Heart Problems Could Sideline Linemen

Heart problems like increased blood pressure and heart wall thickness more common in football linemen


Being an athlete doesn't always protect you from heart problems.

College football linemen may have a raised risk of heart problems — raised blood pressure and changes in heart structure, specifically — compared to other players, a new study found.

"We validated prior results that showed that football participants — freshman football players — after the course of one season, developed significant increases in their blood pressure, some of them actually developing overt hypertension," said lead study author Jeffrey Lin, MD, cardiac imaging fellow at Columbia University in New York City, in a video release.

Dr. Lin added, "And with this they actually developed increases in their left ventricular mass and wall thickness that are associated with the increases in blood pressure. What we then went on to show is that these same changes are associated with a decrease in cardiac function."

Dr. Lin and team studied 87 college freshman football players — 30 linemen and 57 non-linemen — for changes in heart health after one football season.

At the beginning of that season, none of the players had high blood pressure. Fast forward to the end of the season: Nine of the linemen had high blood pressure, as well as four of the non-linemen. The linemen were also more likely to have had thickening of the heart muscle wall. Both heart wall thickening and high blood pressure are tied to heart health risks.

So what's going on here? Health experts almost unanimously advocate exercise to stay heart-healthy, but athletic linemen are seeing decreases in heart health. Dr. Lin offered a potential explanation.

"There are physiologic differences between football linemen and non-linemen," Dr. Lin said in a press release. "Non-linemen tend to be quarterbacks and running backs. Linemen tend to be heavier, making them at higher risk for increased high blood pressure and thickness of heart muscle, and potentially decreased heart function over time."

Linda D. Gillam, MD, MPH, the Dorothy and Lloyd Huck chair of cardiovascular medicine for Atlantic Health System, told dailyRx News that several factors could explain these heart health changes in linemen.

"Although we don’t know the exact reason(s) that linemen have higher blood pressure, possible explanations include the use of stimulants and medications or supplements that can raise the blood pressure, including non-steroidal anti-inflammatory agents, human growth hormone and androgenic hormones," Dr. Gillam, who was not involved in the current study, said. "Additionally, strength and resistance training, high salt intake and the stress associated with competition may contribute."

At a time when the NFL is under scrutiny for high concussion rates among its players, this research could add to the public understanding of football-related health risks, Dr. Lin said.

"Now, we are developing an understanding of football's impact on the structure and function of the heart as well," Dr. Lin said.

Athletes should "avoid taking stimulants, medications or supplements that are known to raise the blood pressure," Dr. Gillam said. "Aerobic training tends to reduce blood pressure so, to the extent possible, there should be an aerobic component to the training as well. Since high blood pressure is common in athletes and non-athletes alike, having blood pressure checked with treatment, if needed, can help protect the heart from the long-term consequences of high blood pressure."

This research was presented Nov. 10 at the American Heart Association's Scientific Sessions 2015. Research presented at conferences may not have been peer-reviewed.

Information on funding and conflicts of interest was not available at the time of publication.