The cardiovascular health of professional football players and those players who aspire to professional status has become the focus of at least one study, which is being published in JAMA on May 27.

A significant increase in body mass index (BMI) for offensive and defensive linemen has been noted during the past 30 years, and body mass index fitting the category of class II obesity, reported in more than a quarter of National Football League (NFL) players in 2003, is another cause for alarm, researchers say.

Just as important, sporadic deaths of active and young retired professional football players have led researchers to investigate whether there's an increase in cardiovascular disease risk among retired NFL players.

Studying this elite population, Andrew M. Tucker, M.D., of Union Memorial Hospital, Baltimore, and colleagues compared the prevalence of CVD risk factors in NFL players with average young men of the same age.

The study included 504 active men who are retired NFL players from 12 NFL teams.

Investigators did the usual workup: Data collected during team mini-camps between April and July 2007 included health histories; height; weight; neck, waist, and hip circumferences; as well as BMI, fasting glucose levels, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides; blood pressure; pulse; and electrocardiograms.

Data were compared with men the same age, who were participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a group which included 1,959 participants age 23 to 35 years old.

The NFL players were taller and heavier than the CARDIA group. The researchers found that despite their larger size, the NFL group had lower average fasting glucose levels and a significantly lower prevalence of impaired fasting glucose (6.7 percent vs. 15.5 percent) compared with the CARDIA group, perhaps because the athletes continued to exercise strenuously.

However, when push came to shove, there were no significant differences between the athletic and non-athletic males; the prevalence of high total cholesterol, high LDL-C, low HDL-C and high triglyceride levels were the same. It should be noted that the NFL players were less likely to smoke than the non-elite athletes in the CARDIA group (0.1 percent of former NFL players smoked versus 30.5 percent in the CARDIA group).

High Blood Pressure Worries

The statistic that worries researchers is the much higher blood pressure levels present among former NFL players. About 14 percent of retired NFL players had high blood pressure readings compared with 5.5 percent of non-athletes.

Just as important, prehypertension among retired NFL players was signficantly higher: 64.5 percent versus 24.2 percent in the CARDIA group.

Prehypertension in young men is a harbinger of hypertension. Researchers reported that several of the veteran players participating in the study were taking anti-hypertensive medicine.

This unexpected prevalence of prehypertension and hypertension has led to plans for an NFL-wide survey and in-depth investigation of the mechanisms of these findings, researchers say.

Proposed areas for investigation include long-term use of nonsteroidal anti-inflammatory drugs, salt intake, and sleep disordered breathing, the authors write.

At the same time, they suggest the high levels of physical activity in the NFL sample is probably important in mitigating the effect of body weight as a CVD risk factor but that the significantly higher rate of hypertension in young, retired football players is a concern that needs to be remedied quickly, before the condition leads to a heart attack or stroke.

Source: Union Memorial Hospital, Baltimore