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Maximum Wellness, Episode 28: Former US Football Athletes at Increased Risk of Cardiovascular Morbidity

“Former US football athletes are at increased risk of cardiovascular (CV) morbidity and mortality compared with the general population and other professional athletes.” That’s a strong conclusion coming from medical researchers from Emory and Furman Universities writing – Weight Gain, Hypertension, and the Emergence of Maladaptive Cardiovascular Phenotypes Among US Football Players – which appeared in the October 16, 2019, online issue of JAMA (Journal of the American Medical Association) Cardiology.

These researchers cite a previous study comparing longevity of professional baseball versus US football athletes, which found a higher cardiovascular risk among the football players, while cross-sectional studies seem to concur that  there is a risk to left ventricular (LV) hypertrophy (enlargement) and hypertension among active professional US football players – specifically the much larger offensive and defensive linemen.

It’s been pointed out that, “the transition from high school to the collegiate US football ranks has been identified as a critical period of CV maladaptation, and weight gain during collegiate US football participation is independently associated with later-life CV morbidity.”

As a result of a gap of knowledge, as to the progression of multiple, independent factors related to college football CV risk, the university researchers sought to examine, “the emergence and progression of multiple independent factors associated with CV risk across serial years of collegiate US football participation.”

It was hypothesized, “that established determinants of CV risk, including weight gain, hypertension, concentric LV hypertrophy with functional impairment, and arterial stiffening, would develop and progress over the course of a multiyear collegiate US football career.”

LV hypertrophy is a thickening of the heart’s left pumping chamber that can be associated with, among other variables, high blood pressure, while arterial stiffness refers to a generalized thickening and stiffening of the arterial wall, also associated with high blood pressure.

From June 2014 and 2017, US football athletes 18 years or older were recruited from National Collegiate Athletic Association Division I programs at Georgia Institute of Technology and Furman University. Exclusion criteria included any athlete with known hypertension requiring pharmacotherapy at enrollment.

Athletes were classified by field position, as either linemen (LM), which included tackle, guard, center, and defensive end positions, or non-linemen (NLM), including quarterbacks, running backs, wide receivers, tight ends, linebackers, cornerbacks, safeties, kickers, and punters.

Assessments were made for age, height, weight, race, current prescription medication usage, systolic and diastolic blood pressure, family history of hypertension and early coronary artery disease, cardiac structure (echocardiography), and arterial function.

It was determined that, “collegiate US football athletes appear to be at risk of developing hypertensive SBP (systolic blood pressure), concentric LV hypertrophy with relative impairments in diastolic function, and arterial stiffening.”

Importantly, the researchers comment, “these analyses identified weight gain throughout collegiate US football participation, a factor that has recently been associated with CV morbidity later in life among former professional US football players, as a potential unifying mechanistic factor in the development of this constellation of early life subclinical CV pathology.”