Excerpts from newsroom.heart.org:

Study Highlights:
  • The majority of firefighters who died due to 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, the main pumping chamber of the heart.
  • Among those who died from cardiac events, conditions like coronary artery disease, an enlarged heart, thickened heart walls, and a prior heart attack were strong and independent risk factors for death in this study.
  • While firefighters face numerous dangers on the job, the biggest threat is often a sudden cardiac event—especially in individuals with pre-existing cardiovascular issues.

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 significantly 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 leading cause of job-related deaths among firefighters. To investigate which heart conditions are most commonly associated with such fatalities, researchers analyzed autopsy reports of U.S. male firefighters who died while on duty between 1999 and 2014. Out of 627 total deaths, 276 were due to cardiac arrest and 351 were trauma-related. The firefighters ranged in age from 18 to 65 at the time of death.

The findings showed that the most frequent underlying heart diseases were coronary artery disease and structural abnormalities, including cardiomegaly (enlarged heart) and left ventricular hypertrophy (thickened heart walls). These conditions were strongly linked to an increased risk of sudden cardiac death.

Specifically, firefighters with narrowed arteries, an enlarged heart, or a history of heart attacks were far more likely to die from cardiac arrest than from other causes. Those with a prior heart attack had a sixfold higher risk of dying on duty.

In the U.S., about one in seven people will die from sudden cardiac arrest. This life-threatening condition occurs when the heart's electrical system fails, causing it to stop beating. Symptoms include unresponsiveness, gasping for air, or not breathing at all. Immediate action—such as CPR and calling emergency services—is crucial for survival.

It's important to note that cardiac arrest is different from a heart attack, which happens when blood flow to the heart is blocked. However, heart attacks and other heart conditions can lead to cardiac arrest. Because cardiac arrest often signals underlying heart disease, early screening and treatment are essential.

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

To reduce the risk of heart disease, the American Heart Association recommends following its "Life’s Simple 7" guidelines: manage blood pressure, control cholesterol, reduce blood sugar, be physically active, eat better, lose weight, and quit smoking.

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