Former NFL Players Show Heart Abnormalities Years After Retiring from Football

Retired National Football League (NFL) players were found to have heart abnormalities specifically associated with high blood pressure (BP), years after departing the sport, according to researchers of a study being presented at the American College of Cardiology’s 68th Annual Scientific Session.

The new research, which is part of a continuous study into the health of former players supported by the NFL Player Care Foundation, marked the first attempt to gauge how an athlete’s body type and training style (strength versus endurance-based training) may impact the configuration of their heart years after retirement. World-class athletes typically display changes in the shape and size of their hearts due to the advanced level of training they undergo; changes collectively referred to as “athlete’s heart”. A key component of athlete’s heart is left ventricle hypertrophy (LVH). Although the condition correlates with an increased rate of hypertension, a key factor in people who develop cardiovascular disease, it is not thought to be dangerous when it develops from athletic training.

To conduct this study, researchers analyzed ECGs and images of the heart, BP measurements, and demographic factors from a sample of 1,172 former players. Approximately 12% of players in the sample had LVH, a comparable rate to the general public. However, retired players with severe LVH had a substantially higher BP, by approximately 13 mm Hg on average, than those with LVH. Moreover, former players experiencing hypertension were 1.5 times more likely to have LVH than those without hypertension.

Big Players Incur Higher Risk

The results revealed no difference in the rate of LVH between players newly retired from the NFL and those retired 20 years earlier or more, suggesting that either LVH fails to regress following retirement, or that LVH recurs relatively quickly, perhaps due to long-term, untreated hypertension. Furthermore, researchers found the likelihood of LVH was closely associated with the player’s position and was observed more prevalently in positions that emphasize strength-based training and require a large body size, such as linemen, fullbacks, running backs, linebackers, and quarterbacks, occurring less often in cornerbacks, punters, wide receivers, returners, and kickers (positions that emphasize speed).

Sleep Apnea Plays a Role

In a related study, researchers uncovered that a simple questionnaire administered during a players’ physical examination is an effective, low-cost method of identifying obstructive sleep apnea, which has increasingly been linked to heart disease. The study showed that former players who reported symptoms of sleep apnea were more likely to incur hypertension and LVH than those reporting minimal to no symptoms of sleep apnea.

“Because of their years of athletic training at the most elite level, there tends to be an expectation that former professional players would have fewer cardiovascular issues, but there’s a growing body of research that suggests that’s not the case,” said lead study author, Genevieve Smith, PhD, a faculty instructor at Tulane University School of Medicine, in a press release. “Our study suggests we need to be vigilant in monitoring players’ cardiovascular health, because we don’t yet truly understand the long-term consequences of high-performing athletics.”