The number one cause of firefighter line of duty death each year is heart attack and has been so for the past twenty years. The problem was the Aberdeen Fire Department (AFD) did not have a system in place that identified or monitored firefighters at increased risk for cardiovascular disease. The purpose of this research was to identify viable methods by which the AFD and local fire departments could reduce the incidence of heart attack by identifying and reducing cardiac risk factors among firefighters.Descriptive research utilizing internal and external questionnaires and personal interviews was used to answer the research questions to: (a) determine if the firefighters included in the research had taken steps to identify and reduce their risk of heart attack; (b) identify the personal and organizational barriers preventing firefighters from improving their cardiovascular health; (c) identify cardiac screening programs that would result in cardiac risk reduction for firefighters, and (d) assess if physical fitness was an organizational priority for the fire departments included in this research.The results indicated that none of the fire departments required incumbent firefighters to undergo annual medical evaluations; that nearly half of the firefighters surveyed could be at increased risk of heart attack due to undiagnosed and untreated cardiac risk factors, and that financial costs, staffing issues, lack of organizational prioritization and personal choice were the primary barriers preventing firefighters from obtaining medical evaluations and improving their overall physical fitness. It was recommended that the fire departments utilize NFPA 1582, The Fire Service Joint Labor Management Wellness-Fitness Initiative and the Health and Wellness Guide for the Volunteer Fire and Emergency Services to develop mandatory cardiac screening programs designed to identify and treat firefighters with elevated cardiac risk factors.