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Purpose: Brachial blood pressure (BP) is the current gold standard for BP assessment; however, measures of pulse wave velocity (PWV) and central blood pressure (CBP) may contribute uniquely to assessment of cardiovascular health status. As of yet, standards for assessment of CBP and PWV have not addressed the impact of hydration status on proper measurement. To understand the impact of hydration, PWV and CBP should be measured in a euhydrated and hypohydrated state., Methods: Forty-three young, healthy participants (21 ± 2 years) completed a dehydration protocol utilizing moderate aerobic activity until they lost 1%-2% of their body weight. PWV and CBP were measured before and following the dehydration protocol. Linear regression was utilized to assess change in hydration status and change in PWV and CBP., Results: No significant relationships were observed between the change in hydration status (% body weight lost) and PWV (β = 0.05, p = 0.78) or central diastolic BP (β = -3.8, p = 0.10), however, a significant relationship was observed with central systolic BP (β = -5.0, p = 0.03)., Discussion: In conclusion, the assessment of hydration status before measurement of CBP or PWV may not be necessary in young, healthy individuals., (© 2024 Scandinavian Society of Clinical Physiology and Nuclear Medicine.)

Objectives: The aim of the study is to determine if law enforcement officers develop subclinical atherosclerotic cardiovascular disease (ASCVD) earlier than nonofficers and, if so, the extent to which conventional risk factors explain this difference. Methods: Estimated pulse wave velocity (ePWV) was the marker of subclinical ASCVD. EPWV, ASCVD risk factors, metabolic syndrome (MetS), and 10-year risk for ASCVD were compared among 408 law enforcement officers and a civilian cohort. Results: EPWV, 10-year ASCVD risk, and MetS prevalence increased significantly with age. All but the officers age 55 and older had higher ePWV cohort than the civilian cohort ( P < 0.001). Ten-year ASCVD risk explained the most variability of ePWV ( R2 = 0.49, P < 0.001). Conclusions: Officers develop subclinical ASCVD earlier than nonofficers. Conventional ASCVD risk factors only explain about half of this increase. Occupational factors may play a role in contributing to this increased ASCVD risk., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Background: Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer., Methods and Results: This cross-sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100-point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (<60), moderate (60-79), or high (≥80) cardiovascular health. Pulse wave velocity (PWV) was used to assess arterial stiffness; with high arterial stiffness defined as a pulse wave velocity ≥10 m/s. The mean cardiovascular health score was 72±11 and 40 survivors (23%) had high arterial stiffness. Compared with low cardiovascular health, the odds ratio of high arterial stiffness was 0.12 (95% CI, 0.03-0.50) and 0.02 (95% CI, 0.003-0.18) for moderate and high cardiovascular health, respectively. Every 10-point increase in the cardiovascular health score was associated with a 0.43 m/s reduction in pulse wave velocity ( P <0.001)., Conclusions: Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.

Introduction: Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity., Methods: This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0%-30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022., Results: Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%-30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA., Conclusions: These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia., (Copyright © 2024 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: High body mass index (BMI) is a major risk factor of gastroesophageal reflux disease (GERD), a prevalent morbidity of older adulthood linked to lower quality of life and an increased risk of esophageal cancers. Daily stepping behavior, the most common physical activity of older adulthood, is associated with an array of favorable health outcomes, sometimes independent of high BMI. Whether stepping behavior is associated with the incidence of GERD independently or in combination with BMI is currently unclear., Materials and Methods: We followed 442 individuals (58.4% female) aged 65-91 years enrolled in the Physical Activity and Aging Study. Baseline steps were obtained by pedometer and categorized by tertiles (lower, middle, upper), while BMI was categorized into normal weight, overweight, and obesity. To explore joint associations, daily steps were dichotomized into "high steps" (middle/upper tertiles) and "low steps" (lower tertile), while BMI was dichotomized into normal weight and overweight/obesity. The joint exposure categories included "low steps and overweight/obesity," "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight.", Results: We identified 35 (7.9%) cases of GERD over a mean follow-up of 2.5 years. Compared to the lower tertile of steps, the hazard ratios (HRs) [95% confidence intervals (95% CIs)] of GERD were 0.44 (0.20-0.96) and 0.17 (0.05-0.54) for the middle and upper tertiles, respectively, after adjusting for confounders (including BMI). Compared to normal weight, the HRs (95% CIs) of GERD were 1.35 (0.54-3.37) and 3.00 (1.19-7.55) for overweight and obesity, respectively, after adjusting for confounders (including steps). In a joint analysis, compared to "low steps and overweight/obesity," the HRs (95% CIs) of GERD were 0.32 (0.10-1.00), 0.23 (0.10-0.54), and 0.20 (0.07-0.58) for "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight," respectively., Conclusion: Higher daily steps were associated with a lower risk of GERD in older adults, independent of BMI. Since accumulating steps through walking is an achievable and acceptable modality of physical activity in older adulthood, future lifestyle interventions designed to achieve high daily steps counts may have favorable implications for the development of GERD in older adults of any BMI status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Saavedra, Lefferts, Song and Lee.)

Acute inflammation impairs vascular function in an age-dependent manner and affects cardiovascular event risk. Regular aerobic exercise preserves vascular function with aging and potentially modifies how acute inflammation affects the vasculature. We hypothesize high cardiorespiratory fitness may accompany greater arterial responsiveness post-acute inflammation in older adults., (Copyright © 2024 by the American College of Sports Medicine.)

Sex differences in resting cerebral hemodynamics decline with aging. Given that acute resistance exercise (RE) is a hypertensive challenge, it may reveal sex-dependent abnormalities in cerebral hemodynamics. Thus, we hypothesized that cerebral blood velocity and pulsatility responses to RE would be sex-dependent in older adults. Fourteen older females and 11 males (50-68 yr) completed a high-intensity unilateral isokinetic knee flexion/extension exercise. Measurements were collected at baseline, immediately, 5- and 30-min post-RE. Blood pressure was measured via finger photoplethysmography. Mean middle cerebral artery blood velocity (MCAv) and pulsatility were assessed via transcranial Doppler ultrasound. Carotid pulsatility was obtained via duplex ultrasound. MCAv increased immediately after RE in older females [mean difference ( d ) = 6.02, 95% CI: 1.66 to 10.39 cm/s, P < 0.001] but not in males ( d = -0.72, 95% CI: -3.83 to 5.27 cm/s, P = 0.99), followed by similar reductions 5-min post-RE in older females ( d = -4.40, 95% CI: -8.81 to -0.10 cm/s, P = 0.045) and males ( d = -6.41, 95% CI: -11.19 to -1.62 cm/s, P = 0.003). MCAv pulsatility increased similarly in older females ( d = 0.24, 95% CI: 0.11 to 0.40, P < 0.001) and males ( d = 0.38, 95% CI: 0.20 to 0.53, P < 0.001), persisting 5-min post-RE. Older females showed smaller increases in carotid pulsatility immediately after RE ( d = 0.18, 95% CI: 0.03 to 0.38, P = 0.01) than males ( d = 0.48, 95% CI: 0.26 to 0.68, P < 0.001). An exercise-mediated hypertensive stimulus revealed differential sex responses in MCAv and carotid pulsatility but not in cerebral pulsatility. Cerebral pulsatility findings suggest a similar sex susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus in older adults. NEW & NOTEWORTHY Sex differences in resting cerebral hemodynamics decline with advancing age as females experience larger reductions in cerebral blood velocity and steeper pulsatility increases than males. However, an exercise-mediated hypertensive stimulus might reveal sex differences in cerebral hemodynamics not apparent at rest. Following high-intensity resistance exercise, older females but not males exhibit increases in cerebral blood velocity, despite similar increases in cerebral pulsatility. The susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus appears similar between sexes.

Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot e-health lifestyle walking intervention was conducted in 21 sedentary older adults (73 ± 5 years old) with hypertension (13 female, 8 male) to investigate the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure control. The intervention consisted of two phases, with behavior change assistance provided during the first active phase (weeks 1-10) to help reach step goals and minimal assistance provided during the second self-maintenance phase (weeks 11-20). Nineteen participants (91%) completed both the 10- and 20-week assessments. The participants wore the pedometer for ≥10 h on 97% of the days over 20 weeks. They significantly increased average steps/day from 3899 ± 2198 at baseline to 6512 ± 2633 at 10 weeks and 5567 ± 2587 at 20 weeks. After 20 weeks, both systolic (137 ± 10 to 130 ± 11 mm Hg, p < 0.001) and diastolic (81 ± 6 to 77 ± 6 mm Hg, p = 0.01) blood pressure improved. The response was consistent in participants with ( n = 8) and without ( n = 13) anti-hypertensive medication. The results of our lifestyle walking intervention are encouraging for reducing blood pressure in older adults with hypertension; however, larger randomized, controlled trials need to be performed to confirm these findings.

Background: Individuals with Down syndrome (DS) have low levels of cardiorespiratory fitness and previous studies have shown that these low levels of fitness have a physiological cause. During exercise, the cardiovascular, ventilatory and muscular systems are simultaneously active. While individual parameters of these systems have been investigated in DS before, the interaction between these parameters and systems have not been discussed in detail. Doing so may provide important insight regarding the aetiology of low cardiorespiratory fitness and which parameters of the cardiovascular, pulmonary and muscular systems are altered in individuals with DS compared with their peers without DS., Methods: Cardiopulmonary exercise tests were performed in healthy adults with and without DS. Parameters related to the cardiovascular, ventilatory and muscular systems were collected until VO 2peak . In total, 51 participants were included in analysis, of which 21 had DS., Results: Individuals with DS showed lower peak values for all collected outcomes (P ≤ 0.001) compared with those without DS, except for ventilatory threshold as a percentage of maximal oxygen uptake and V E /VCO 2 slope, which were similar., Conclusions: Our results show that individuals with DS present impairments across the cardiovascular, ventilatory and muscular aspects of the cardiopulmonary system., (© 2022 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Introduction: Age-related stiffening of the large elastic arteries (e.g., common carotid artery [CCA]) may impair wall dynamics (i.e., strain) and amplify transmission of pulsatile blood flow into the brain with large increases in pressure that occur during maximal resistance exercise (RE). The purpose of this study was to compare CCA arterial wall dynamics, central hemodynamics, and cerebral blood velocity responses during maximal RE between young and older adults., Methods: Thirty-one young (YA; 26 ± 5 yrs; 23.8 ± 3.3 kg/m 2 ) and 25 older adults (OA; 60 ± 6 yrs; 30.0 ± 5.5 kg/m 2 ) performed a unilateral maximal isokinetic knee flexion/extension exercise protocol (i.e., maximal RE). All measures were recorded at baseline and during the last 10 s of maximal RE. Common carotid artery strain, CCA strain time to peak, and CCA strain rate (i.e., variables of arterial wall dynamics) were analyzed using 2D speckle tracking software from circumferential ultrasound images. Transcranial Doppler was used to measure right middle cerebral artery (MCA) blood velocity. Non-invasive arterial blood pressure measurements were obtained using finger photoplethysmography., Results: Older adults had greater reductions in CCA strain time to peak from baseline to maximal RE (345 ± 39 to 242 ± 52 ms) than YA (308 ± 35 to 247 ± 42 ms; interaction effect, p < 0.01). MCA velocity was similar between YA and OA during maximal RE (p = 0.48), despite a greater arterial pressor response in OA (p < 0.01)., Conclusion: These data suggest cerebral blood velocity responds similarly during maximal RE among OA compared to YA, despite subtle age-related differences in the pressor and extracranial vascular response during maximal RE., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cerebral hemodynamics and pulsatility are important mechanisms of cerebrovascular and brain health. Cardiorespiratory fitness may improve cerebrovascular pulsatility in healthy females, but not in males. Whether cardiovascular disease (CVD) risk factors modify sex-specific associations of fitness with cerebral hemodynamics and vascular contributors to cerebral hemodynamics is unknown. We assessed V̇o 2peak and cerebrovascular hemodynamics in 157 adults without (42 ± 13 yr, BMI 24.5 ± 2.7 kg/m 2 ), and 66 adults with modifiable CVD risk factors (54 ± 8 yr, BMI 29.9 ± 4.0 kg/m 2 ). Intracranial [middle cerebral artery (MCA) pulsatility index (PI), mean velocity, conductance, and pulsatile damping] and extracranial hemodynamics [carotid artery wave transmission/reflection, PI, pulse wave velocity (PWV)-β, and carotid-femoral PWV] were assessed via transcranial Doppler/ultrasound and tonometry. Cardiorespiratory fitness was assessed via V̇o 2peak during an incremental exercise test. Multiple regression was used to assess contributions of V̇o 2peak to cerebrovascular outcomes after adjustment for relevant covariates. V̇o 2peak was inversely associated with MCA PI among females (β = -0.39, P = 0.01) but not males (β = -0.16, P = 0.25) without CVD risk factors. V̇o 2peak was positively associated with MCA PI among females (β = 0.44, P = 0.01) and not associated in males with CVD risk factors (β = -0.06, P = 0.079). V̇o 2peak was beneficially associated with vascular contributors to cerebral hemodynamics but had sex-specific associations with carotid stiffness and pulse pressure in females without CVD risk factors only. These results suggest that sex-specific associations between fitness and cerebral pulsatility among females without CVD risk factors may relate to the differential effects of fitness on carotid stiffness and pulse pressure. In addition, the presence of modifiable CVD risk factors may influence the protective relations of fitness on cerebrovascular hemodynamics. NEW & NOTEWORTHY We identify beneficial associations between cardiorespiratory fitness and lower carotid stiffness and pulse pressure as potential mechanisms underlying sex-specific associations of fitness and cerebral pulsatility in females without modifiable risk factors. Greater fitness is beneficially associated with conductance, pulsatile damping, and forward wave energy among adults without risk factors; however, associations are attenuated among adults with modifiable risk factors. These data suggest sex and risk factors may alter cerebrovascular sensitivity to cardiorespiratory fitness.

Breast cancer survivors (BCS) have a high prevalence of cardiovascular disease and low cardiorespiratory fitness (CRF). CRF is an important predictor of survival in BCS. However, the physiological factors that contribute to low CRF in BCS have not been completely elucidated. To assess differences in physiological factors (cardiac, pulmonary, muscle function) related to CRF between BCS and controls. Twenty-three BCS and 23 age-body mass index (BMI) matched controls underwent a peak cycling exercise test to determine CRF, with physiological factors measured at resting and at peak exercise. Cardiac hemodynamics (stroke volume [SV], SVindex, heart rate [HR], cardiac output [Formula: see text], and [Formula: see text]index) were evaluated using ultrasonography. Pulmonary function was evaluated using the oxygen uptake efficiency slope (OUES), ventilation to carbon dioxide production slope [Formula: see text] and breathing reserve at peak exercise (BR). Muscle oxygenation variables (oxygenated [HbO 2 ] deoxygenated [HHb] and total hemoglobin [Hb], and tissue oxygenation index [TSI]) were measured with near-infrared spectroscopy (NIRS). Both groups had similar CRF and similarly increased all hemodynamic variables (HR, SV, SVindex, [Formula: see text] and [Formula: see text]index) at peak exercise compared to resting (p < 0.001). BCS had higher overall HR and lower SVindex (group effect, p < 0.05). BCS had similar OUES, [Formula: see text] and BR compared to the controls. Both groups decreased TSI, and increased Hb and HHb similarly at peak exercise compared to resting (p < 0.001). Our data suggest BCS do not exhibit differences in cardiac, pulmonary, or muscle function at peak exercise compared to controls, when both groups have similar CRF and physical activity., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Examine the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index (BMI) with the prevalence of diverticulitis in older adults., Methods: 476 older adults (61% Female; 71 ± 5 years) with no history of myocardial infarction, stroke, cancer, inflammatory bowel disease, or diabetes were included in this cross-sectional study. Diverticulitis cases were identified by self-reported physician diagnosis from the medical history questionnaire. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the prevalence of diverticulitis by tertiles of CRF and BMI category. CRF and BMI were further dichotomized into either "unfit" (the lowest one-third of CRF), "fit" (the upper two-thirds of CRF), "overweight/obese" (BMI ≥25.0 kg/m2), or "normal-weight" (BMI <25.0 kg/m2) to investigate the joint association of CRF and BMI with diverticulitis., Results: Thirty-five (7.4%) participants were identified as having diverticulitis. Compared with the lowest CRF tertile, the ORs (95% CIs) of diverticulitis were 0.52 (0.22-1.22) and 0.33 (0.12-0.94) in the middle and upper CRF tertiles, respectively, after adjusting for potential confounders. After further adjustment for BMI, the association was no longer significant with ORs (95% CIs) of 0.55 (0.23-1.33) and 0.37 (0.12-1.10) in middle and upper CRF tertiles, respectively. Compared with the normal-weight group, the ORs (95% CIs) of diverticulitis were 2.86 (1.05-7.79) and 2.98 (0.95-9.35) in the overweight and obese groups, respectively, after adjusting for possible confounders and CRF. Compared with the "unfit and overweight/obese" group in the joint analysis, the OR (95% CI) of diverticulitis was 0.16 (0.04-0.61) in the "fit and normal-weight" group., Conclusions: Older adults who maintain higher CRF and lower BMI may have significantly lower odds of diverticulitis, with the lowest odds found in the normal-weight and fit older adults., Competing Interests: The authors have declared that no competing interests exist.

New Findings: What is the central question of this study? It is valuable to be able to monitor disease- or treatment-related changes in the microcirculation. Laser Doppler flowmetry with local heating allows non-invasive monitoring of the skin microcirculation and its ability to vasodilate. Does reactive hyperaemia augment the increase in skin blood flow elicited by local heating? What is the main finding and its importance? The addition of reactive hyperaemia to local heating results in greater vasodilatation than heating alone. Thus, reactive hyperaemia can augment local heat-induced hyperaemia in the skin., Abstract: The skin circulation has been proposed as a model of generalized microvascular function that could be monitored non-invasively using laser Doppler flowmetry (LDF). The response to heat hyperaemia (HH) is commonly used to monitor disease- or treatment-related changes in microvascular function. We hypothesized that reactive hyperaemia would augment the increase in skin blood flow elicited by local heating. Fourteen healthy young adults were subjected to three different conditions: reactive hyperaemia (RH; skin temperature controlled at 33°C), heat hyperaemia (HH; 42°C held for 40 min) and HH+RH. Two Peltier-controlled thermomodules with LDF probes were placed on the right forearm to monitor skin blood flow continuously. A cuff was placed on the right upper arm to elicit RH by inflation to 220 mmHg for 5 min. This procedure was performed with the skin temperature at 33°C and again after 40 min of local heating to 42°C. Beat-by-beat mean arterial pressure (MAP) obtained by a photoplethysmographic sensor on the middle finger of the left hand allowed calculation of cutaneous vascular conductance (CVC) as LDF/MAP. Both HH and RH increased LDF (P < 0.0001 and P < 0.0001, respectively) and CVC (P = 0.0001 and P < 0.0001, respectively) above baseline values. The LDF and CVC values were significantly higher during HH+RH when compared with RH or HH alone (P < 0.0001). In summary, HH+RH resulted in greater vasodilatation when compared with HH or RH alone. These results indicate that RH can augment local heat-induced hyperaemia in the skin., (© 2022 The Authors. Experimental Physiology © 2022 The Physiological Society.)

Whether the COVID-19 pandemic has long-lasting effects on physical activity (PA) and sedentary behavior in the vulnerable older adult population is uncertain. A total of 387 older adults (75 ± 6 years) completed a retrospective questionnaire on time spent sitting, walking, and performing aerobic and muscle-strengthening PA before, during the first three months, and one year into the COVID-19 pandemic. Whether the participants met the aerobic and muscle-strengthening PA guidelines was then determined. Of the 387 older adults, 376 (97%) were vaccinated. The participants completed 361 ± 426, 293 ± 400, and 454 ± 501 min/week of moderate-to-vigorous aerobic PA before, during the first three months, and one year into the pandemic, respectively. During the same time periods, the participants performed muscle-strengthening PA 87 ± 157, 68 ± 163, and 90 ± 176 min/week, walked 2.4 ± 1.7, 2.3 ± 1.7, and 2.6 ± 1.9 h/day, and sat 6.2 ± 2.9, 7.4 ± 3.1, and 6.1 ± 2.9 h/day, respectively. Aerobic PA, muscle-strengthening PA, and walking time decreased, whereas sitting time increased, during the first three months of the pandemic (p < 0.05), and then returned to pre-pandemic levels after one year (p < 0.05). The percentage of participants meeting both aerobic and muscle-strengthening PA guidelines decreased during the first three months of the pandemic (48.9% to 33.5%, p < 0.001), but returned to pre-pandemic levels one year later (p < 0.001). In conclusion, the COVID-19 pandemic significantly decreased PA and increased sitting time in older adults; however, both PA and sitting time returned to pre-pandemic levels after one year.

Introduction: Cardiovascular events are a leading cause of firefighter duty-related death, with the greatest risk occurring during or shortly after fire suppression activity. Increased cardiovascular risk potentially manifests from detrimental changes in ventricular function, vascular load, and their interaction, described as ventricular-vascular coupling., Purpose: To determine the effect of live-fire training on ventricular-vascular coupling., Methods: Sixty-eight male (28 [Formula: see text] 7 years, 26.9 [Formula: see text] 3.9 kg/m 2 ) and fifteen female (36 [Formula: see text] 8 years, 24.3 [Formula: see text] 3.9 kg/m 2 ) firefighters completed hemodynamic and cardiac measures before and after 3 h of intermittent live-fire training. Left ventricular function was assessed as ejection fraction (EF) and ventricular elastance (E LV : end systolic pressure [ESP]/end systolic volume) via echocardiography and applanation tonometry-estimated ESP. Vascular load was assessed as arterial elastance (E A : ESP/stroke volume [SV]). Ventricular-vascular coupling (VVC) was quantified as the ratio of E A to E LV and indexed to body surface area (E A I, E LV I)., Results: Following firefighting EF decreased (p < 0.01) with no change in E LV I (p = 0.34). SV decreased (p < 0.01) with no change in ESP (p = 0.09), driving a significant increase in E A I (p < 0.01). These changes resulted in a significant increase in the VVC ratio (p < 0.01)., Conclusion: The findings suggest that firefighting does not alter ventricular elastance but increases arterial elastance in healthy firefighters, resulting in a mismatch between ventricular and vascular systems. This increase in ventricular-vascular coupling ratio and concomitant reduction in ventricular systolic function may contribute to increased cardiovascular risk following live firefighting., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)