NFL Players Not at Increased Heart Risk

TUESDAY, May 26 (HealthDay News) -- Those refrigerator-sized National Football League players you see on television every Sunday aren't at any higher risk of cardiovascular problems than the guy next door, a new study finds.

"Overall, the risk is similar to that of American males of similar age and race distribution," said Dr. Andrew M. Tucker, medical director of sports medicine at Union Memorial Hospital in Baltimore, co-chair of the NFL subcommittee on cardiovascular health and lead author of a report in the May 27 issue of the Journal of the American Medical Association.

And that's true even though the 504 players from 12 NFL teams examined in the study had an average body mass index (BMI) of 31, while a BMI of 30 is the accepted marker for obesity in the general population. That extra weight consists mostly of muscle rather than fat, Tucker explained.

"The mean average body fat was 14 percent," he said. "For wide receivers it was 8 percent, for offensive linemen 25 percent, the upper limit of normal."

The study was done because "we have been wondering about whether the extremely large size we've been seeing in NFL players is having a detrimental effect on cardiovascular risk," he said. And so Tucker and other members of the subcommittee selected veteran NFL players from 12 teams to be compared for cardiovascular risk factors with 1,959 young adults in an ongoing coronary risk study.

There were differences, some favorable -- the NFL players looked better on blood glucose readings, a measure of diabetes -- and some unfavorable -- most notably, a higher incidence of high blood pressure and borderline elevated blood pressure in the NFL group. Their incidence of high blood pressure was 13.8 percent, compared to 5.5 percent of the men in the general population. The incidence of what doctors call prehypertension was 64.5 percent, versus 24.2 percent in the general population sample.

The reason for the difference is unclear, Tucker said. "We think that something more than bigness contributes to higher blood pressure in these athletes," he said. "We will do a league-wide study of blood pressure this year to try to figure out why there is a difference."

It's possible that their higher blood pressure is caused by the players' steady use of nonsteroidal anti-inflammatory drugs or by a high intake of sodium in the large amounts of food they eat to keep up their weight, Tucker said.

Both of those explanations could apply, said Dr. Neil Coplan, director of the section of clinical cardiology at Lenox Hill Hospital in New York City. "The use of nonsteroidal medications is much higher in the football population than the non-football population, and nonsteroidals are significantly associated with high blood pressure," Coplan said.

But the blood pressure finding was not firm because it was based on a single reading, "and to define hypertension you need to have a number of measurements at different times," he said.

And the entire study was made at a single point in time, so that a long follow-up would be needed to determine the true long-term cardiovascular risk for the players, Coplan said.

On the plus side of the risk factor equation, only one of the NFL players said they smoked, compared to 30.5 percent of men in the general population sample.

As for blood fats such as cholesterol, no difference was seen between the two groups.

The high levels of physical activity needed to keep a job in the NFL probably help keep the cardiovascular risk low, the report said. Physical activity is a standard recommendation for reducing risk.

A study of 201 retired NFL players last year found that they were not at increased risk of cardiovascular disease after their careers ended. The study found that the former players were more likely to remain physically active than other men of their age group, had a lower incidence of diabetes, and had the same incidence of atherosclerosis, the build-up of fatty plaques that narrow coronary arteries.

But life is not all roses for former pro football players. A 2007 study of 3,377 retired members of the NFL Players Association found that nearly 15 percent of them reported moderate to severe depression. While that is about the incidence in the general population, half of those respondents said they suffered from chronic pain.

That study was timely because it came shortly after the suicide of Andre Waters, a former star safety in the NFL who was suffering from brain damage caused by multiple concussions during a 12-year career.

The NFL is aware of the concussion issue, said Greg Aiello, a spokesman for the league. "We have an ongoing study on the long-term effects of concussion," Aiello said. "Meanwhile, we emphasize prevention and proper treatment of concussions among our current players."


SOURCES: Andrew M. Tucker, M.D., medical director, sports medicine, Union Memorial Hospital, Baltimore; Neil Coplan, M.D., director, section of clinical cardiology, Lenox Hill Hospital, New York City; Greg Aiello, spokesman, National Football League; May 27, 2009, Journal of the American Medical Association
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