TY - JOUR
T1 - Blood pressure in firefighters, police officers, and other emergency responders
AU - Kales, Stefanos N.
AU - Tsismenakis, Antonios J.
AU - Zhang, Chunbai
AU - Soteriades, Elpidoforos S.
N1 - Funding Information:
acknowledgments: The study was supported in part by grant number EMW-2006-FP-01493 from the US Department of Homeland Security. The funding agency had no involvement in study design, data analysis, writing of the paper, and/or the decision to submit the paper for publication.The contents are solely the responsibility of the authors and do not necessarily reflect the views of the US Department of Homeland Security. S.N.K. conceived of the idea for the paper. a.j.T. and C.Z. identified the relevant literature. all authors reviewed part of the medical literature. S.N.K. and a.j.T. wrote the first draft of the manuscript. all authors contributed to, read and approved of the final version of the manuscript.
PY - 2009/1
Y1 - 2009/1
N2 - Elevated blood pressure is a major risk factor for cardiovascular morbidity and mortality. Increased risk begins in the prehypertensive range and increases further with higher pressures. The strenuous duties of emergency responders (firefighters, police officers, and emergency medical services (EMS) personnel) can interact with their personal risk profiles, including elevated blood pressure, to precipitate acute cardiovascular events. Approximately three-quarters of emergency responders have prehypertension or hypertension, a proportion which is expected to increase, based on the obesity epidemic. Elevated blood pressure is also inadequately controlled in these professionals and strongly linked to cardiovascular disease morbidity and mortality. Notably, the majority of incident cardiovascular disease events occur in responders who are initially prehypertensive or only mildly hypertensive and whose average premorbid blood pressures are in the range in which many physicians would hesitate to prescribe medications (140-146/88-92). Laws mandating public benefits for emergency responders with cardiovascular disease provide an additional rationale for aggressively controlling their blood pressure. This review provides a background on emergency responders, summarizes occupational risk factors for hypertension and the metabolic syndrome, their prevalence of elevated blood pressure, and evidence linking hypertension with adverse outcomes in these professions. Next, discrepancies between relatively outdated medical standards for emergency responders and current, evidence-based guidelines for blood pressure management in the general public are highlighted. Finally, a workplace-oriented approach for blood pressure control among emergency responders is proposed, based on the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
AB - Elevated blood pressure is a major risk factor for cardiovascular morbidity and mortality. Increased risk begins in the prehypertensive range and increases further with higher pressures. The strenuous duties of emergency responders (firefighters, police officers, and emergency medical services (EMS) personnel) can interact with their personal risk profiles, including elevated blood pressure, to precipitate acute cardiovascular events. Approximately three-quarters of emergency responders have prehypertension or hypertension, a proportion which is expected to increase, based on the obesity epidemic. Elevated blood pressure is also inadequately controlled in these professionals and strongly linked to cardiovascular disease morbidity and mortality. Notably, the majority of incident cardiovascular disease events occur in responders who are initially prehypertensive or only mildly hypertensive and whose average premorbid blood pressures are in the range in which many physicians would hesitate to prescribe medications (140-146/88-92). Laws mandating public benefits for emergency responders with cardiovascular disease provide an additional rationale for aggressively controlling their blood pressure. This review provides a background on emergency responders, summarizes occupational risk factors for hypertension and the metabolic syndrome, their prevalence of elevated blood pressure, and evidence linking hypertension with adverse outcomes in these professions. Next, discrepancies between relatively outdated medical standards for emergency responders and current, evidence-based guidelines for blood pressure management in the general public are highlighted. Finally, a workplace-oriented approach for blood pressure control among emergency responders is proposed, based on the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
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U2 - 10.1038/ajh.2008.296
DO - 10.1038/ajh.2008.296
M3 - Review article
C2 - 18927545
AN - SCOPUS:57749176712
SN - 0895-7061
VL - 22
SP - 11
EP - 20
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 1
ER -