02 Understanding and Reducing Cardiovascular Disease... Flashcards
Sudden cardiac events are the #1 cause of LODDs in the fire service. They account for approximately ______ of all FF duty-related deaths.
45%
Additionally, for every duty-related fatal cardiac event, approximately ______ duty-related nonfatal events are reported.
25
32% of deaths occurred during fire suppression despite firefighting accounting for only ________ of annual time on the job.
1-5%
In terms of risk, this translates to an estimated _______ higher risk of death from heart disease during fire suppression than during non-emergency duties.
10 to 100 times
Contributing factors to the cardiovascular strain of firefighting:
- Activation of the sympathetic nervous system
- Heavy muscular work
- Heat stress
- Dehydration
- Severe envinronmental conditions
Physiological Disruptions that may or may not be noticable
- Cardiovascular
- Increase in HR, BP, Arterial stiffness, and a decrease in stroke volume
- Hematological
- Increase in clotting potential (thrombus) and decrease in plasma volume
Stroke volume decreased by ____ after firefighting,
13%
Other bad cardiovascular things that happen after firefighting:
- reduction in left ventricular diastolic size and volume
- left ventricular shortening fraction
- Shortening of ejection time
Cardiovascular Strain of firefighting
- Maximal or near maximal heart rates (~190 bpm)
- Decreased stroke volume (decreased by 13-30%)
- Increased arterial stiffness
- Reduced plasma volume (decreased 15%)
- Increased blood clotting potential
Who is at risk of sudden cardiac death?
Firefighters with
1. An excess of cardiovascular disease risk factors
2. A previous diagnosis of CVD
3. Undetected structural heart disease
4. Any combo
Risk of On-duty Coronary Heart Disease Death by Risk Factor
Risk Factor - Odds Ratio
Age > 45 - 18.0
Current Smoking - 8.6
Hypertension - 12.0
Obesity (BMI > 30) - 3.1
Cholesterol (> 200mg/dL) - 4.4
Diabetes Mellitus - 10.2
Prior diagnosis of coronary heart disease - 35.0
Coronary Heart Disease (CHD) accounts for approximately ______ of all CVD.
50%
CHD results from damage to the coronary arteries supply the heart muscle (myocardium).
Steps to Prevent Cardiovascular Events
- Get an appropriate medical evaluation
- Maintain a high level of physical fitness
- Eat a healthy diet and avoid excess body fat
- Get adequate sleep
- Embrace a wellness-related lifestyle
- Minimize smoke exposure
- Follow FD guidelines for rehab during emergency ops and training
NFPA 1582 requires a minimum aerobic capacity of
12 METS
Aerobic fitness is also associated with many health benefits (for each 1 MET increase in aerobic capacity)
- 13% reduction in risk of all-cause mortality
- 15% reduction in risk of coronary heart disease and cardiovascular disease
Benefits of Fitness
Increase in
- Work capacity
- Cardiac efficiency
- Muscular strength and endurance
- Thermal tolerance
- Plasma volume
- Clotting potential
- Metabolism
- Sleep quality
Decrease in cardiovascular risk
Studies support the Mediterranean diet in reducing
- All-cause mortality
- CVD morbidity and mortality
- Cancer mortality
- Diabetes
- Obesity
- Risk of dementia
- Risk of other chronic diseases
Recommended Practices for Obtaining Proper Rest
- Get at least 8 hours of sleep on nights you are not on shift
- Consider day time naps
- Keep sleeping quarters as quiet as possible to permit sleep
Minimize Smoke Exposure: Particulate matter is associated with
- Increased BP
- May promote arrhythmias
- Promote the progression of atherosclerosis
- Increased coagulatory potential
- Which increases risk of myocardial infarction
- Cellular reactions leading to tissue hypoxemia and myocardial ischemia
Rehab provides time for
- rest
- rehydration
- cooling
- medical monitoring
