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Causes of weight gain, higher BP identified in college football players
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Weight gain and increased systolic BP in collegiate U.S. football players may be due to concentric left ventricular hypertrophy, arterial stiffening and reduced left ventricular diastolic function, according to a study published in JAMA Cardiology.
After adjustment for race, height and player position, researchers observed that significant weight gain (mean weight gain, 4.74 kg; P < .001) in collegiate U.S. football athletes was due to arterial stiffening (increased pulse-wave velocity, beta = 0.01; P = .003) as well as the development of concentric LV hypertrophy (OR = 1.09; 95% CI, 1.05-1.14).
Moreover, increases in systolic BP (mean increase, 11.6 mm Hg; P < .001) were associated with arterial stiffening (beta = 0.01; P = .007) as well as the development of concentric LV hypertrophy (OR = 1.04; 95% CI, 1.01-1.07), according to the researchers.
Healio had previously reported on similar findings from a different study of former NFL athletes at the ACC Scientific Session.
“At present, practitioners and athletic trainers charged in the care of U.S. football athletes are faced with the challenge of identifying U.S. football athletes at high risk, who warrant close CV monitoring,” Jonathan H. Kim, MD, MSc, assistant professor of sports cardiology at Emory Clinical Cardiovascular Research Institute at Emory University School of Medicine, and colleagues wrote. “Our findings demonstrate that serial anthropometric and blood pressure measurements, coupled with the consideration of differential LV structural phenotypes, represent easily accessible metrics that can be used to identify U.S. football athletes who may benefit from lifestyle counseling, and when indicated, guideline-based medical therapies.”
In other findings, collegiate U.S. football players also experienced changes in CV risk factors that included rises in pulse-wave velocity (mean increase, 0.24 m/s; P = .007) as well as significant declines in E velocity (mean decline, 1.7 cm/s; P < .001).
“Multiple independent and likely synergistic indices of CV risk, including increased systolic BP, arterial stiffening and concentric LV hypertrophy with relative impairments in diastolic function, develop and progress over the course of a multiyear collegiate U.S. football career,” the researchers wrote. “Our analyses suggest that weight gain and increased systolic BP during the years of collegiate U.S. football exposure are associated with the development of this complex maladaptive CV phenotype, which may be used to identify U.S. football athletes that warrant close clinical surveillance both during and after U.S. football participation.”
In this multiyear, multicenter, longitudinal and observational cohort study of 126 collegiate U.S. football athletes from NCAA Division I programs at Georgia Institute of Technology and Furman University (49% white; 39% linemen; 100% men; mean weight, 101.1 kg; mean systolic BP, 129.1mm Hg at baseline), researchers aimed to characterize the maladaptive CV phenotypes associated with weight gain and higher systolic BP in the group. Factors associated with CV risk were assessed clinically using transthoracic echocardiography and vascular applanation tonometry, between June 2014 and June 2017, at multiple points during 3 complete years of football participation.
“Clarification of the mechanistic link between deliberate weight gain and the emergence of CV pathology, coupled with the development of directed preventive strategies designed to minimize later-life morbidity and mortality in this population, represent essential future directives,” the researchers wrote. – by Scott Buzby
Disclosures: One author reports he received funding from the NIH/NHLBI, the National Football Players Association and the American Heart Association to study CV health and physiology in U.S. football players. The other authors report no relevant financial disclosures.
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