Hypertension: A Serious Health Concern for America, A Deadly Health Concern for Firefighters

By Robert Blaufarb, Director of Health and Wellness – Mamaroneck Fire Department

Hypertension (high blood pressure) afflicts over 1 billion people over 25 years old worldwide. This represents 40 percent of the world in this age group. This serious health concern is responsible for over 9 million deaths worldwide.

Blood pressure is measured by an instrument called a sphygmomanometer. The World Health Organization (WHO) has established that a blood pressure of 120/80 is normal and healthy.

Two major variables directly affect blood pressure health: genetics and lifestyle choices. Potentially increased health risks of hypertension include cardiovascular disease, kidney disease and death.

The human kidneys regulate and maintain fluid balance within the body (homeostasis), which is critical for survival. Compromised blood pressure health is a serious risk factor associated with hypertension and cardiovascular disease.

The smaller the diameter of a blood vessel, the greater the pressure exerted on the heart to secure sufficient blood flow throughout the body. There are thousands of blood vessels in the network of the circulatory system, each one co-dependent on each other. A heart under sustained, unhealthy pressure will eventually fail.

The physiological and biochemical processes of the body to regulate blood pressure are complicated and require a working understanding of biology. However, the purpose here is not to present a tutorial on blood pressure. It is to create a personal awareness of your individual blood pressure levels and to understand how as firefighters, elevated levels of blood pressure (hypertension) are a ticking time bomb.

There is one very important physiological concern, however, that I want to emphasize. That is the diameter of the blood vessels responsible for carrying the blood.

It is essential for firefighters to know the status of their blood vessel health. When we are born all systems are basically in pristine health. The blood vessels are clear of plaque build-up, thus allowing for the most efficient flow of blood with the least amount of pressure. As we age, largely because of unhealthy lifestyle choices we have made, the vessels begin the build-up dangerous plaque within the walls of the blood vessels. This ever-increasing problem, if not mediated with better, healthier lifestyle choices, will eventually cause the blood vessel walls to develop more plaque and reduce the area available for the same volume of blood.

This puts the heart under greater pressure with less efficiency and creates a potentially dangerous sustained pressure on the heart. The smaller the opening of a vessel, the greater pressure exerted on the heart to get the same amount of vital, life-sustaining blood throughout your body compared to when the openings were clear and open.

Hypertension existing within anyone is potentially fatal. However, as firefighters, the risks are exponentially greater. The general public does not enter super-heated, toxic structures with temperatures in excess of 1,000 degrees. The average American man or woman does not climb ladders wearing 50 to 75 pounds of gear – all while carrying other heavy equipment for fire suppression.

Compounding these almost super-human efforts is the 0-to-60 adrenaline rush when the bell rings and lights and sirens are blaring in weather and traffic conditions that can be hazardous in their own right.

Although we train at high levels in our drills and amass a wealth of experience every time we respond, we are not superheroes. We get injured and sometimes we die performing tasks to keep the public safe.

Firefighter deaths under any circumstances are tragic whether the event occurs on the fireground or hours after the call when the firefighter is safely home. The job is extremely hazardous and, as firefighters, the potential for injury or death is something we carry with us to every event.

But, we can minimize the ever-present dangers to at least a level playing field. We know our jobs and we know the risks.

Many of us signed up because of the excitement attached to these dangers. However, your body and your state of health are under your control and these are the very tools that can be the difference between you surviving an event or losing your life. We have husbands, wives, children, moms and dads who depend on us to make it home after our heroic sacrifice to serve and protect our communities.

It is your responsibility to be in the highest possible status of health to both serve the community and to make it home. Remember job No. 1 – your personal survival. Anything you do to reduce your chances of survival is tragic. Anything you do to increase your chance of making it home is your moral responsibility to yourself, your family and your department.