In response to a 911 alert or page, firefighters’ systolic and diastolic blood pressure surges and their heart rate accelerates, with a similar response whether the call is for a fire or medical emergency, a small study suggests.
Dr. Deborah Feairheller
On average, the 41 firefighters monitored in the study, who were middle-aged and overweight, had a 9% increase in systolic blood pressure when called to a fire, a 9% increase in diastolic blood pressure when called to a medical emergency, and a 16% increase in heart rate for both types of calls.
Senior study author Deborah Feairheller, PhD, presented these results at the virtual American Heart Association scientific sessions.
Firefighters have a higher prevalence of cardiovascular disease (CVD) than that of the general population, explained Dr. Feairheller, director of the Hypertension and Endothelial Function with Aerobic and Resistance Training (HEART) Lab and clinical associate professor of kinesiology at the University of New Hampshire, Durham.
More than 50% of firefighter deaths in the line of duty are from CVD, she noted. Moreover, almost 75% of firefighters have hypertension and fewer than 25% have it under control.
The study findings show that all emergency and first responders “should know what their typical blood pressure level is and be aware of how it fluctuates,” Dr. Feairheller said in a press release from the AHA. “Most important, if they have high blood pressure, they should make sure it is well controlled,” she said.
“I really hope that fire departments everywhere see these data, rise to the occasion, and advocate for BP awareness in their crews,” Dr. Feairheller, a volunteer firefighter, said in an interview.
“I do think this has value to any occupation that wears a pager,” she added. “Clinicians, physicians, other emergency responders, all of those occupations are stressful and could place people at risk if they have undiagnosed or uncontrolled hypertension.”
Invited to comment, Comilla Sasson, MD, PhD, an emergency department physician who was not involved with this research, said in an interview that she saw parallels between stress experienced by firefighters and, for example, emergency department physicians.
The transient increases in BP, both systolic and diastolic, along with the heart rate are likely due to the body’s natural fight or flight response to an emergency call, including increases in epinephrine and cortisol, said Dr. Sasson, vice president of science and innovation for emergency cardiovascular care at the American Heart Association.
“The thing that is most interesting to me,” said Dr. Sasson, who can be subject to a series of high-stress situations on a shift, such as multiple trauma victims, a stroke victim, or a person in cardiac arrest, is “what is the cumulative impact of this over time?”
She said she wonders if “having to be ‘ready to go’ at any time, along with disruptions in sleep/wake schedules, and poorer eating and working-out habits when you are on shift, has long-term sequelae on the body.”
Stress-related surges in blood pressure “could be a reason for worse health outcomes in this group,” Dr. Sasson said, adding that this needs to be investigated further.