Police officers and firefighters are far more likely than the general population to suffer heart attacks or sudden cardiac death on the job. But their coronary CT calcium scores don't differ all that much from those of the general population, according to a study presented Saturday at the American College of Cardiology (ACC) meeting in Atlanta.
The results show that stress -- more than coronary artery disease -- may be responsible for the additional heart attacks.
The study used CT coronary artery calcium (CAC) scoring to assess whether the higher rate of on-the-job cardiac events was due to increased plaque burden or the physical and emotional stress these workers experience in their jobs.
"It's critical that we understand what causes these cardiac events because the approaches to prevention might be very different," lead investigator Dr. Zubair Jafar from Hudson Valley Heart Center in Poughkeepsie, NY, said in a statement. "We are talking about a high-risk population that needs to be treated differently and more aggressively."
Sudden spikes in stress levels that are commonly experienced in stressful professions may lead to the rupture of unstable coronary artery plaques leading to a heart attack, the authors noted. Jafar and colleagues began a free CAC screening program for police officers and firefighters in New York City.
They examined 717 CAC scores from police and firefighters, and compared the results with an age-matched cohort of 449 individuals as a control group. Using calcium scores of 100 or higher as a marker of clinically significant heart disease, they found no significant difference between the groups (13.8% of police officers and firefighters versus 12.7% of controls).
"If we take two similar people, one with a desk job and the other with a high-risk, high-demand job like being a firefighter, they are likely to have significant differences in their risk of suffering a cardiac event at work," Jafar said.
More studies are needed -- for example to determine what preventive measures are appropriate in such populations of high-risk workers, he said. But it's clear that police officers and firefighters should be evaluated for coronary artery disease risk factors, in addition to an assessment of their mental and physical stress levels.
By Eric Barnes
AuntMinnie.com staff writer
March 15, 2010
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