Association of cardio-ankle vascular index with physical fitness and cognitive symptoms in aging Finnish firefighters
Monitoring cardiovascular risk factors is important in health promotion among firefighters. The assessment of arterial stiffness (AS) may help to detect early signs of atherosclerosis. The aim of this study was to analyze associations between aerobic fitness, cognitive symptoms and cardio-ankle vascular index (CAVI) as a measure for AS among Finnish firefighters.
The data are one part of a large 13-year follow-up study of the health and physical and mental capacity of Finnish professional firefighters. The subjects in this substudy comprised 65 male firefighters of a mean age of 48.0 (42–58) years in 2009. Their maximal oxygen uptake was successfully measured in two cross-sectional studies in 1996 and 2009, and they responded to questionnaires at both sessions, and their CAVI was measured in 2009. CAVI was calculated from the pulse waveform signal and pulse wave velocity. The lifestyle habits and subjective cognitive stress-related symptoms were collected via a standardized questionnaire. Muscular fitness was measured by the routine test battery used for Finnish firefighters.
CAVI was related to age. About one-fifth of the firefighters had a CAVI of >8. Aerobic fitness was the main physiological factor correlating with increased CAVI. Interestingly, VO2max and the accelerated decrease in VO2max during a 13-year follow-up were associated with signs of impaired vascular function. The cognitive symptoms derived from the Profile of Mood States questionnaire (POMS) were mainly associated with stress and sleeping difficulties. No clear association with physical fitness was found in this population of fit firefighters.
Among firefighters, the decrease in aerobic fitness predicts increased arterial stiffness. The speed of the age-related decline in maximal oxygen consumption is as important as absolute level. Against expectations, the cognitive function did not correlate with vascular health parameters. The cognitive symptoms, however, were only mild.
KeywordsFirefighters Cardiovascular health Arterial stiffness Cognitive symptoms
The Fire Protection Fund of Finland and a grant from the Jubiläumsfonds of the National Bank of Austria (OENB—Grant Project number 12979) provided financial support for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
- Aguilar-Shea A, Gallardo-Mayo C, Garrido-Elustondo S, Calvo-Manuel E, Zamorano-Gómez J (2010) Carotid intima-media thickness as a screening tool in cardiovascular primary prevention. Eur J Clin Invest. doi:10.1111/j.1365-2362.2010.02440
- Benetos A, Watfa G, Hanon O, Salvi, P, Fantin F, Toulza O, Manckoundia P, Agnoletti D, Labat C, Gautier S (2011) Pulse wave velocity is associated with 1-year cognitive decline in the elderly older than 80 years: the PARTAGE. Study J Am Med Dir Assoc (in press)Google Scholar
- Hänninen H (1989) Neurotoksisten haittojen seulonta: oirekyselyt ja psykologiset testit (in Finnish). Finnish Institute of Occupational Health, HelsinkiGoogle Scholar
- Hayashi S (2010) Significance of plasma D-dimer in relation to the severity of atherosclerosis in patients evaluated by non-invasive indices of cardio-ankle vascular index and carotid intima-media thickness. Int J Hematol 92:76–82. Eurostat. http://ec.europa.eu/eurostat. Accessed 17 June 2011Google Scholar
- Helakorpi S, Pajunen T, Jallinoja P, Virtanen S, Uutela A (2011) Health behaviour and health among the Finnish adult population, Spring 2010. National Institute of Health and Welfare. http://www.thl.fi/fi_FI/web/fi/tiedote?id=25833
- Huck C, Bronas U, Williamson E, Draheim C, Duprez D, Dengel D (2007) Noninvasive measurements of arterial stiffness: repeatability and interrelationships with endothelial function and arterial morphology measures. Vasc Health Risk Manag 3:343–349Google Scholar
- Ilmarinen R, Mäkinen H, Lindholm H, Punakallio A, Kervinen H (2008) Thermal strain in fire fighters while wearing task-fitted versus en 469:2005 protective clothing during a prolonged rescue drill. Int J Occup Saf Ergon 14:7–18Google Scholar
- Janssen I, Heymsfield S, Wang Z, Ross R (2000) Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. J Appl Physiol 89:81–88Google Scholar
- Liu-Ambrose T, Eng JJ, Boyd LA, Jacova C, Davis JC, Bryan S, Lee P, Brasher P, Hsiung GY (2010) Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment. BMC Neurol 10:14CrossRefGoogle Scholar
- Lusa S (1994) Job demands and assessment of the physical work capacity of fire fighters. Studies in sport, physical education and health 33. University of Jyväskylä, JyväskyläGoogle Scholar
- Lusa S, Louhevaara V, Kinnunen K (1994) Are the job demands on physical work capacity equal for young and aging firefighters? J Occup Med 36:70–74Google Scholar
- Lusa S, Punakallio A, Luukkonen R (2011) Factors predicting perceived working capacity of Finnish firefighters. In: Proceedings of the 4th symposium on working capacity, Tampere, Finland, 6–9 June 2010 (in press)Google Scholar
- McNair D, Lorr M, Droppleman L (1981) Edits manual for the profile of mood states. Educational and industrial services, San DiegoGoogle Scholar
- Miyachi M, Donato AJ, Yamamoto K, Takahashi K, Gates PE, Moreau KL, Tanaka H (2003) Greater age-related reductions in central arterial compliance in resistance-trained men. Hypertension 41:130–135Google Scholar
- Mustata S, Groeneveld S, Davidson W, Ford G, Kiland K, Manns B (2011) Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study. Int Urol Nephrol (in press)Google Scholar
- Nomura K, Nakao M, Karita K, Nishikitani M, Yano E (2005) Association between work related psychological stress and arterial stiffness measured by brachial-ankle pulse-wave velocity in young Japanese males from an information service company. Scand J Work Environm Health 31:352–359CrossRefGoogle Scholar
- Punakallio A, Lusa S (2011) Eri-ikäisten palomiesten terveys ja toimintakyky: 13 vuoden seurantatutkimus. In Finnish. http://www.ttl.fi/fi/verkkokirjat/Documents/Palomiesten_terveys.pdf
- Punakallio A, Lusa-Moser S, Louhevaara V, Viikari-Juntura E, Ilmarinen R, Ollila J (1999) Health, physical and mental capacity of fire fighters in different age groups. In: Ilmarinen J, Louhevaara V (eds) FinnAge—respect for the aging: action programme to promote health, working capacity and well-being of aging workers in 1990–96. Helsinki: People and work—Research reports 26. Finnish Institute of Occupational Health, Helsinki, pp 117–127Google Scholar
- Punakallio A, Lusa S, Luukkonen R, Lindholm H (2011) Physical capacities for predicting the perceived working capacity of firefighters. In: Proceedings of the 4th symposium on working capacity, Tampere, Finland, 6–9 June 2010 (in press)Google Scholar
- Riggio S, Mandraffino G, Sardo MA, Iudicello R, Camarda N, Imbalzano E, Alibrandi A, Saitta C, Carerj S, Arrigo T, Saitta A (2010) Pulse wave velocity and augmentation index, but not intima-media thickness, are early indicators of vascular damage in hypercholesterolemic children. Eur J Clin Invest 40:250–257CrossRefGoogle Scholar
- Satoh N, Shimatsu A, Kato Y, Araki R, Koyama K, Okajima T, Tanabe M, Ooishi M, Kotani K, Ogawa Y (2008) Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res 31:1921–1930CrossRefGoogle Scholar
- Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takhashi M, Suzuki K, Takata M (2011) Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscl Thromb. doi:10.5551/jat.7716
- Vaitkevicius PV, Fleg JL, Engel JH, O’Connor FC, Wright JG, Lakatta LE, Yin FC, Lakatta EG (1993) Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation 88:1456–1462Google Scholar
- Wu CF, Kuo IC, Su TC, Li YR, Lin LY, Chan CC, Hsu SC (2010) Effects of personal exposure to particulate matter and ozone on arterial stiffness and heart rate variability in healthy adults. Am J Epidemiol 171:1299–1309Google Scholar
- Yamamoto N, Yamanakaa G, Ishikawaa M, Takasugia E, Murakamib S, Yamanakaa T, Ishined M, Matsubayashid K, Hanafusac T, Otsukaa K (2009) Cardio-ankle vascular index as a predictor of cognitive impairment in community-dwelling elderly people: four-year follow-up. Dement Geriatr Cogn Disord 28:153–158CrossRefGoogle Scholar