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Apr 24, 2019

Heart Issues in Retired NFL Players

Left ventricular hypertrophy, related to the presence of high blood pressure, tracked closely to former defensive players in this study.

Experts recommend close monitoring of heart health in NFL players, based on a recent study that found professional football players—especially those who played in defensive position—show signs of heart issues after retirement.

Funded by the NFL Player Care Foundation, this analysis was part of an ongoing study of the health of professional football players in the NFL. Through the study, researchers examined images of the heart in a sample of 1,172 retired football players. They then compared imaging results with blood pressure, weight, demographics and football position.

The goal of the study was to see how these factors impact risk for left ventricular hypertrophy. This condition, often referred to as LVH, occurs when the heart’s main pumping chamber becomes too thick. With LVH, the heart can’t pump blood as strongly and causes symptoms like shortness of breath, chest pain and fatigue.

According to authors, LVH can result from high blood pressure—a condition sometimes brought on by excess body weight and other unhealthy lifestyle choices. However, LVH can also occur from years of intense exercise training—a condition known as “athlete’s heart.”

After analysis, researchers found that 12 percent of study participants had LVH, a rate similar to that of the general public. However, those with severe LVH had significantly higher blood pressure than those without LVH. Researchers also found that former players with high blood pressure were 1.5 times more likely to have LVH than those with normal blood pressure.

What findings show is that LVH in retired football players appears to be linked to hypertension, rather than their years of elite exercise training. That means that the intense exercise is likely harmless, according to authors, when it comes to LVH in retired football players.

However, that doesn’t mean retired football players are in the clear when it comes to LVH. Researchers found that risk of LVH tracked closely with the player’s position in the NFL. Compared to smaller players like quarterbacks and tight ends, participants in defensive positions who tend to be larger were more likely to have LVH after retirement.

Researchers also note that findings did not change when looking at newly retired players vs. those retired for 20 or more years.

The take-home message, according to authors, is that former NFL players need to keep an eye on any cardiovascular risk factors and work to keep blood pressure in a healthy range.

“Because of their years of athletic training at the most elite level, there tends to be an expectation that former professional players would have fewer cardiovascular issues, but there’s a growing body of research that suggests that’s not the case,” said Genevieve Smith, PhD, a faculty instructor at Tulane University School of Medicine and the study’s lead author. “Our study suggests we need to be vigilant in monitoring players’ cardiovascular health, because we don’t yet truly understand the long-term consequences of high-performance athletics.”

Authors add that since risk for LVH didn’t change based on length of retirement, the condition either doesn’t reverse after retiring or is easily triggered by high blood pressure.

“In spite of the fact that these guys were, at one point, incredibly active and in incredibly good cardiovascular shape, down the line they may still end up having some significant cardiovascular abnormalities,” Smith said. “What we don’t know is whether the changes we’re seeing later in life are related to the high blood pressure or to the ‘athlete’s heart’ that they had when they were professional players.”

Either way, authors believe it’s clear that continued health monitoring is key for NFL players on and off the field. As past research has shown, professional football players face unique and serious health risks from their years of intensely rough play. Experts hope that future studies like those funded by the NFL Player Care Foundation will help us understand and improve health outcomes for current and retired players.

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