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Prevalence of Cardiovascular Disease Risk Factors Among National Football League Players
Andrew M. Tucker, MD;
Robert A. Vogel, MD;
Andrew E. Lincoln, ScD;
Reginald E. Dunn, BA;
Debra C. Ahrensfield, MD;
Thomas W. Allen, DO;
Lon W. Castle, MD;
Robert A. Heyer, MD;
Elliot J. Pellman, MD;
Patrick J. Strollo Jr, MD;
Peter W. F. Wilson, MD;
Anthony P. Yates, MD
JAMA. 2009;301(20):2111-2119.
Context Concern exists about the cardiovascular health implications of large size among professional football players and those players who aspire to professional status.
Objectives To assess cardiovascular disease (CVD) risk factors in active National Football League (NFL) players and to compare these findings with data from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Design, Setting, and Participants A cross-sectional study of 504 active, veteran football players from a convenience sample of 12 NFL teams at professional athletic training facilities between April and July 2007. Data were compared with men of the same age in the general US population (CARDIA study, a population-based observational study of 1959 participants aged 23 to 35 years recruited in 1985-1986).
Main Outcome Measures Prevalence of CVD risk factors (hypertension, dyslipidemia, glucose intolerance, and smoking).
Results The NFL players were less likely to smoke when compared with the CARDIA group (0.1% [n = 1]; 95% confidence interval [CI], 0%-1.4%; vs 30.5% [n = 597]; 95% CI, 28.5%-32.5%; P < .001). Despite being taller and heavier, NFL players had significantly lower prevalence of impaired fasting glucose (6.7% [n = 24]; 95% CI, 4.6%-8.7%; vs 15.5% [n = 267]; 95% CI, 13.8%-17.3%; P < .001). The groups did not differ in prevalence of high total cholesterol and low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), or high triglycerides. Hypertension (13.8% [n = 67]; 95% CI, 11.0%-16.7%; vs 5.5% [n = 108]; 95% CI, 4.6%-6.6%) and prehypertension (64.5% [n = 310]; 95% CI, 58.3%-70.7%; vs 24.2% [n = 473]; 95% CI, 22.3%-26.1%) were significantly more common in NFL players than in the CARDIA group (both P < .001). Large size measured by body mass index (BMI) was associated with increased blood pressure, LDL-C, triglycerides, and fasting glucose, and decreased HDL-C.
Conclusions Compared with a sample of healthy young-adult men, a sample of substantially larger NFL players had a lower prevalence of impaired fasting glucose, less reported smoking, a similar prevalence of dyslipidemia, and a higher prevalence of hypertension. Increased size measured by BMI was associated with increased CVD risk factors in this combined population.
Author Affiliations: Union Memorial Sports Medicine, Union Memorial Hospital (Dr Tucker), Department of Cardiology, University of Maryland School of Medicine (Dr Vogel), and Sports Medicine Research Center, MedStar Research Institute (Dr Lincoln and Mr Dunn), Baltimore, Maryland; Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania (Dr Ahrensfield); Department of Family/Sports Medicine, University of Oklahoma College of Medicine, Tulsa (Dr Allen); Cardiovascular Medicine, Cleveland Clinic, Westlake, Ohio (Dr Castle); Department of Internal Medicine, Carolinas Medical Center, Charlotte, North Carolina (Dr Heyer); ProHEALTH Care Associates, Lake Success, and Departments of Medicine and Orthopaedics, Mount Sinai School of Medicine, New York (Dr Pellman), New York; Department of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine (Dr Strollo) and Department of Medicine, University of Pittsburgh Medical Center (Dr Yates), Pittsburgh, Pennsylvania; and Department of Medicine, Emory University School of Medicine, Atlanta, Georgia (Dr Wilson).
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