The American Journal of Medicine
Volume 122, Issue 9 , Pages 811-814 , September 2009

Early Cardiovascular Mortality in Professional Football Players: Fact or Fiction?

  • Michael A. Selden, MD

      Affiliations

    • University of Missouri-Kansas City School of Medicine, Kansas City, Mo
    • Saint Luke's Hospital of Kansas City, Kansas City, Mo
  • ,
  • John H. Helzberg, MD

      Affiliations

    • University of Missouri-Kansas City School of Medicine, Kansas City, Mo
    • Saint Luke's Hospital of Kansas City, Kansas City, Mo
    • Corresponding Author InformationRequests for reprints should be addressed to John H. Helzberg, MD, University of Missouri-Kansas City School of Medicine, 4321 Washington St, Suite 5600, Kansas City, MO 64111
  • ,
  • Joseph F. Waeckerle, MD

      Affiliations

    • University of Missouri-Kansas City School of Medicine, Kansas City, Mo

References 

  1. Mueller FO, Colgate B. Annual survey of football injury research 1931-2007. http://www.unc.edu/depts/nccsi/FootballAnnual.pdfAccessed February 17, 2009
  2. Dick R, Ferrara MS, Agel J, et al. Descriptive epidemiology of collegiate men's football injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train. 2007;42:221–233
  3. Baron S, Rinsky R National Institute for Occupational Safety and Health. NFL Mortality Study. http://www.cdc.gov/niosh/pdfs/nflfactsheet.pdfAccessed September 1, 2008
  4. Hargrove T, et al. Supersized in the NFL: many ex-players dying young. Scripps Howard News Service Online. January 31, 2006;
  5. Nicholas SJ, Nicholas JA, Nicholas C, et al. The health status of retired American football players: Super Bowl III revisited. Am J Sports Med. 2007;35:1674–1679
  6. Miller MA, Croft LB, Belanger AR, et al. Prevalence of metabolic syndrome in retired National Football League players. Am J Cardiol. 2008;101:1281–1284
  7. Croft LB, Belanger A, Miller MA, et al. Comparison of National Football League linemen versus nonlinemen of left ventricular mass and left atrial size. Am J Cardiol. 2008;102:343–347
  8. Retired NFL players at increased risk for heart problems (Science Daily). http://www.sciencedaily.com/releases/2008/03/080327171014.htmAccessed September 1, 2008
  9. Harp JB, Hecht L. Obesity in the National Football League. JAMA. 2005;293:1061–1062
  10. Vega GL, Adams-Huet B, Peshock R, et al. Influence of body fat content and distribution on variation in metabolic risk. J Clin Endocrinol Metab. 2006;91:4459–4466
  11. Gelber RP, Gaziano JM, Orav EJ, et al. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol. 2008;52:605–615
  12. George CF, Kab V, Levy AM. Increased prevalence of sleep-disordered breathing among professional football players. N Engl J Med. 2003;348:367–368
  13. Bertovic DA, Waddell TK, Gatzka CD, et al. Muscular strength training is associated with low arterial compliance and high pulse pressure. Hypertension. 1999;33:1385–1391
  14. Antman EM, Bennett JS, Daugherty A, et al. Use of nonsteroidal anti-inflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation. 2007;115:1634–1642
  15. Androgue HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2007;356:1966–1978
  16. Selden MA, Helzberg JH, Waeckerle JF, et al. Cardiometabolic abnormalities in current National Football League players. Am J Cardiol. 2009;103:969–971
  17. Kannel WB, Vasan RS, Keyes MJ, et al. Usefulness of the triglyceride-high-density lipoprotein versus the cholesterol-high-density lipoprotein ratio for predicting insulin resistance and cardiometabolic risk (from the Framingham Offspring Cohort). Am J Cardiol. 2008;101:497–501
  18. Cordero A, Laciaustra M, Leon M, et al. Comparison of serum lipid values in subjects with and without the metabolic syndrome. Am J Cardiol. 2008;102:424–428
  19. McLaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139:802–809
  20. McKimmie RL, Daniel KR, Carr JJ, et al. Hepatic steatosis and subclinical cardiovascular disease in a cohort enriched for Type 2 diabetes. Am J Gastroenterol. 2008;103:3029–3035
  21. Ioannou GN. Implications of elevated serum alanine aminotransferase levels: think outside of the liver. Gastroenterology. 2008;135:1851–1854
  22. Ioannou GN, Weiss NS, Boyko EJ, et al. Elevated serum alanine aminotransferase activity and calculated risk of coronary heart disease in the United States. Hepatology. 2006;43:1145–1151
  23. Schindhelm RK, Dekker JM, Nijpels G, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study. Atherosclerosis. 2007;191:391–396
  24. Goessling W, Massaro JM, Vasan RS, et al. Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease. Gastroenterology. 2008;135:1935–1944
  25. Vozarova B, Stefan N, Lindsay RS, et al. High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes. 2002;51:1889–1895
  26. Tucker AM, Vogel RA, Lincoln AE, et al. Prevalence of cardiovascular disease risk factors among National Football League players. JAMA. 2009;301:2111–2119
  27. Center for the Study of Retired Athletes. News. www.csra.unc.edu/statistics.htmAccessed September 1, 2008
  28. Laurson KR, Eisenmann JC. Prevalence of overweight among high school football linemen. JAMA. 2007;297:363–364
  29. Gomez JE, Ross SK, Calmbach WL, et al. Body fatness and increased injury rates in high school football linemen. Clin J Sports Med. 1998;8:115–120
  30. Keith AE. Fattened up for football. People. 2008;70:93–96
  31. Buell JL, Calland D, Hanks F, et al. Presence of metabolic syndrome in football linemen. J Athl Train. 2008;43:608–616

 Funding: None.

 Conflict of Interest: None.

 Authorship: All authors had access to the data and a role in writing the manuscript.

PII: S0002-9343(09)00441-0

doi: 10.1016/j.amjmed.2009.03.027

The American Journal of Medicine
Volume 122, Issue 9 , Pages 811-814 , September 2009