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THE NEWSLETTER OF THE BUREAU OF HEALTH SERVICES • COUNSELING SERVICES UNIT • FDNY
APRIL 2009

What's new for APRIL 2009

STOP • DROP • CONTROL HIGH BLOOD PRESSURE

Elevated Blood Pressure remains the number ONE reason that members coming down for their annual examinations have a duty change. Hypertension is a treatable condition that should be addressed for the health and wellbeing of every individual.

Recently the IAFF has launched an initiative STOP • DROP • CONTROL HIGH BLOOD PRESSURE to help spread the word about the serious risks associated with undiagnosed and /or untreated high blood pressure.

The FDNY has partnered with the IAFF in Wellness-Fitness Initiative programs in designing our current medical examinations including our fitness Stairmaster evaluation.

Let’s review some of the facts:

NATIONWIDE: 45% of on duty fire fighter deaths are caused by heart disease each year 74% of firefighters with high blood pressure do not have their blood pressure adequately controlled. Hypertension is one of the most important treatable risk factors of heart disease.

Let’s start with FDNY hypertension myths:

MYTH: If the medical office finds out you have high Blood Pressure, you can’t do full duty anymore.
FACT: Bureau of Health Services is committed to good health. Blood pressure is a treatable condition. Life style modifications are the first step in dropping blood pressure. If medication is required, medications can be selected that are compatible with full duty. Well controlled BP is an important part of remaining healthy and protecting your cardiovascular system. If you are already on medications, don’t skip your medicine the day you come for your medical examination. If medication has been prescribed, take it.

MYTH: My blood pressure is only high when I come to the medical office.
FACT: One elevated blood pressure reading does not make the diagnosis but multiple readings are taken here at BHS if a member’s BP is elevated. If it remains markedly elevated, members must follow up with their treating medical professionals for further evaluation. If the BP is high-normal, members are encouraged to follow-up and get their BP rechecked. When BP is only high when measured in the office, this is termed white coat effect. But even these individuals have higher cardiovascular disease risk than individuals with normal blood pressure. You put surge protectors on your computers to protect your equipment. Protect your own cardiovascular system by controlling your blood pressure.

What is high blood pressure?
High Blood pressure is defined as having a reading of greater than 140/90 mmHg. The ideal blood pressure is less than 120/80. Prehypertension is defined as readings of 120-130/80-89 which increases the risk for developing high blood pressure. Uncontrolled blood pressure of greater
than 140/90 on at least two occasions indicates high blood pressure.

Why is it important to control blood pressure?
Elevated blood pressure damages blood vessels, makes the heart work harder and damages organs like the kidneys and brain. Blood pressure elevation remains a significant contributing factor leading to onduty cardiovascular deaths in firefighters. It is a controllable factor that can make the difference in your life.

Can I avoid medications?
Maybe. Lifestyle modifications can certainly help and are the first critical steps you can take to get your blood pressure under control. Most people notice BP rising with age. As it reaches the prehypertension readings (120-130/80-89), this is the time to ensure that changes in your health are made.

What steps should I take?

  • KNOW YOUR OWN BLOOD PRESSURE, track your readings, and get it checked at different times, in different situations. Hypertension can be a silent disease, with little or no symptoms. Don’t just shrug it off as I was tired or I was rushing around; keep track of your readings. Watch the pattern. Remember, family history is a strong predictor of hypertension and with age, blood pressure rises as the blood vessels become more rigid.
  • CHANGE YOUR DIET – EAT HEALTHY FOODS. Foods that are high in salt and in fat contribute to high blood pressure. Select fresh fruit and vegetables. When cooking avoid adding salt; foods contain salts. Get your firehouse and home on board with the plan. One in three Americans has high blood pressure. Dietary modifications help all ages. The firehouse meals and the home meals can be modified to lower the salt and fat and keep everyone healthier. In the DASH ( dietary approaches to stop hypertension) diet, a diet rich in fruits, vegetables and lowfat dairy products but low in saturated and trans fats have been shown to lower blood pressure.
  • REGULAR EXERCISE: Aim for 30 minutes a day of moderate intense aerobic activity. Make exercise a fun part of your day. If you enjoy the activity, you are more likely to stick with it. Make your friends and family part of this program. Whether its biking, swimming, hiking, walking, rollerblading, getting out and keeping busy beats watching TV and playing video games anytime.
  • STOP SMOKING: Smoking cessation is of critical importance in improving every aspect of your health. There are both long term and immediate improvements to health when you stop smoking. Cigarette smokers have chronic Carbon Monoxide in their blood, closing blood vessels, raising blood pressure and damaging organs.
  • WEIGHT MAINTENANCE. For every 10 pound weight gain, the systolic blood pressure can increase by 4 to 5 points above the normal level. Identify your ideal weight. Set reasonable goals to attain it and maintain it. Weight loss also helps the heart and joints as you unload the extra strain on the system.
  • LIMITINGALCOHOLCONSUMPTION of alcoholic beverages (2 drinks per day for men; 1 drink per day for women): The studies which show the protective effect of alcohol on the heart also show that these limits are critical. Excess amounts not only raise blood pressure, they act as a toxin to the heart muscle, brain and other organs. Also, you can’t save up your alcohol allowance and have 14 drinks on one day. That’s called binge drinking and that is toxic to your system.

What happens if my Blood Pressure stays high even with lifestyle changes?
Medications are of critical importance in maintaining good control of blood pressure when the other steps are just not enough. Medications can provide that surge protection that keeps your blood pressure from going too high. Your medical professional will decide the best medications that can be taken to maintain good blood pressure control and allow you to remain full duty. Our physicians at BHS are available to discuss this with you and provide your treating professional a list of approved medications. Everyone’s goal is to adequately control your blood pressure and keep you healthy.

How can I succeed in controlling my blood pressure?

  • Enlist the support of your family, friends and colleagues to promote healthy choices.
  • Make a decision to stick with manageable changes for a healthy lifestyle.
  • Accept that pitfalls may lie ahead, but be flexible to adjust your daily routine when necessary and get back on track when you go astray.
  • Monitor your blood pressure regularly, maintain your medications as directed, and focus on your goal of reaching and maintaining normal blood pressure. If a medication is bothering you, or you believe that you are experiencing sideeffects, speak to your physician about adjusting or changing the medication. There are many medications available to choose from and your doctor can select the medications that fit you and your lifestyle. Partner with your primary care medical professional to stay on top of your health.

If you want to know more about the IAFF STOP DROP CONTROL HIGH BLOOD PRESSURE, call 1-877-352- 6474 ext. 29111 or go to the IAFF Website: www.iaff.org/hs/fts for program details. When you come down for your annual examination, discuss your risk factors and how you can modify them. Questions in between visits, call BHS at 718 999 1918.

FDNY Bureau of Health Services will be partnering with the IAFF to bring you more information, and programs designed for the first responder. Remember, stay safe.

FDNY Bureau of Health Services will be partnering with the IAFF to bring you more information, and programs designed for the first responder. Remember, stay safe.

 

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Dr. Kerry Kelly
Chief Medical Officer

Dr. Viola Ortiz
Deputy Chief Medical Officer

Malachy Corrigan
Director
FDNY CSU

Mary T. McLaughlin
Director
FDNY BHS


 

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