NFL players have comparable dyslipidemia and more hypertension than healthy men

Currently active athletes in the National Football League have lower impaired fasting glucose and higher levels of hypertension and prehypertension than their counterparts in a comparable population of the same age, study results suggested.

Researchers evaluated 504 active, veteran NFL players from a convenience sample of 12 NFL teams and compared the data generated to that of a population of healthy adult-men of the same age from the CARDIA study (n=1,959). CARDIA is a population-based, observational study of adults aged 23 to 35 years who were recruited in 1985 to 1986. The primary outcome measure was the prevalence of cardiovascular disease risk factors like hypertension, smoking, dyslipidemia and glucose intolerance.

NFL players were taller and heavier than their counterparts in the CARDIA group, but had a lower prevalence of IFG (6.7% vs. 15.5%; P<.001). The NFL players were also less likely to smoke vs. the CARDIA group (0.1% vs. 30.5%; P<.001). The researchers also reported no significant differences between the groups for total cholesterol, LDL levels, HDL levels or triglycerides.

There was more hypertension (13.8% vs. 5.5%; P<.001) and prehypertension (64.5% vs. 24.2%; P<.001) among the NFL players vs. the CARDIA group. BMI was positively associated with total cholesterol, LDL, HDL and triglycerides in both groups.

“Compared with a sample of healthy young adult-men, taller and heavier active NFL players had a lower prevalence of IFG and similar prevalence of dyslipidemia,” the researchers wrote in their conclusion. “Of concern was the higher prevalence of prehypertension and hypertension among NFL players. Investigation into the causes and long-term trends in hypertension in the NFL is currently underway.” – by Eric Raible

Tucker A. JAMA. 2009;301:2111-2119.

What I found interesting was the evaluation of the group with the BMI above 30, which is the definition of obesity. Some might argue that these football players are big guys and maybe the BMI measures do not reflect the proper parameters. The fact was that the individuals in the high BMI group, which in the rest of the world we would say are obese, in fact metabolically looked like they were obese. They had low HDL and high triglycerides. That defined them as a group at slightly increased risk for CVD. The message there - particularly with the linemen where size is more important than agility- is that these folks are becoming obese in order to become big linemen, and the obesity is moving them towards a higher CVD risk. The obese linemen group is a subset, but on the average, the whole group looks pretty decent. Keep in mind that you are averaging in the really athletic football players like receivers and ends, and when you look at the subset of obese linemen, that subgroup does not look as good. This obesity issue in linemen works its way all the way down to high school. I have done some sports medicine, and have seen some of these high school kids who are grossly obese. The coaches love them and want these kids on the line. They are obese and have the early metabolic changes that go along with higher CVD risk. There is a tendency for the linemen to be more obese, but that may be a mistake in the long-term, particularly at the high school and college levels, where these kids might be encouraged to gain weight.

– Alfred Bove, MD, PhD

President, American College of Cardiology