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CHARACTERIZATION AND STRATIFICATION OF RESTING BLOOD PRESSURE IN MALE CAREER FIREFIGHTERS

Abstract

Robert Bailey1, Thomas Nagel1, Bridget Melton1, Wesley Blumenburg2, Brett Cross2, Gregory Grosicki2. 1Georgia Southern University, Statesboro, GA. 2Georgia Southern University, Savannah, GA.

Cardiovascular (CV) events are the leading cause of death in career firefighters, and uncontrolled high blood pressure (BP) is a leading risk factor for CV disease. The American Heart Association (AHA) recently updated BP categories to stratify individuals by disease risk. Characterization of BP status in career firefighters using these guidelines may provide insight as to the prevalence and severity of high blood pressure in this at-risk population. PURPOSE: To stratify resting BP levels in male career firefighters, and to explore biological and/or lifestyle BP correlates. METHODS: Twenty-four male career firefighters (34±8 yrs; 31±5 kg/m2) were tested during morning hours (0700-0900) following a 12-hour fast. To characterize lifestyle habits, subjects completed the Pittsburgh Sleep Quality Index (PSQI) and Perceived Stress Scale (PSS) surveys. After 10 minutes of supine rest, resting BP was assessed via an oscillometric brachial cuff. Measurements were performed twice, and the mean value was analyzed. BP values were used to stratify risk of CV events based AHA guidelines (systolic, diastolic): normal = <120 and <80 mmHg, elevated = 120-129 and <80 mmHg, stage I hypertension = 130-139 or 80-89 mmHg, stage II hypertension = >140 or >90 mmHg. Pearson’s correlations were used to assess the relationship of mean arterial pressure (MAP) with age and body mass index (BMI), and non-parametric Spearman’s correlations were run to assess relationships of MAP with PSQI and PSS scores. RESULTS: Average systolic pressure was 131.2±10.8 mmHg, while diastolic (dia) pressure was 77.6±7.6 mmHg. As per the AHA guidelines, 5 subjects (21%) were classified as normal, 5 subjects (21%) as elevated, 10 subjects (41%) as stage I hypertensive, and 4 subjects (17%) as stage II hypertensive. Neither age nor BMI were associated with MAP (P>0.05). PSS score, but not PSQI score (P>0.05) was associated with MAP (rs=-.50, P=0.014). CONCLUSIONS: In comparison to age- and gender-matched prevalence estimates (~25% via Center for Disease Control), we observed a substantially greater prevalence of hypertension in male career firefighters (~60%) that may underlie the inequitable burden of CV events in this population. The lack of relationship between BMI and BP, and the inverse relationship between BP and stress is counter to the literature and deserving of further inquiry.

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