Despite the longstanding issue of CVD deaths in the fire service and the frequent observation of LV hypertrophy/cardiomegaly in autopsies, very little is known about these conditions in active firefighters. For example, how common is heart enlargement among working firefighters, what are the best methods of measuring its presence, and which firefighters are at highest risk and therefore, should be screened. It is important to note that if recognized beforehand, effective treatments for LV hypertrophy/ cardiomegaly are available. Thus, it is imperative that we find effective ways to screen firefighters at risk for this condition.
Our understanding of CVD in the fire service has greatly increased over the past 15 years, with an increasing recognition in the role of cardiac enlargement. Although additional research is required to address remaining questions, this should not slow efforts to act on what we currently know. It is critical that we take aggressive steps to prevent and manage CVD to reduce cardiac-related deaths and disability in the fire service. To make significant progress, participation and buy-in at all levels is essential. Therefore, we have presented recommendations for reducing the risk of CVD, and specifically addressing obesity, that are targeted at different groups in the fire service as well recommendations for future research in the field.