Excerpts from newsroom.heart.org:

Study Highlights:
  • The majority of firefighters who died from cardiac arrest had confirmed evidence of coronary artery disease, or narrowed arteries, as well as structural heart abnormalities such as an enlarged heart and thickened walls in the left ventricle, which is responsible for pumping blood to the body.
  • Among those who died from cardiac events, coronary artery disease, an enlarged heart, thickened ventricular walls, and a history of heart attack were strong and independent risk factors for death, according to the study.
  • While firefighters face numerous dangers on the job, the leading cause of death remains sudden cardiac arrest—especially among those with pre-existing cardiovascular conditions.

New research published in the Journal of the American Heart Association, an open-access journal of the American Heart Association and American Stroke Association, reveals that firefighters who died from cardiac arrest were more likely to show signs of both atherosclerotic and hypertensive heart disease at autopsy compared to those who died from other causes.

Cardiac arrest is the most common cause of on-duty deaths among firefighters. To better understand which heart conditions are most commonly linked to these fatalities, researchers analyzed autopsy reports of U.S. male firefighters who died between 1999 and 2014. Out of 627 total deaths, 276 were due to cardiac arrest, while 351 were caused by trauma. The firefighters ranged in age from 18 to 65 years old at the time of death.

The study found that the most frequent conditions were coronary artery disease and structural heart abnormalities, including cardiomegaly (enlarged heart) and left ventricular hypertrophy (thickened heart walls). These findings highlight the critical role of underlying heart disease in firefighter fatalities.

Specific risk factors such as arterial narrowing, an enlarged heart, and a prior heart attack were strongly linked to an increased likelihood of dying from cardiac arrest. Firefighters with a history of heart attack were six times more likely to die on duty due to a cardiac event.

Sudden cardiac arrest affects about one in seven people in the U.S. It occurs when the heart’s electrical system fails, causing the heart to stop beating. Symptoms include unresponsiveness and abnormal breathing. Immediate action, such as CPR and calling emergency services, is essential for survival.

It's important to note that cardiac arrest is different from a heart attack, which is caused by a blockage in blood flow to the heart. However, heart attacks and other heart conditions can lead to cardiac arrest. Since cardiac arrest often signals undiagnosed heart disease, early screening and treatment are vital for prevention.

The study has some limitations, including variations in how heart disease was described during autopsies, the use of a fixed weight threshold for diagnosing an enlarged heart, and limited data on other risk factors like smoking and hypertension.

To reduce the risk of heart disease, the American Heart Association recommends following the Life’s Simple 7® guidelines: manage blood pressure, control cholesterol, reduce blood sugar, stay physically active, eat a healthy diet, maintain a healthy weight, and quit smoking.

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