SUMMARY Some studies suggest that fire fighters are at a higher risk of developing coronary heart disease than are males in the general population. We followed 1646 men for 10 years to determine the incidence of coronary heart disease. Subjects were participants of the Normative Aging Study, a longitudinal study of aging. Comparison of fire fighters (n = 171) and non-fire fighters (n = 1475) showed no significant difference in the incidence rates of coronary heart disease. Comparison of the groups regarding baseline risk factors revealed no material difference. These data suggest that fire fighters do not have an excess risk of coronary heart disease.MANY FACTORS might influence risk of developing coronary heart disease. Cigarette smoking,' high blood pressure,2' elevated serum cholesterol4' 5 and low levels of high-density lipoprotein cholesterol6 7 are important contributors to coronary disease risk.Other factors, such as occupation, have not been examined as extensively.Barnard and Weber8 stated that fire fighters are at a higher risk of coronary heart disease than are males in the general population. This conclusion is based in part'on U.S. census data9' 10 and on results of electrocardiographic stress testing." It has been suggested fire fighters' excess risk is due to high occupational exposure to smoke'2 or to carbon monoxide. 8 We studied the findings in 1646 participants of the Normative Aging Study, followed for 10 years to de' termine the incidence of coronary heart disease, to test the hypothesis that fire fighters have'a greater incidence of coronary heart disease than non-fire fighters. determined by a trained interviewer. Smokers were defined as men who smoked one or more cigarettes a day; all others were considered nonsmokers. Weight and height were measured with the subjects wearing only stockings and undershorts. Body mass index (weight/height2) was then calculated. MethodsSimilar examinations were repeated every 5 years on the average. The data were supplemented by information on cardiovascular illness obtained from hospital records. The data presented here were obtained from the first three examinations.The diagnostic categories of coronary heart disease under consideration include myocardial infarction, angina pectoris' and death from coronary heart disease. The criteria for myocardial infarction and angina pectoris were those used in the Framingham Heart Study.15 The records of all possible cases of myocardial infarction were reviewed by a cardiologist. Myocardial infarction was diagnosed only when documented by unequivocal electrocardiographic changes (i.e., pathologic Q waves), by a diagnostic elevation of serum enzymes (SGOT and lactic dehydrogenase) accompanying chest discomfort consistent with myocardial infarction, or by autopsy. Angina pectoris was diagnosed when the subject reported recurrent chest discomfort that lasted up to 15 minutes, was distinctly related to exertion or excitement and was relieved by rest or nitroglycerin. The diagnosis was rejected when another explanation wa...
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