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Cardiovascular Risk Factors and Coronary Atherosclerosis in Retired National Football League Players

      A high prevalence of obesity exists in National Football League (NFL) players as determined by body mass index (BMI). It is not established whether increased BMI is associated with a greater prevalence of cardiovascular (CV) risk factors or coronary atherosclerosis in former NFL players than in nonathletes. This study compared CV risk factors and coronary atherosclerosis in retired NFL players to 2 groups of community controls, the population-based Dallas Heart Study and the preventive medicine cohort, the Aerobics Center Longitudinal Study. Retired NFL players (n = 201) were matched for ethnicity, age, and BMI (Aerobics Center Longitudinal Study, age only). CV risk factors were assessed by survey and screening visit. Coronary atherosclerosis was measured by computed tomography as coronary artery calcium (CAC). Compared to population-based controls, retired NFL players had a significantly lower prevalence of diabetes, hypertension, sedentary lifestyle, and metabolic syndrome, yet a higher prevalence of impaired fasting glucose and hyperlipidemia. However, there was no significant difference in the prevalence of detectable CAC (46% vs 48.3%, p = 0.69) or distribution of CAC (0 to 10, 10 to 100, 100 to 400, ≥400, p = 0.11). Comparing retired NFL players to the physically active preventive medicine controls, there was no difference in the amount of CAC. In retired NFL players, age and hyperlipidemia, not body size, were the most significant predictors of CAC. In conclusion, despite their large body size, retired NFL players do not have a greater prevalence of CV risk factors or amount of CAC than community controls.
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      References

        • Associate Press
        Coroner says Herrion died from heart disease.
        USA Today. Gannett Company, Denver2005
        • Harp J.B.
        • Hecht L.
        Obesity in the National Football League.
        JAMA. 2005; 293: 1061-1062
        • Laurson K.R.
        • Eisenmann J.C.
        Prevalence of overweight among high school football linemen.
        JAMA. 2007; 297: 363-364
        • Wei M.
        • Kampert J.B.
        • Barlow C.E.
        • Nichaman M.Z.
        • Gibbons L.W.
        • Paffenbarger Jr, R.S.
        • Blair S.N.
        Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men.
        JAMA. 1999; 282: 1547-1553
        • Wilson P.W.F.
        • D'Agostino R.B.
        • Sullivan L.
        • Parise H.
        • Kannel W.B.
        Overweight and obesity as determinants of cardiovascular risk: the Framingham experience.
        Arch Intern Med. 2002; 162: 1867-1872
        • Ode J.J.
        • Pivarnik J.M.
        • Reeves M.J.
        • Knous J.L.
        Body mass index as a predictor of percent fat in college athletes and nonathletes.
        Med Sci Sports Exerc. 2007; 39: 403-409
        • Greenland P.
        • Bonow R.O.
        • Brundage B.H.
        • Budoff M.J.
        • Eisenberg M.J.
        • Grundy S.M.
        • Lauer M.S.
        • Post W.S.
        • Raggi P.
        • Redberg R.F.
        • Rodgers G.P.
        • Shaw L.J.
        • Taylor A.J.
        • Weintraub W.S.
        • Harrington R.A.
        • Abrams J.
        • Anderson J.L.
        • Bates E.R.
        • Grines C.L.
        • Hlatky M.A.
        • Lichtenberg R.C.
        • Lindner J.R.
        • Pohost G.M.
        • Schofield R.S.
        • Shubrooks Jr, S.J.
        • Stein J.H.
        • Tracy C.M.
        • Vogel R.A.
        • Wesley D.J.
        ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation clinical expert consensus task force (ACCF/AHA writing committee to update the 2000 expert consensus document on electron beam computed tomography) developed in collaboration with the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography.
        J Am Coll Cardiol. 2007; 49: 378-402
        • Cheng Y.J.
        • Church T.S.
        • Kimball T.E.
        • Nichaman M.Z.
        • Levine B.D.
        • McGuire D.K.
        • Blair S.N.
        Comparison of coronary artery calcium detected by electron beam tomography in patients with to those without symptomatic coronary heart disease.
        Am J Cardiol. 2003; 92: 498-503
        • Church T.S.
        • Levine B.D.
        • McGuire D.K.
        • Lamonte M.J.
        • Fitzgerald S.J.
        • Cheng Y.J.
        • Kimball T.E.
        • Blair S.N.
        • Gibbons L.W.
        • Nichaman M.Z.
        Coronary artery calcium score, risk factors, and incident coronary heart disease events.
        Atherosclerosis. 2007; 190: 224-231
        • Victor R.G.
        • Haley R.W.
        • Willett D.L.
        • Peshock R.M.
        • Vaeth P.C.
        • Leonard D.
        • Basit M.
        • Cooper R.S.
        • Iannacchione V.G.
        • Visscher W.A.
        • Staab J.M.
        • Hobbs H.H.
        The Dallas Heart Study.
        Am J Cardiol. 2004; 93: 1473-1480
        • Mostaza J.M.
        • Schulz I.
        • Vega G.L.
        • Grundy S.M.
        Comparison of pravastatin with crystalline nicotinic acid monotherapy in treatment of combined hyperlipidemia.
        Am J Cardiol. 1997; 79: 1298-1301
        • Khera A.
        • McGuire D.K.
        • Murphy S.A.
        • Stanek H.G.
        • Das S.R.
        • Vongpatanasin W.
        • Wians Jr, F.H.
        • Grundy S.M.
        • de Lemos J.A.
        Race and gender differences in C-reactive protein levels.
        J Am Coll Cardiol. 2005; 46: 464-469
        • Agatston A.S.
        • Janowitz W.R.
        • Hildner F.J.
        • Zusmer N.R.
        • Viamonte Jr, M.
        • Detrano R.
        Quantification of coronary artery calcium using ultrafast computed tomography.
        J Am Coll Cardiol. 1990; 15: 827-832
        • Jain T.
        • Peshock R.
        • McGuire D.K.
        • Willett D.
        • Yu Z.
        • Vega G.L.
        • Guerra R.
        • Hobbs H.H.
        • Grundy S.M.
        African Americans and Caucasians have a similar prevalence of coronary calcium in the Dallas Heart Study.
        J Am Coll Cardiol. 2004; 44: 1011-1017
        • Drazner M.H.
        • Dries D.L.
        • Peshock R.M.
        • Cooper R.S.
        • Klassen C.
        • Kazi F.
        • Willett D.
        • Victor R.G.
        Left ventricular hypertrophy is more prevalent in blacks than whites in the general population: the Dallas Heart Study.
        Hypertension. 2005; 46: 124-129
        • Grundy S.M.
        • Cleeman J.I.
        • Daniels S.R.
        • Donato K.A.
        • Eckel R.H.
        • Franklin B.A.
        • Gordon D.J.
        • Krauss R.M.
        • Savage P.J.
        • Smith Jr, S.C.
        • Spertus J.A.
        • Costa F.
        Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement.
        Circulation. 2005; 112: 2735-2752
      1. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report.
        Circulation. 2002; 106: 3143-3421
        • Baron S.
        • Rinsky R.
        NIOSH Mortality Study of NFL Football Players: 1959–1988.
        Center for Disease Control NIfOSaH, Cincinnati1994
        • Miller M.A.
        • Croft L.B.
        • Belanger A.R.
        • Romero-Corral A.
        • Somers V.K.
        • Roberts A.J.
        • Goldman M.E.
        Prevalence of metabolic syndrome in retired national football league players.
        Am J Cardiol. 2008; 101: 1281-1284
        • Sattar N.
        • McConnachie A.
        • Shaper A.G.
        • Blauw G.J.
        • Buckley B.M.
        • de Craen A.J.
        • Ford I.
        • Forouhi N.G.
        • Freeman D.J.
        • Jukema J.W.
        • Lennon L.
        • Macfarlane P.W.
        • Murphy M.B.
        • Packard C.J.
        • Stott D.J.
        • Westendorp R.G.
        • Whincup P.H.
        • Shepherd J.
        • Wannamethee S.G.
        Can metabolic syndrome usefully predict cardiovascular disease and diabetes?.
        Lancet. 2008; 371: 1927-1935
        • Wannamethee S.G.
        • Shaper A.G.
        • Lennon L.
        • Morris R.W.
        Metabolic syndrome vs Framingham risk score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus.
        Arch Intern Med. 2005; 165: 2644-2650
        • Weinstein A.R.
        • Sesso H.D.
        • Lee I.M.
        • Cook N.R.
        • Manson J.E.
        • Buring J.E.
        • Gaziano J.M.
        Relationship of physical activity vs body mass index with type 2 diabetes in women.
        JAMA. 2004; 292: 1188-1194
        • Wei M.
        • Gibbons L.W.
        • Mitchell T.L.
        • Kampert J.B.
        • Lee C.D.
        • Blair S.N.
        The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men.
        Ann Intern Med. 1999; 130: 89-96
        • Jeon C.Y.
        • Lokken R.P.
        • Hu F.B.
        • van Dam R.M.
        Physical activity of moderate intensity and risk of type 2 Diabetes: A systematic review.
        Diabetes Care. 2007; 30: 744-752
        • Blair S.N.
        • Church T.S.
        The fitness, obesity, and health equation: is physical activity the common Denominator?.
        JAMA. 2004; 292: 1232-1234
        • Romero-Corral A.
        • Montori V.M.
        • Somers V.K.
        • Korinek J.
        • Thomas R.J.
        • Allison T.G.
        • Mookadam F.
        • Lopez-Jimenez F.
        Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies.
        Lancet. 2006; 368: 666-678
        • See R.
        • Abdullah S.M.
        • McGuire D.K.
        • Khera A.
        • Patel M.J.
        • Lindsey J.B.
        • Grundy S.M.
        • de Lemos J.A.
        The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study.
        J Am Coll Cardiol. 2007; 50: 752-759
        • Nelson J.C.
        • Kronmal R.A.
        • Carr J.J.
        • McNitt-Gray M.F.
        • Wong N.D.
        • Loria C.M.
        • Goldin J.G.
        • Williams O.D.
        • Detrano R.
        Measuring coronary calcium on CT images adjusted for attenuation differences.
        Radiology. 2005; 235: 403-414
        • Donahue R.P.
        • Jacobs Jr, D.R.
        • Sidney S.
        • Wagenknecht L.E.
        • Albers J.J.
        • Hulley S.B.
        Distribution of lipoproteins and apolipoproteins in young adults the CARDIA study.
        Arteriosclerosis. 1989; 9: 656-664