Understanding cardiovascular risks to first responders

Because we know how high the risk is for first responders, we must be diligent in detecting and preventing cardiac disease


Cardiac disease. Heart attacks. Plaque build-up. These terms are probably familiar to you as cardiovascular health issues have almost certainly had a direct impact on you or someone you know. But these problems are largely preventable.

If we increase our understanding of how these problems arise in first responders and take steps to identify them early on, we can prevent career- or life-ending cardiac events and ultimately ensure safe and healthy lives through first responders’ careers and into retirement.

In a recent Lexipol webinar, “Cardiac Disease: 3 Ways to Fight the #1 First Responder Killer,” Fire Chief (Ret.) Dan Kerrigan, Police Chief (Ret.) Noel March and cardiologist Jon Sheinberg, M.D., discuss how to mitigate the risks of cardiovascular disease with Lexipol’s Strategic Wellness Director Mandy Nice.

The risks

The research has spoken: The risk of cardiovascular disease to first responders is too high to ignore. Cardiac issues affect first responders at higher rates – and earlier in life – than civilians. Just take a look at the numbers:

  • In the general population, the average age of a first heart attack is 65; for law enforcement officers, that age is 46.
  • The life expectancy for the general population is 79, while one study put the life expectancy for law enforcement officers at only 57.
  • The risk of sudden cardiac death increases by 18 times when first responders reach the age of 45. That risk is even higher with hypertension and smoking.
  • 55% of firefighter line-of-duty deaths are due to stress, overexertion, heart attacks and strokes.

This is a problem across the board for public safety professionals – and it’s largely a preventable one.

Underlying heart issues, stress and decreased plasma volume can be revealed during or after incident response. Often, cardiac events occur in personnel when they are recovering from the strain of response, not necessarily while on duty. What’s critical is that we discover these risks before a tragedy takes place.

“If this doesn’t underscore the importance of early detection in first responders, I don’t know what will,” said Chief Kerrigan. “We can exercise and eat right and do all those things for ourselves, but probably the most basic aspect of any health and wellness program is to get checked.”

Early detection

Because we know how high the risk is for first responders, we must be diligent in detecting and preventing cardiac disease. We now have the technology to identify blockages and other signs of heart disease in the early stages, when it’s pre-symptomatic.

Dr. Sheinberg highlights three modalities for early screening in first responders:

1. Imaging modality

  • Coronary artery calcium scoring: This is a low-dose CT scan that identifies plaque build-up through measuring calcium levels in the heart.
  • Carotid ultrasound: This test is a very simple, non-invasive early screening that allows doctors insight into early plaque build-up and inflammation in arteries of the neck.

2. Coronary Inflammatory Markers: These markers do not indicate all-body inflammation but are specific to the cardiovascular system.

  • Lp-Pla2 markers
  • Oxidized LDL

3. Standard or Advanced Lipid Panel:

  • Everybody needs to have their cholesterol checked. However, typical cholesterol testing using the range for the general population do not always reveal the risk first responders have for cardiac issues, underscoring the need that cholesterol testing should be paired with other screening modalities.

“It doesn’t have to be everything,” explains Dr. Sheinberg. “We can’t expect all of our first responders to get every test done. But what we have to do is empower the individuals…” to advocate for their health.

An agency perspective

From an agency perspective, it makes sense to protect your people from their number one killer – cardiac disease. We have the data, we know how to look for cardiac issues and address them, so why aren’t we doing anything about it? Even financially, prevention makes sense. It can cost agencies up to $750,000 per cardiac event, while the cost for pre-symptomatic screenings is comparatively a drop in the bucket.

“The financial dimension of this solvable, preventable risk to the health of our first responder community is a business decision that can be justified all day long,” explains Chief March. “We spend about as much on Kevlar or bullet-resistant vests for our police officers – and replace them every five years – for the same cost of one full cardiac screening for that officer. And it is 25 times more likely that your career as a police officer will end to heart disease than it will to gunfire.”

Take time to ensure your personnel receive the care they need and encourage and empower them to take their health seriously – by getting annual physicals, working with doctors to get the appropriate screenings and maintaining their physical health.

Cardiac events are largely predictable and preventable. Public safety professionals must begin taking steps to protect their health – and agencies must support them. Learn more about cardiac disease risks, detection and intervention in the on-demand webinar, “Cardiac Disease: 3 Ways to Fight the #1 First Responder Killer.”

Watch the on-demand webinar, “The Emerging Science of Improved Health & Resilience for Fire & EMS” for more information about how aging and stress contribute to overall first responder health, and where improvements can be made to enhance quality of life.

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