Introduction: Operational cardiology is an emerging field of military medicine focused on cardiovascular risk assessment and maintaining mission fitness. Military activities involve intense physical exertion, operational stress, sleep deprivation, and occupational exposures that can trigger acute cardiovascular events, including in apparently healthy individuals. The aim of this review is to synthesize data on cardiovascular risk in the military population and its implications for determining mission fitness. Materials and Methods: This review included 52 studies published between 2000 and 2026, identified in PubMed/MEDLINE, Web of Science, and Scopus. The papers were analyzed thematically: cardiovascular epidemiology, sudden cardiac death, specific risk factors, impact of exertion and operational stress, cardiovascular screening, and physiological monitoring. Results: Cardiovascular events occur predominantly during intense exertion and are frequently associated with previously undiagnosed pathology. Traditional risk factors coexist with operational stressors, increasing cardiovascular load. Cardiovascular screening and cardiorespiratory fitness assessment allow risk stratification and identification of overload. Conclusions: Integration of cardiovascular screening, fitness assessment, and physiological monitoring may reduce the risk of cardiovascular events and optimize operational safety. Standardized protocols adapted to the military environment are needed.
As reported by literature, rheumatoid arthritis is a rheumatic disease with an increased risk of developing cardiovascular complications. Early detection of atherosclerosis by non-invasive techniques represent a current challenge of patient management. Current EULAR guidelines recommend careful monitoring of cardiovascular risk factors by stratification of patients and strict control of rheumatic disease activity to reduce it. The classic evaluation of intima- medium thickness (IMT) was completed by quantifying the degree of inflammation of the carotid plate using positron emission tomography or the degree of coronary calcifications by calculating Agatston score using Coronary Computer Tomography. These modern investigation techniques allow identification of several subclinical stages of atherosclerosis, the interest in their early detection resulting from the fact that, in this stage, through specific measures, the cardiovascular complications can be prevented.
Auto-immune rheumatic diseases are characterised by high levels of inflammation that accelerate the development of atherosclerosis, increasing the cardiovascular risk. Direct evaluation of arteries such as of intima media thickness measurement is a simple test that asesses the cerebral and cardiovascular risk. In the initial stages, an increase of the intimal media thickness can be observed. Later on, atherosclerosis (plaques), stenosis and occlusion of the arteries can be identified. Indirect evaluation of the cardiovascular risk can be performed using serological markers - fibrinogen, C reactive protein, estimated sedimentation rate, total cholesterol, low density lipoproteins and high density lipoproteins, homocysteine levels etc. The presence of certain lifestyle factors that increase the risk, such as smoking, sedentarism and associated pathologies such as obesity, diabetes, hypertension were assesed in patients with rheumatoid arthritis. The aim of the study is to prove the relationship between anti-tumor necrosis factor alpha therapy effect on the cardiovascular risk in rheumatoid arthritis patients.
