Correlates of atherosclerotic cardiovascular disease risk in older Colorado firefighters.

Background: It has been documented that cardiovascular disease is the leading cause of mortality in on-duty firefighters and little is known about the association between cardiorespiratory fitness and 10-year risk of atherosclerotic cardiovascular disease (ASCVD). Aims: To estimate the probability of 10-year ASCVD risk and its association with per cent body fat (%BF), metabolic syndrome (MetS) and physical fitness in Colorado firefighters. Methods: Ten-year ASCVD risk was calculated using the newly developed pooled cohort equations in firefighters. Logistic regression was conducted to examine the association of 10-year ASCVD risk (<5 versus ≥5%) with estimated maximum volume of oxygen (VO2 max), %BF and MetS. Results: Out of 294 firefighters, 9% had a 10-year ASCVD risk >5%. In the unadjusted models, %BF (odds ratio [OR] = 1.13, P < 0.01), VO2 max (OR = 2.87, P < 0.05) and MetS (OR = 2.66, P < 0.05) were significantly associated with 10-year ASCVD risk. In the adjusted model, only %BF (OR = 1.17, P < 0.01) was significantly associated with 10-year ASCVD risk. Conclusions: Among Colorado firefighters, %BF, but not cardiorespiratory fitness, was independently associated with 10-year ASCVD.

Cardiac health and fitness of Colorado male/female firefighters.

BACKGROUND: Cardiovascular disease (CVD) is documented as the leading cause of mortality in on-duty firefighters. AIMS: To examine the prevalence of metabolic syndrome (MetS) components, cardiorespiratory fitness levels and the association between them in firefighters in Colorado, USA. METHODS: This study included male and female Colorado firefighters. MetS was identified where three or more metabolic abnormalities were present, using Cholesterol Education Program/Adult Treatment Panel III guidelines. Cardiorespiratory fitness (indicated by VO2 max) was evaluated with the Bruce protocol. Poisson regression was conducted to examine the association between MetS components and VO2 max. RESULTS: Among the 947 male and 76 female study subjects, MetS was present in 9% of all firefighters, in 5% of females and 10% of males. The mean age was 37 ± 10 years. MetS prevalence increased with age (from 3% at age <30 to 17% at 50 and older, data not shown). In addition, 35% had one and 19% had two abnormal MetS components and 49% of participants did not meet the minimum recommended VO2 max of 42.0 ml/kg/min. VO2 max was negatively associated with abnormal MetS components (incident rate ratios = 0.95, 95% confidence interval 0.94-0.96, P < 0.001). CONCLUSIONS: About one in 10 of these Colorado firefighters had MetS and nearly half had insufficient cardiorespiratory fitness. Comprehensive CVD risk management and cardiorespiratory fitness improvement are essential for firefighter health and safety.

Fluvoxamine and sleep disturbances in posttraumatic stress disorder.

This study assesses the efficacy of fluvoxamine treatment on different domains of subjective sleep quality in Vietnam combat veterans with chronic posttraumatic stress disorder (PTSD). Medically healthy male Vietnam theater combat veterans (N = 21) completed a 10-week open label trial. Fluvoxamine treatment led to improvements in PTSD symptoms and all domains of subjective sleep quality. The largest effect was for dreams linked to the traumatic experience in combat. In contrast, generic unpleasant dreams showed only a modest response to treatment. Sleep maintenance insomnia and the item "troubled sleep" showed a large treatment response, whereas sleep onset insomnia improved less substantially. These therapeutic benefits contrast with published reports that have found activating effects of Selective Serotonin Reuptake Inhibitors on the sleep electroencephalogram.