Analysis of Cardiovascular Risk Factors in a Wellness-Fitness Program for Career Firefighters

Background: Sudden cardiac death remains the primary cause of on-duty death among career firefighters in the United States. Previous research has established that many of these deaths are contributed to by underlying cardiovascular disease. Methods: 109 male career firefighters participated in a Wellness-Fitness program over 11 years which included annual physical exams, laboratory testing, physical examination, and maximal or sub-maximal stress treadmills. Body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol, high density (HDL) and low density cholesterol (LDL), cholesterol ratios, triglycerides and METs achieved was analyzed using hierarchical linear modeling to determine if there was any change within individuals, or within the group, over the 11-year period. Results: Negative findings were that BMI and DBP increased slightly over the period. Neutral findings were that triglycerides, HDL, cholesterol ratios, and sub-maximal estimated METs remained unchanged. Positive findings were that SBP, total cholesterol, and LDL decreased and estimated maximal METs increased. Time and age were the most influential with the exception of total cholesterol and LDL which were significantly influenced by the use of statins. Conclusion: The program implemented did facilitate improvement of cardiovascular risk factors, especially in terms of total cholesterol, LDL, SBP, and maximal exercise treadmill METs. The cardiovascular risk profile of this group did not worsen over the eight years of intervention. As cardiovascular disease has significant latency throughout the lifespan it will be critical to continue to assess risk factors and any cardiovascular events for further determination of the program's efficacy