Unexpected Finding: Army Personnel Less Likely Than Civilians to Have Ideal Heart Health

Photo of Darwin R. Labarthe

Darwin Labarthe, the study’s senior author

Alice Shrestha, University of Pennsylvania; Tiffany E. Ho, University of Pennsylvania; Loryana Vie, University of Pennsylvania; Darwin R. Labarthe, Northwestern University; Lawrence M. Scheier, University of Pennsylvania; Paul B. Lester, Army Research Facilitation Laboratory; and Martin E.P. Seligman, University of Pennsylvania

Active duty Army personnel are less likely than civilians to have ideal heart health — even when excluding the least healthy recruits, according to a first-of-its kind study.

The finding, published today in the Journal of the American Heart Association, surprised the study’s authors in light of the Army’s health threshold for entry and its commitment to physical fitness.

Researchers used data from routine Army physical examinations in 2012 and from the National Health and Nutrition Examination Survey (NHANES) in 2011-2012 to compare a cohort of active duty Army personnel with a representative sample of the U.S. civilian population.

Looking at four measures of cardiovascular health — body mass index (BMI), blood pressure, presence of diabetes and current smoking status — in both groups overall and by gender, age and race/ethnicity, they found:
  • Demographically, the Army cohort was younger, less often female or Hispanic, and had less post-high school education than the corresponding civilian population.
  • Current smoking rates were about equal (20%) in the Army and civilian cohorts overall, although among females and Hispanics in the Army rates were lower (15%) than among civilians.
  • Ideal BMI (<25 kg/m2) was found in only one-third of the overall Army and civilian cohorts, although nearly half of the Army females had ideal BMI.
  • Ideal blood pressure (<120/<80 millimeters of mercury) was strikingly less frequent in the Army (30%) than in the civilian (55%) cohort (see figure below for Blood Pressure Categories).
  • Diabetes was rare in both populations.

Figure: Categories of Blood Pressure Chart (“normal” corresponds with ideal cardiovascular health)

Figure: Categories of Blood Pressure Chart (“normal” corresponds with ideal cardiovascular health)

Parsing the study’s results

Researchers were unable to explore factors potentially underlying their findings, such as dietary patterns and physical activity, in this analysis; and aside from race/ethnicity and education, they couldn’t compare measures of social disadvantage between the two cohorts. Measures such as these, considered among the social determinants of health, may disfavor members of the Army cohort relative to the civilian sample.

In addition, the present analysis didn’t extend to factors such as deployment history, combat exposure and other military-specific experiences that might have influenced members’ cardiovascular health. Whether similar findings are present in other military service branches warrants further exploration as well, researchers said.

Cardiovascular health and military preparedness

Only about one-third of the overall active duty Army cohort had ideal levels of BMI and blood pressure, and prevalence of ideal blood pressure was especially low among Army males — about 27%, versus 46% for civilian males.

These figures are a call to action – both further analysis of the extensive data on physical and psychological health of Army personnel and implementation of current policies and recommendations to promote ideal cardiovascular health for the U.S. population as a whole are important next steps. For the Army, in particular, efforts to promote and sustain favorable levels of blood pressure and BMI may contribute to significant improvements in cardiovascular health and quality of life, as well as reduced health care costs during and after military service. Enhanced military preparedness could accrue as well – a topic for investigation.