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Ratchford Lab

Principal Investigator: Elizabeth Ratchford, MD
Cardiovascular Disease Prevention Among Firefighters


  • Dominique Ashen

In a combined effort between the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease and the Center for Vascular Medicine, Dominique Ashen PhD, CRNP and Elizabeth Ratchford, MD have developed a center of cardiovascular disease (CVD) prevention for firefighters.  CVD accounts for ~50% of deaths among on-duty firefighters; early detection and treatment of CVD risk factors may prevent disability and death. They have completed two studies, funded by the National Fallen Firefighters Foundation, that have focused on methods of detection of subclinical atherosclerosis (CVD without symptoms) and primary prevention of CVD (avoiding its initial occurrence) in firefighters through risk assessment and risk reduction. Strategies for risk assessment and risk reduction include coronary artery calcium scan and blood work as well as education about a healthy diet, aerobic exercise, maintenance of a normal weight, and tobacco cessation.  Their first study was published in the American Journal of Cardiology in 2014. They are now working on their second manuscript to include the cost-benefit analysis of a CVD prevention program that can be utilized by fire departments throughout the nation. In September 2017, the CVD prevention program expanded to fire departments in 3 Maryland counties and 2 clinics. 

Active Projects

  • Prospective registry looking at cardiovascular risk assessment and risk reduction among firefighters in order to develop a quantitative picture of the cardiovascular burden of firefighters.
  • We will work with our partners, the National Fallen Firefighters Foundation, to translate our research into policy for CVD prevention among firefighters as well as to implement our cost-effective CVD prevention model to fire departments nationally.


  • Ratchford EV, Carson KA, Jones SR, Ashen MD. Usefulness of coronary and carotid imaging rather than traditional atherosclerotic risk factors to identify firefighters at increased risk for cardiovascular disease. Am J Cardiol. 2014; 113(9):1499-504.