Early cardiovascular mortality in professional football players: fact or fiction?

Present data about the increased incidence of early cardiovascular disease and mortality in National Football League (NFL) players is conflicting. These findings are particularly concerning given the escalating weight of current football players at the high school, collegiate, and professional levels. Recent studies have confirmed that heavier former NFL linemen have an increased prevalence of cardiovascular disease compared with an age- and sex-matched reference population. Former linemen had a higher prevalence of obesity, lower high-density lipoprotein cholesterol, increased left ventricular mass and left atrial area, and the metabolic syndrome, compared with nonlinemen. There have been sparse data on the cardiovascular health of current players. A recent analysis of one team demonstrated that the cardiometabolic syndrome and its individual components were significantly more common in linemen versus nonlinemen. Because current heavier NFL players already have evidence of the cardiometabolic syndrome and its individual markers, careful medical evaluation of former and active players is warranted to reduce their risks. This medically and ethically indicated intervention, however, might limit interpretation of future longitudinal studies designed to assess mortality endpoints.