estimate the 5-year weight change among younger and older US firefighters. Methods Data from two occupational medical exams separated by 5 years (2009–2016) were examined from a cohort of US career firefighters in Virginia (males, n = 589; females, n = 67). The cohort was grouped into two age categories (< 45 years and ≥ 45 years). Weight change subgroups were Loss (decrease of > 3% body weight), Stable (within ±3% body weight) and Gain (increase of > 3% body weight). Multinomial logistic regression models and linear regression models were conducted to examine differences in the probability of being in a particular weight change category, weight change overall and by weight change category between younger and older firefighters. Results At baseline, 25 and 35% of younger (< 45 years) and older (≥ 45 years) were obese, respectively. Younger firefighters gained significantly (P < 0.05) more weight (3.0 ± 0.2 kg) than older firefighters (0.8 ± 0.5 kg). Younger firefighters were more likely to gain weight (53% versus 39%) and less likely (10% versus 20%) to lose weight as compared to older firefighters. Smaller weight gains were associated with age and BMI with the smallest increases observed in overweight and obese firefighters ≥45 years of age. Conclusions Health care providers should be attentive to weight gain, even among young non-obese firefighters, and counsel firefighters to avoid the additive risks of being older and heavier. In addition, weight loss/management programs should be promoted in the fire service to encourage healthy body weight and to prevent unhealthy weight gain among both young and old firefighters alike.

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“…The prevalence of low fitness, obesity, and cardiovascular disease (CVD) risk factors, such as hypercholesterolemia, hypertension, and high blood glucose, among United States (US) career firefighters is high [ 1 ]. When these risk factors interact with the strenuous physical activity, emotional stress, and environmental pollutants characteristic of the firefighter profession, the risk of CVD events is increased [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Anthocyanin Intake and Physical Activity: Associations with the Lipid Profile of a US Working Population

et al. 2020

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While growing evidence exists on the independent associations between anthocyanins and physical activity on cardiovascular disease (CVD) risk determinants, the possible interaction between these exposures has not yet been studied. We aimed to study the potential synergism between anthocyanin intake and physical activity on lipid profile measures. This cross-sectional study was conducted among 249 US career firefighters participating in the Feeding America’s Bravest trial. Anthocyanin intake was calculated using a validated food frequency questionnaire (FFQ) and physical activity level by a validated questionnaire. Multivariable linear regression models determined the extent to which anthocyanin intake and physical activity predicted lipid parameters. Generalized linear models were used for joint effect and interaction analyses on the multiplicative and additive scales. Both anthocyanins and physical activity were independently inversely associated with total cholesterol:high density lipoprotein (HDL) cholesterol. Only physical activity was inversely associated with triglycerides, low density lipoprotein (LDL) cholesterol:HDL, and triglycerides (TG):HDL. Although the combined exposure of low anthocyanin intake and low physical activity was associated with lower (RR = 2.83; 95% CI: 1.42 to 5.67) HDL cholesterol <40 mg/dL, neither multiplicative (p = 0.72) nor additive interactions were detected (relative excess risk due to interaction (RERI): 0.02; 95% CI: −1.63 to 1.66; p = 0.98). Our findings provide insight on the potential synergism between anthocyanin intake and physical activity on the lipid profile.

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Cardiovascular Disease Risk Factor Changes Over 5 Years Among Male and Female US Firefighters

Cited by 36 publications

References 17 publications

Hypertension in the United States Fire Service

Hypertension in the United States Fire Service

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

Anthocyanin Intake and Physical Activity: Associations with the Lipid Profile of a US Working Population

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