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Original Contribution

Heart Hazards, Heart Health

John Erich
May 2004

Heart attacks were responsible for the deaths of 48 firefighters in 2011, according to statistics from the U.S. Fire Administration, which was nearly the same proportion as firefighter deaths from heart attack or stroke (60%) in 2010. 

Getting the picture? If so, you’re a step up on many EMS providers. Heart disease is America’s top killer, and heart attack is its most visible sign,1 but year after year, people who should know better fall victim.

The danger signs are no secret. You know how to reduce the risk. The information is out there—why aren’t you listening?

Outliving Heart Disease

The basis of heart disease is coronary atherosclerosis, the growth of plaques on the insides of the arteries. There are steps you can take to reduce the probability of those developing.

“A diet that’s low in fat, not being obese, and getting regular aerobic exercise are all things that reduce your likelihood of developing coronary disease,” says Richard Stein, MD, a spokesperson for the American Heart Association. “If you have high blood pressure, it’s essential it be treated down to a low level. If you have elevated cholesterols, bringing them down is critical as well. Eat a diet that emphasizes fruits and vegetables, with portions of protein—that is, meat and fish and chicken—that are about the size of a deck of cards, as opposed to the size of the plate.”

Those steps will improve your chances of not developing heart disease. But some will anyway, and some already have. In that event, what can you do to avoid a heart attack?

First and foremost, know the symptoms, and if they occur, don’t be reluctant to address them, pronto.

“Denial is the single greatest risk factor for dying of a heart attack,” says Stein. “Men—and men who are firefighters—are great at writing the symptoms off to something else: ‘Maybe I did too much weightlifting, maybe I had the oxygen tank on wrong, maybe it’s the pizza I ate before the bell rang.’ If you take those early symptoms and go see a physician, you have a much greater likelihood of outliving heart disease.”

This is where many Americans run into trouble. We’re a macho culture. We play through pain. We may ignore the symptoms of heart attack and heart disease. A firefighter who seeks treatment for such will likely be taken off-duty, and no one wants that.

“You have to determine what the greater risk is,” says Stein. “Is it worth taking the risk of dying suddenly because you’re not doing everything you could to prevent a heart attack? Ask that question when you’re having dinner with your wife and family. Picture your place empty and ask, ‘Exactly how important is it that I continue not knowing?’ Because the major thing that prevents you from dying of a heart attack is knowing if you have heart disease. And knowing if you have heart disease really just means paying attention to your body and not writing off everything to indigestion and muscle pain.”

Many of the risk factors for heart disease, you can do something about: stop smoking, control cholesterol and blood pressure, eat better, lose weight, etc. Family history is a bit trickier, but even a genetic predisposition doesn’t mean you can’t improve your odds.

“Having a mother or father who had a heart attack and died early is a marker of high risk,” says Stein. “More than half the time, that risk is in the form of blood pressure or cholesterol. It may even be a habit passed down generation to generation, like smoking or eating fast foods. So a good deal of it, if we know about it and look aggressively at it, we can actually interrupt, and not give you the same risk as your dad.”

Exercise factors into this equation too, and while usually a good thing, it can also occasionally be bad. Extremes of exercise—vigorous activities to which you’re not accustomed—can trigger heart attacks.

“Firefighters aren’t performance athletes, but they periodically have to perform intense, physically demanding feats,” notes Stein. “The job can be sedentary, with short bursts of intense activity, and your risk of a heart attack is slightly greater during and for about two hours after a bout of strenuous exercise. But there’s clear evidence that people who exercise regularly, even in the presence of coronary disease, dramatically reduce their risk of exercise inducing a heart attack.”

The best exercise in this regard is aerobic—running, swimming or cycling at least three times a week.

Conclusion

Good heart health isn’t glamorous or fun, but it’s vitally important. You can’t serve your community or provide for your family if you’re dead. Taking care of your heart isn’t a sign of weakness. Ignoring it is.

Says Stein: “You don’t get credits on your gravestone for how macho you were.”

For more on heart disease and heart health, visit www.americanheart.org.

Reference

1. American Heart Association.

John Erich is an associate editor for EMS World.

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