Heart Disease and Law Enforcement
The Facts
There is a simple reason that law enforcement officers have some of the best pensions in the country; they don’t live long enough after retirement to fully collect them.
· Heart attacks are always in the top four to five categories of police line of duty deaths. Sudden cardiac death accounts for up to 10% of all U.S. police LODD
· However, if extrapolated to a full 24-hour day, heart attacks likely become the number one killer of men and women in uniform.
· The International Association of Chiefs of Police (IACP) published some of their initial data (Violanti, 2013).
- ü The life expectancy of a police officer is 20 years less than his or her civilian counterpart.
- ü The average age of a law enforcement officer (LEO) who has suffered a heart attack is 49 years, compared to 67 years of age for the general population.
- ü LEOs are 25 times more likely to suffer death and disability from heart disease than from a violent action of a suspect.
- ü Despite this information, many agencies have been slow to develop wellness programs and cardiac screening assessments.
· According to a recent study from the Harvard School of Public Health and the Cambridge Health Alliance, police officers in the United States face a 30 to 70 times higher risk of sudden cardiac death when they’re involved in stressful situations when compared with the risks during routine or nonemergency activities. The risk of sudden cardiac death for police officers are:
- ü 34 - 69 times higher during restraints or altercations;
- ü 32 - 51 times higher during pursuits;
- ü 20 - 23 times higher during physical training;
- ü 6 - 9 times higher during medical or rescue operations
What is a Heart Attack?
A heart attack (also called a myocardial infarction), occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol, blood clots and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle.
Heart Attack Signs & Symptoms
According to the Society of Cardiovascular Patient Care, early heart attack symptoms occur in 50% of all people who have heart attacks. If you’re aware of the early symptoms, you may be able get treatment quickly enough to prevent heart damage. 85% of heart damage occurs in the first two hours following a heart attack.
Although the classic symptoms of a heart attack are usually easily identified (pain, sweating, shortness of breath); other subtler signs may not be. Unfortunately, the more vague symptoms are often ignored. This can be a fatal mistake. Additionally, not all symptoms are immediate; they can take weeks to develop. Nor do all myocardial infarctions cause cardiac arrest; but that does not mean that significant cardiac damage has not taken place.
o Intense, sometimes squeezing, pressure or pain in or around the chest (the most classic symptom)
o Profuse sweating
o Unexplained sudden shortness of breath
o Intense anxiety
o Racing Heart
o Overwhelming sense of fear or impending doom
o Relatively mild discomfort in the chest, back, abdomen, shoulders, arms
o Nausea and vomiting
o Feeling of “heartburn”/indigestion
o Sudden cold sweats
o Lack of energy
o Lightheadedness
o Dizziness
o Change in normal behavior or mental status
Anyone who has one or more risk factors (listed below) for coronary artery disease needs to pay close attention to any sudden, unusual or unexplained symptoms involving the upper half of the body.
Risk Factors for a Heart Attack
Heart researchers report that there are ten risk factors, factors which you have control over, that account for 90% of all heart attacks.
1. High blood pressure
2. High blood cholesterol
3. Diabetes and prediabetes
4. Smoking
5. Obesity, especially abdominal obesity
6. Sedentary lifestyle
7. Eating too few fruits and vegetables
8. Stress
9. High alcohol intake
10. Using stimulant drugs
There are additional risk factors are out of an individual’s control, such as age (in males older than 45 years, females older than 55 years, ethnicity), family history of early heart disease and certain autoimmune disorders.
Prevention
Heart disease is the leading cause of death in the United States for both men and women. Cardiovascular disease accounts for over 800,000 deaths in the US. That’s about 1 of every 3 deaths in the US. About 2,200 Americans die of cardiovascular disease each day, an average of 1 death every 40 seconds.
The following ten steps can also help prevent a heart attack and/or help you recover from one.
1. Quit smoking: The single most important thing you can do to improve your heart's health is to stop smoking. Avoid secondhand smoke. Being around secondhand smoke can potentially trigger a heart attack.
2. Maintain a healthy cholesterol level: Your total blood cholesterol is a measure of LDL cholesterol, HDL cholesterol, and other lipid components. The recommended total cholesterol level is below 200. If your LDH "bad cholesterol” levels are high, your doctor can prescribe changes to your diet and medications to help lower the numbers.
3. Check your blood pressure regularly and control it. An estimated 67 million people in the U.S. have high blood pressure, and more than half don’t have it under control, according to the CDC. Your goal is 120/80 or lower.
4. Exercise regularly: Doctors recommend 30 minutes of cardiovascular exercise three times a week at the bare minimum.
5. Get adequate sleep: Doctors suggest that you should get about 8 hours of sleep per night.
6. Maintain a healthy weight and body mass index.
7. Eat a heart-healthy diet. Cut down on saturated fat, cholesterol, and salt. Increase your consumption of fish, whole grains, nuts, fruit and vegetables.
8. Manage/reduce stress in your day-to-day activities.
9. Aspirin Therapy: The American Heart Association recommends that people at high risk for a heart attack should take a daily low-dose of aspirin (if told to by their physician). Additionally, heart attack survivors regularly take low-dose aspirin. Your doctor will suggest a dosage of 75-325 mg.
10. If you drink alcohol, do so in moderation. In moderation, alcohol helps raise HDL levels (good cholesterol) and can have a protective effect against heart attack. Men should have no more than two drinks a day, and women should have no more than one.
If You Suspect You Are Having a Heart Attack
If you experience chest discomfort (or any of the heart attack symptoms listed above) activate EMS immediately. If you are driving, pull over right away if you have symptoms, you may only have seconds before you lose consciousness. Don’t over analyze this; be safe and not sorry or dead. Never wait more than 5 minutes to make that call. Don’t try to drive to a hospital unless there is literally no other alternative. Then chew an aspirin, during a heart attack, taking a full dose (325 mg) aspirin can actually save your life. Make sure you chew it for 30 seconds and swallow it. Remember, a heart attack is a dynamic event, and early intervention can limit the damage.
While you wait for paramedics lie or sit down and rest. The more exercise or stress you put on the heart, the more damage the heart attack will do. Don’t panic, try to stay calm. Help is on the way.
Paramedics can provide oxygen, medication, and monitor your blood pressure and heart rhythm to forestall complications as they whisk you away to the emergency room. Medics can also revive you if you go into cardiac arrest.
It is time to take your cardiac health seriously. Be careful out there. Double check your pocket, is your aspirin still there?
Pamela Kulbarsh
Pamela Kulbarsh, RN, BSW has been a psychiatric nurse for over 25 years. She has worked with law enforcement in crisis intervention for the past ten years. She has worked in patrol with officers and deputies as a member of San Diego's Psychiatric Emergency Response Team (PERT) and at the Pima County Detention Center in Tucson. Pam has been a frequent guest speaker related to psychiatric emergencies and has published articles in both law enforcement and nursing magazines.
