Fighting arterial stiffness: A case for the importance of cardiorespiratory fitness in firefighters

Cardiovascular disease (CVD) is responsible for nearly 50% of on-duty firefighter fatalities, and the majority of CVD-related events in firefighters occur during or immediately following the fire scene. Arterial stiffness is an independent predictor of all-cause and cardiovascular-specific mortality that naturally increases with advancing age, but this phenomenon can be altered by health behaviors. In firefighters, strenuous tasks, dangerous envi-ronments, and long hours summate with underlying medical conditions in a manner that greatly increases risk for premature alterations in arterial structure and function that may be exacerbated by acute increases in stiffness following a simulated firefight. Intriguingly, cardiorespiratory fitness is associated with an attenuation of age-related arterial stiffening and structured aerobic training is demonstrated to improve arterial compliance. Meanwhile, the majority of tested firefighters exhibit fitness levels that are under industry standards. Thus, we hypothesize that 1) the occupation of firefighting places individuals at risk for premature arterial stiffening, and 2) structured aerobic exercise training tailored to improving cardiorespiratory fitness will attenuate arterial stiffening and reduce the inequitable burden of CVD in firefighters.