Prospective Surveillance of Hypertension in Firefighters

Abstract

The authors evaluated blood pressure and antihypertensive medication use in 334 firefighters in an occupational medical surveillance program. Firefighters received written summaries of their examination results, including blood pressures, and were encouraged to see their personal physicians for any abnormal results. The mean age of the participants was 39 years, and the vast majority were men (n=330). The prevalence of hypertension was 20% at baseline (1996), 23% in 1998, and 23% in 2000. Among firefighters with high blood pressure readings, only 17%, 25%, and 22% were taking antihypertensive medications at the baseline, 1998, and 2000 examinations, respectively. Medical surveillance was effective in detecting hypertension in firefighters; however, after 4 years of follow-up, only 42% of hypertensives were receiving treatment with medications, including only 22% of firefighters with hypertensive readings. Overall, 74% of hypertensives were not adequately controlled. Possible reasons for low treatment rates may be the inadequate recognition among primary care physicians that mild hypertension is a significant risk factor for cardiovascular disease.

Blood pressure and heart rate responses in volunteer firefighters while wearing personal protective equipment

“…In a population of volunteer firefighters, we confirmed what other studies have reported; firefighters may have increased cardiovascular risk [4,5,7]. The volunteer firefighters in our study were inactive, had low fitness levels, were overweight or obese, and had prehypertension.…”

“…The average weight of the firefighting PPE was 54.2 3.5 lbs. The volunteer firefighters had several cardiovascular risk factors, confirming what other studies have found [7,21]. The average BMI of the firefighters was 30.8 6.3 kg/m 2 , with most participants being overweight (23%) or obese (44%), similar to other studies [21] The average resting BP of the firefighters was 129.4/75.1 mmHg, which is classified as prehypertension.…”

“…BP awareness continues to be low, whereas hypertension rates continue to be high [2]. Hypertension control also remains a problem among both the general population and firefighters [1,7]. Supporting this, Soteriades et al [7] reported that 74% of hypertensive firefighters did not have adequate control of their BP.…”

“…Hypertension control also remains a problem among both the general population and firefighters [1,7]. Supporting this, Soteriades et al [7] reported that 74% of hypertensive firefighters did not have adequate control of their BP. Thus, it is important to increase the awareness of BP levels in firefighters, both at rest and under different work conditions.…”

Firefighter Heart Presumption Retirements in Massachusetts 1997???2004

“…We have previously shown that hypertension and dyslipidemia are often inadequately treated among professionally active Massachusetts firefighters and that uncontrolled hypertension is associated with a higher risk of adverse changes in employment status. [15][16][17] Therefore, we believe that risk factor screening alone is insufficient, and fire department medical programs should include incentives to promote more aggressive risk factor reduction. These should include measures for progressively controlling hypertension, 17,26 which is a treatable illness yet one whose failure to control accounted for almost 10% of heart retirements and most likely contributed to others.…”