Understanding cardiovascular risks to first responders

Cardiac disease poses a significant risk to first responders, necessitating our commitment to detecting and preventing it. The familiar terms of cardiac disease, heart attacks, and plaque build-up have likely affected you or someone you know within the realm of cardiovascular health. However, these issues can be largely avoided.

By enhancing our comprehension of how these problems manifest in first responders and implementing early identification measures, we can avert career- or life-threatening cardiac events. Ultimately, this approach ensures the safety and well-being of first responders throughout their careers and into retirement.

In a recent Lexipol webinar titled “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., delve into strategies for mitigating the risks of cardiovascular disease, alongside Lexipol’s Strategic Wellness Director Mandy Nice.

The research unequivocally demonstrates the elevated risk of cardiovascular disease among first responders, surpassing that of the general population both in terms of prevalence and early onset. Consider the following statistics:

• The average age for a first heart attack in the general population is 65, while for law enforcement officers, it is 46.
• The life expectancy of the general population is 79, whereas studies indicate the life expectancy of law enforcement officers to be only 57.
• First responders face an 18-fold increase in the risk of sudden cardiac death once they reach the age of 45, with even higher risks associated with hypertension and smoking.
• Stress, overexertion, heart attacks, and strokes account for 55% of firefighter line-of-duty deaths.

This problem affects public safety professionals across the board, but it is predominantly preventable.

During or after incident response, underlying heart issues, stress, and decreased plasma volume can become apparent. Often, cardiac events occur during the recovery phase following the strain of response rather than while on duty. Hence, it is crucial to identify these risks before tragedies occur.

Chief Kerrigan emphasizes, “If this doesn’t underscore the importance of early detection in first responders, I don’t know what will.” He adds, “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.”

Given the high risk faced by first responders, it is imperative that we diligently detect and prevent cardiac disease. Fortunately, we now possess the technology to identify blockages and other early signs of heart disease, even before symptoms manifest.

1. Imaging Modality:

• Coronary artery calcium scoring: This low-dose CT scan measures calcium levels in the heart to identify plaque build-up.
• Carotid ultrasound: This non-invasive test provides insight into early plaque build-up and artery inflammation in the neck.

2. Coronary Inflammatory Markers: These markers specifically indicate inflammation within the cardiovascular system, rather than overall body inflammation.

• Lp-Pla2 markers
• Oxidized LDL

3. Standard or Advanced Lipid Panel:

• Cholesterol testing is essential for everyone. However, conventional cholesterol tests based on general population ranges may not sufficiently assess the risk of cardiac issues for first responders. Therefore, cholesterol testing should be complemented with other screening modalities.

Dr. Sheinberg emphasizes, “It doesn’t have to be everything. 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.

From an agency perspective, safeguarding personnel from their number one killer—cardiac disease—makes perfect sense. We possess the data and knowledge to identify cardiac issues and address them, so why are we not taking action? Furthermore, prevention also makes financial sense. Cardiac events can cost agencies up to $750,000 each, while the expenses for pre-symptomatic screenings are comparatively minimal.

Chief March explains, “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. 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 due to heart disease than it will to gunfire.”

It is essential to allocate sufficient time for personnel to receive the necessary care and to encourage and empower them to take their health seriously. This includes undergoing annual physicals, collaborating with doctors for appropriate screenings, and maintaining physical well-being.

Cardiac events are largely predictable and preventable. Public safety professionals must take proactive steps to protect their health, and agencies must support them in this endeavor. To learn more about the risks, detection, and intervention regarding cardiac disease, watch the on-demand webinar provided by Lexipol.