Acute effects of firefighting on arterial stiffness and blood flow

Fahs, Christopher A.; Yan, Huimin; Ranadive, Sushant M.; Rossow, Lindy M.; Agiovlasitis, Stamatis; Echols, George; Smith, Denise L.; Horn, Gavin P.; Rowland, Thomas; Lane, Abbi D.; Fernhall, Bo

doi:10.1177/1358863x11404940

Cited by 59 publications

(60 citation statements)

References 45 publications

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“…3,26 This cardiovascular strain typically manifests as markedly elevated HR 3,4,15,[27][28][29] that results in increased RPP and myocardial work. Consistent with previous literature, our findings illustrate significant cardiovascular strain following EIHS compared to NHS.…”

Section: Discussionmentioning

confidence: 99%

Vascular and central hemodynamic changes following exercise-induced heat stress

et al. 2015

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This study examined the effects of moderate exercise-induced heat stress (EIHS) on vascular function, central hemodynamic load and indices of coronary perfusion. Vascular-hemodynamic measures were collected in 12 healthy men (aged 22±3 years) pre and post 100 minutes of moderate, intermittent exercise in two randomized conditions: heat stress (HS; wearing firefighter personal protective equipment (PPE)), and no heat stress (NHS; wearing a cooling shirt and equivalent PPE weight). Aortic blood pressure, reflected wave pressure (Pb), systolic (SPTI) and diastolic pressure time-integral (DPTI), and aortic stiffness were assessed before and after each condition. SPTI was significantly greater, and DPTI and Pb were significantly lower for HS-post compared to NHS-post (p<0.05). Pulse wave velocity was not different between conditions. In conclusion, EIHS does not affect aortic stiffness, but increases indices of myocardial work and reduces indices of coronary perfusion which may be related to chronotropic responses to EIHS. The mismatch between oxygen demand and oxygen supply may increase cardiac vulnerability to ischemia during strenuous work in the heat.

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Section: Discussionmentioning

confidence: 99%

Vascular and central hemodynamic changes following exercise-induced heat stress

et al. 2015

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“…They also reported that treatment with vitamin C had no effect on these hemodynamic and vascular parameters when compared to a placebo. 6 In our study, we found that exercise in thermal protective clothing resulted in a transient non-significant increase in AI followed by a significant drop in AI at 90 minutes after exertional heat stress. Additionally, we observed a beneficial effect of daily low-dose aspirin on peripheral arterial stiffness, but not on endothelial function, before and after exertional heat stress.…”

Section: Discussionmentioning

confidence: 70%

“…6 Among 69 volunteer and career firefighters, Fahs and colleagues observed increases in aortic diastolic blood pressure, heart rate, AI, pulse wave velocity and RHI, and significant decreases in brachial and aortic pulse pressure following firefighting activities. They also reported that treatment with vitamin C had no effect on these hemodynamic and vascular parameters when compared to a placebo.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,15 Furthermore, AI and pulse wave velocity have been observed to increase with firefighting activities. 6 Increased AI, indicating enhanced arterial wave reflections and peripheral arterial stiffness, leads to increased left ventricular (LV) afterload and mechanical strain of the LV, 19 and is an early manifestation of vascular disease. 20 In a recent study, increased AI was also found to be predictive of future cardiovascular events and all-cause mortality in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is thought that the combination of high levels of heat stress and physical exertion lead to sudden cardiac events in susceptible firefighters 2,3 through hyperthermia, dehydration, inflammation and considerable cardiovascular strain. 4,5 Research also indicates that prolonged periods of firefighting have an unfavorable impact on vascular function, including increased arterial stiffness and wave reflection, 6 both of which predict all-cause and cardiovascular mortality in the general population. 7,8 Subclinical vascular dysfunction may mediate the link between firefighting activities and sudden cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

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Effect of aspirin on acute changes in peripheral arterial stiffness and endothelial function following exertional heat stress in firefighters: The factorial group results of the Enhanced Firefighter Rehab Trial

et al. 2015

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Peripheral arterial stiffness and endothelial function, which are independent predictors of cardiac events, are abnormal in firefighters. We examined the effects of aspirin on peripheral arterial stiffness and endothelial function in firefighters. Fifty-two firefighters were randomized to receive daily 81 mg aspirin or placebo for 14 days before treadmill exercise in thermal protection clothing, and a single dose of 325 mg aspirin or placebo immediately following exertion. Peripheral arterial augmentation index adjusted for a heart rate of 75 (AI75) and reactive hyperemia index (RHI) were determined immediately before, and 30, 60, and 90 minutes after exertion. Low-dose aspirin was associated with lower AI75 (-15.25±9.25 vs −8.08±10.70, p=0.014) but not RHI. On repeated measures analysis, treatment with low-dose aspirin before, but not single-dose aspirin after exertion, was associated with lower AI75 following exertional heat stress (p=0.018). Low-dose aspirin improved peripheral arterial stiffness and wave reflection but not endothelial function in firefighters.

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Overexertion and heat stress in the fire service: a new conceptual framework

Wohlgemuth

Sekiguchi

Mota

2023

American J Industrial Med

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From the year 2000, the United States Fire Administration (USFA) has been recording all line‐of‐duty deaths in the fire service. Stress or overexertion caused 1096 out of 2598 total line‐of‐duty deaths in the United States from 2000 to 2021. Those deaths due to stress or overexertion were further classified as myocardial infarction (90%), cerebrovascular accident (6.8%), other (2.6%), and heat exhaustion (0.6%). Environmental heat exposure is a concern in firefighting, as firefighters work in extreme conditions, such as high ambient temperatures, while wearing protective clothing. Heat stress is not only hazardous to the cardiovascular system, but may accentuate muscle fatigue and overexertion. In addition, overexertion itself is related to increased incidence of musculoskeletal injuries, usually to the lower extremities. Further, there is a strong physiological mechanistic link to suggest that the increased occupational heat exposure and thermoregulatory strain firefighters experience may be a stressor that increases the risk of injuries. This commentary hopes to show the need for further research on the effects of occupational exposures and physiological strain in the fire service.

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Acute effects of firefighting on arterial stiffness and blood flow

Cited by 59 publications

References 45 publications

Vascular and central hemodynamic changes following exercise-induced heat stress

Vascular and central hemodynamic changes following exercise-induced heat stress

Effect of aspirin on acute changes in peripheral arterial stiffness and endothelial function following exertional heat stress in firefighters: The factorial group results of the Enhanced Firefighter Rehab Trial

Overexertion and heat stress in the fire service: a new conceptual framework

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