Abstract P562: Firefighters Have Worse Cardiovascular Health And Mental Health Characteristics Than Civilians And Different Blood Pressure Surge Responses To Pager Activation
Authors: Megan A Carty, Rachel L Dickinson, Emily H Reeve, Zana Lee, Emily N Blaszkow, Amber N Orfe, Concetta M Magliochetti, Julia Gilpin, Brian Varani, Meghan Lashley, Paige E DeAlba, Deborah L Feairheller
Journal: Circulation (2020)

Introduction: Heart-related incidents cause over 50% of LODD in firefighters (FF). Physical, health-related, and emotional stress are all part of the FF job; and these all increase BP levels and cardiac risk. Using ambulatory BP (ABP) monitoring to measure BP over time and quantify the BP surge with alarm is a novel way to assess risk, so we compared a group of FF to Civilians. We hypothesized that FF would have worse CV health and higher BP surges compared to civilians. Methods: We included 43 FF and 30 Civilians who completed 3 visits: ABP monitoring with pager activation, a fasted clinical appt, and fitness testing. Participants wore the ABP cuff for a 12-hr period, during which they were paged by a pager app (OnPage) or by emergency service dispatch. When the pager sounded, they were instructed to force an ABP reading to assess the BP surge. Average BP levels and surges were determined. Fasted visit included BP, body fat, lipid panel, and vascular health measures. Fitness test included a treadmill VO 2peak and a battery of other fitness tests. Participants also completed a health history form and the DASS-21 questionnaire assessing stress, anxiety, and depression. Results: We found that FF (39.4 ± 2.2 yrs) had worse CV health, better fitness, but higher stress and depression levels compared to Civilians (39.7 ± 2.7 yrs), P&lt;0.05 for differences. FF had higher clinic SBP (128.7 ± 1.7 vs 119.7 ± 1.9), clinic DBP (81.8 ± 1.2 vs 75.7 ± 1.7), central arterial pressures measured by SphygmoCor® XCEL (121.8 ± 2.7 vs 112.3 ± 2.9 and 84 ± 1.5 vs 78.3 ± 2.3), and average SBP measured by ABP (130.9 ± 1.5 vs 119.6 ± 4.3 mmHg). FF had higher Pre-Alarm SBP levels (126.9 ± 3.3 vs 112.5 ± 4.8 mmHg) but similar Post-Alarm SBP levels. Thus, FF had a smaller SBP surge with alarm (12.5 ± 2.3 vs 16.2 ± 5.5 mmHg). Clinically, FF had similar cholesterol (183.5 ± 5.3 vs 188.9 vs 9.9) and LDL levels (117.9 ± 4.8 vs 116 ± 10.2 mg/dl), had similar BF percentages (29.4 ± 1.5 vs 31.7 ± 1.5 %), but were heavier (203.9 ± 5.5 vs 182.7 ± 7.3 lbs). FF also had lower HDL (46.8 ± 2.6 vs 59.9 ± 3.6 mg/dl), percent flow-mediated dilation (8.4 ± 0.8 vs 10.1 ± 1 %), and SEVR (156.1 ± 4.1 vs 172.6 ± 5.4) levels. For fitness, FF had similar VO 2peak (35.2 ± 0.9 vs 37.1 ± 1.8 ml/kg-min) but better plank pose (110.1 ± 9.5 vs 73.8 ± 6.7), wall sit (112.7 ± 15.9 vs 59.4 ± 5.2 sec), and #steps climbed in 2 min (320.8 ± 10.1 vs 280.2 ± 11.8). FF had worse overall psychometric characteristics: higher DASS-21 total score 13.9 ± 2.3 vs 5.5 ± 1.3; depression score 5.1 ± 1.3 vs 0.7 ± 0.3; stress score 5.9 ± 0.9 vs 2.7 ± 0.7; but similar anxiety scores 2.9 ± 0.4 vs 2 ± 0.6. Conclusions: In conclusion, with this subset of baseline data, we confirmed that FF have worse CV health, stress, depression and perceived health ratings. It is known that exercise and diet can improve all of these. Therefore, our participants are currently undergoing a diet and exercise intervention to assess changes in health, psychometric scores, and BP surge levels.