NFL Players Face Blood Pressure Hurdles

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Professional Football Players Have Higher Rates of Hypertension Than Other Healthy Young Men

By Bill Hendrick
WebMD Health News

Reviewed by Elizabeth Klodas, MD, FACC

May 26, 2009 -- They pump iron and work out often to stay in top shape, yet professional football players are more likely to have high blood pressure than are average healthy young men, a new study indicates.

"This unexpected prevalence of pre-hypertension and hypertension has led to plans for an NFL-wide survey and in-depth investigation of the mechanisms of these findings," researchers say in the May 27 issue of the Journal of the American Medical Association. "Proposed areas for investigation include strength and resistance training, long-term use of nonsteroidal anti-inflammatory drugs, salt intake, and sleep-disordered breathing."

On the positive side, the study also found that despite being larger and heavier, NFL players have similar cholesterol profiles as average, otherwise healthy young men.

What's more, professional athletes had a lower incidence of "impaired fasting glucose," considered a pre-diabetic condition, and they were less likely to smoke.

Andrew M. Tucker, MD, of Union Memorial Hospital in Baltimore and lead author of the study, tells WebMD that most people look at large individuals, including large football players, and assume they have problems associated with obesity, such as prediabetes.

"But the average football player is pretty lean, and that includes wide receivers as well as offensive linemen," Tucker says. "These guys are incredibly active, and even though many are huge, they are fit. Despite what their tummies might look like, they have large amounts of muscle mass."

But being big, "whether you are a football player or an average person," puts a person at greater risk for high blood pressure, Tucker tells WebMD. "Size matters."

However, there is something unique about football players. "When we compared NFL players weighing 200 pounds to 200-pound people, the NFL players' pressures were much higher." That's somewhat of a mystery, Tucker says, but may be related to strength training pumping up blood pressure, higher salt intake, or the use of anti-inflammatory pain medications.

Football Pros and High Blood Pressure

The study arose out of a concern about the cardiovascular health implications of the large size of pro football players and also those young men who aspire to become pros. Greater player size and sporadic deaths of active and young retired professional players have raised questions about an increased risk of cardiovascular disease among these men.

The study included information on 504 active, non-rookie football players from 12 NFL teams. The data were collected during team mini-camps between April and July 2007. The doctors measured height, weight, neck, waist and hip circumferences, body composition, fasting glucose (blood sugar), total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, high-density lipoprotein (HDL or "good") cholesterol , and triglycerides. Players also had their pulse taken, got their blood pressure evaluated, and underwent electrocardiograms.

The researchers compared that data with information on men in the general population who were participants in the Coronary Artery Risk Development in Young Adults study, which included 1,959 men between 23 and 35 years of age. Not surprisingly, the football players were heavier and taller than the average man.

Despite their larger size, the NFL group had lower average fasting glucose levels and a significantly lower prevalence of abnormal fasting glucose measurements. Cholesterol levels were similar between the groups.

The researchers conclude that high levels of physical exercise among the NFL players were probably important in lessening the effect of body size on some of the cardiovascular risk factors.

The cause for higher blood pressure readings in NFL players could not be explained by the study, although some clues were evident. The researchers say they found no major difference in hypertension or pre-hypertension based on the position of players, although those with highest blood pressure rates tended to have a higher body mass index (an indicator of weight relative to height).

And one-fifth of the players had used nonsteroidal anti-inflammatory drugs (NSAIDs) in the month prior to blood pressure testing. Aspirin, Advil, Motrin, and Aleve are examples of NSAIDs.

SOURCES:
News release, Journal of the American Medical Association.
Tucker, A. Journal of the American Medical Association, May 27, 2009; vol 301: pp 2111-2118.
Andrew M. Tucker, MD, Union Memorial Sports Medicine, Union Memorial Hospital.
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