Cardiovascular Care of Tactical Athletes
Year: 2024
Type: editorial
Abstract: T actical athletes (TAs) are those "whose occu- pations have significant physical fitness requirements.potentialexposure to lifethreatening situations" 1 all while serving others.Accordingly, there are numerous occupations that may be considered TAs, including military members, law enforcement, firefighters (both structure and wildland), emergency medical services personnel, and astronauts.These athletes may encounter intense mental and physical stressors (often requiring significant muscular work including speed and burst performance while wearing personal protective clothing and carrying heavy equipment), extreme environmental conditions (eg heat, cold, altitude), unpredictable work schedules and most importantly, the lives of others may be dependent on the TA.Furthermore, teams of TAs may include individuals across a wide spectrum of age and fitness.These stressors and characteristics represent unique differences between TAs and athletes participating in competitive sports.There has been a paradigm shift to adopt a shared decision-making approach for eligibility decisions among athletes with cardiovascular conditions who participate in competitive sports.However, this approach may not be feasible for TAs where the lives of others or the success of missions may depend on an individual TA's ability to safely perform duty.While significant prior research has defined the impact of high levels of exercise on the cardiovascular system and the safety of exercise among competitive athletes with cardiovascular disease (CVD), there has been little scientific inquiry on the cardiovascular care of TAs.In the following sections, we summarize prior cardiovascular research focused on TAs and identify key areas for future scientific inquiry (Table 1).Unlike many other disciplines within cardiology, most research studies on TAs come from small observational cohorts from individual centers, with few prospective registries.As a result, there are significant knowledge gaps on the optimal cardiovascular care of TAs, and most recommendations from individual TA governing/advising bodies are derived from expert opinion rather than robust scientific evidence.Cardiovascular society scientific statements and guidelines on best practices for TAs do not currently exist.There is also imbalance in the published research for different TA groups, with many studies among military and firefighter populations, and few studies among other occupations such as law enforcement.Overall, large-scale prospective registries are needed to advance knowledge on the cardiovascular care of TAs and thus, enable evidencebased recommendations in TA-specific scientific statements and guidelines (Table 1, Number 1 and 2).Sudden cardiac arrest/death (SCA/D) is the most consequential cardiovascular event among TAs as
Source: JACC Advances
Institutions: Oregon Health & Science University, Harvard University, Massachusetts General Hospital, Emory University, Skidmore College, Cambridge Health Alliance, University of Lausanne, Uniformed Services University of the Health Sciences, Institute for Exercise and Environmental Medicine, The University of Texas Southwestern Medical Center, Mayo Clinic in Florida
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,850
OpenAlex ID: W4402052232