Central blood pressure and arterial stiffness in firefighters and matched controls

Introduction: Firefighters have greater risk of cardiovascular disease (CVD), likely related to high occupational physical, environmental, and psychological demands, with ~50% of on-duty deaths attributed to CVD. Elevated central blood pressure (BP) and arterial stiffness have emerged as key risk factors for CVD, although it is unclear if these factors are elevated in firefighters (FF). Objective: Examine differences in central BP and arterial stiffness in FF compared to matched controls. Hypothesis: FF will display greater arterial stiffness and central BP compared to match controls. Methods: Forty-seven FF (41±10 yrs; BMI 29.1±4.5 kg/m 2 ; 6 females) and 47 age-, sex-, and BMI-matched controls underwent resting hemodynamic assessments. Central BP was measured via carotid tonometry. Aortic stiffness was assessed as carotid-femoral pulse wave velocity (cfPWV) and carotid stiffness as elastic modulus via tonometry and ultrasound, respectively. Group differences were evaluated adjusting for age, sex, and BMI. Results: cfWPV was lower in FF compared to controls (652.1±100.8 vs. 692.3±138.3 cm/s, p = 0.048) while carotid elastic modulus was higher (92.5±39.5 vs. 79.9±25.0 kPa, p = 0.04). Central systolic pressure was higher in FF 122±13 vs. 117±12 mmHg, p = 0.048) with no observed differences in central diastolic pressure (77±9 vs. 75±8 mmHg, p = 0.21). Conclusion: FF demonstrated greater carotid stiffness and central BP, but lower aortic stiffness, compared to matched controls. Regular exposure to stressful environments among FF may chronically increase sympathetic nervous system activity, thus increasing BP and carotid stiffness and potentially contributing to CVD risk in this group. Interestingly, FF exhibited lower aortic stiffness than controls despite higher BP, suggesting differing sensitivity of the aorta versus carotid to the physical, environmental, and psychological stressors that accompany firefighting. Future research is warranted to disentangle the divergent effects observed between aortic and carotid stiffness among FF and its potential implications for CVD risk. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.