High Prevalence of Cardiovascular Disease and Risk Factors Among Former National Football League Players

I expected that former football players, especially at the national level would continue some form of physical activity and remain relatively fit during the rest of their life as they have been well trained. But results of an analysis of HUDDLE study tells us differently [1]. Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms was aimed to raise awareness and estimate the prevalence of cardiovascular disease and associated risk factors among members of the United States, National Football League Alumni Association and their family members through education and screening events. HUDDLE was a multicity cross-sectional study of individuals aged 50 years and older and they participated in health education, and screening of blood pressure, ECG and transthoracic echocardiograms were done. The current paper focussed on former players.

Among the 285 former players in the study, of which over two thirds were African American, prevalence of hypertension was 89.8%, though only 37.5% were aware of it. Structural cardiac abnormalities by echocardiogram were noted in 61.8%. Hypertension was a significant predictor of clinically relevant structural abnormalities on transthoracic echocardiogram. I was rather surprised by this finding and still more surprised by what was mentioned in an accompanying editorial [2]. The editorial mentioned that up to one third of former American football players die of cardiovascular disease. They also pointed out that the left ventricular hypertrophy noted is unlikely to have been due to “athlete’s heart” which is known to reverse rapidly after stopping training. It was more likely associated with hypertension, that too often undetected and untreated in many.

References

1. Okoh AK, Amponsah MKD, Cheffet-Walsh S, Patel M, Carfagno D, Linton D, Dimeff R, Braunreiter D, Harrington P, Brennan FH Jr, Kavinsky C, Everett M, Park B, Gunnarsson M, Snowden S, Mootz L, Koepnick T, Wheeler J, Clarke SE, Prince H, Sannino A, Grayburn P, Rice EL. Prevalence of Cardiovascular Disease and Risk Factors Among Former National Football League Players. J Am Coll Cardiol. 2024 May 14;83(19):1827-1837. doi: 10.1016/j.jacc.2024.03.371. Epub 2024 Apr 7. PMID: 38593943.
2. Guseh JS 2nd, Januzzi JL Jr. The Hidden Cardiovascular Crisis Among Former NFL Athletes: After the HUDDLE. J Am Coll Cardiol. 2024 May 14;83(19):1838-1840. doi: 10.1016/j.jacc.2024.03.403. PMID: 38719364.