heartdiseasefacts.com
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April 8, 2024
3 minute read
Important points:
- Hypertension, abnormal electrocardiogram findings, and abnormal echocardiogram findings were common in retired NFL players.
- The results raise questions about heart disease screening for people over 50.
ATLANTA — A screening study presented at the American College of Cardiology’s Scientific Sessions shows a high prevalence of unrecognized heart disease among former National Football League players.
Results released at the same time showed that nearly 90% of former NFL players had high blood pressure, even though few knew it before screening, and that transthoracic echocardiography (TTE) More than 30% of patients had structural heart abnormalities. Journal of the American College of Cardiology.
The review included not only former NFL players but also coaches and family members.
“Based on these data, we find that the overall population, and especially among former professional athletes such as American football players, have a high prevalence of cardiovascular disease based on risk factors, particularly poorly controlled blood pressure and TTE. ” Michael Amponsah, MD, ChB, FACC, said the interventional cardiologist at Banner Boswell Medical Center in Peoria, Arizona, during a presentation.
Amponsah said his team undertook this study because little is known about the prevalence of cardiovascular disease in retired athletes.
Reduce the impact of CVD
“Professional athletes are often assumed to have healthy lifestyle habits, but at a young or post-competitive age they can be at significant risk for cardiovascular disease,” Amponsah says. “The HUDDLE study aimed to assess the prevalence of CVD and risk factors in a representative sample of former NFL players, coaches, and family members. We also aimed to quantify gaps in knowledge regarding cardiovascular disease and engage with participants through education. And finally, to identify opportunities for comprehensive screening to reduce the impact of cardiovascular disease.”
This cohort consists of 498 retired NFL players, coaches, and family members (mean age 63 years, 67 men) aged 50 and older who attended one of nine screening events in 2021 or 2022 and completed testing. % and 63% African American or Black). 30-day follow-up telephone visit.
According to pre-screening self-report, medical history of risk factors was as follows: Hypertension, 41.6% for the entire cohort and 37.5% for former NFL players. high cholesterol, 31.9% for the entire cohort and 32.6% for former NFL players; Amponsah said diabetes was 11.8% across the cohort and 12.6% among former NFL players.
The prevalence of hypertension, defined as known hypertension with a blood pressure greater than 130/80 mm Hg at screening or when taking antihypertensive medication, was 89.3% in the entire cohort and 89.8% in former NFL players, he said. .
Among those who self-reported not having hypertension, 80.1% of the entire cohort and 81.5% of former NFL players had hypertension; among those who self-reported hypertension, 41.2% of the entire cohort and 36.5% of former NFL players had hypertension. It wasn’t. Researchers said it was under control at the time of screening.
The rate of abnormal electrocardiograms was 37.5% for the entire cohort and 46.1% for former NFL players, and the rate of abnormal TTE findings based on American Society of Echocardiography (ASE) guidelines was 55% for the entire cohort and 61.8% for former NFL players. . Amponsah noted one significant finding in the TTE of a former NFL player who suffered an abdominal aortic aneurysm and underwent surgery.
Participants with systolic blood pressure below 120 mmHg also had a high prevalence of abnormal TTE findings (43.1% for the entire cohort and 64.7% for former NFL players), he said.
Among those with a known history of CVD or risk factors, 76.1% were recommended for follow-up due to hypertension, abnormal ECG findings, and abnormal TTE findings, compared to 56.3% of those with no known history of A follow-up survey was recommended. Amponsah said 53 participants had abnormal TTE findings despite having no medical history.
Predictors of heart disease
In the entire cohort, independent predictors of clinically significant structural abnormalities for TTE included age as a continuous variable (OR = 1.05; 95% CI, 1.02-1.08; P = .001), male gender (or female gender = 0.61; 95% CI, 0.39-0.97; P = .04) and abnormal findings on ECG (OR = 1.56; 95% CI, 1.03-2.37; P = .04), whereas among former NFL players, hypertension at screening was an independent predictor of abnormal TTE findings (OR = 2.02; 95% CI, 1.03-3.96; P = .04), according to the researchers.
“Based on these data, we feel there may be benefit in TTE screening of individuals over 50 years of age to assess for structural pathology,” Amponsah said during his presentation.
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Dr. Matthew W. Martinez
The key message about the HUDDLE trial is that primary prevention, assessing CVD risk factors, including hypertension, is critical, even in athletes. Like other parts of the world, it is ignored. This is another study that reminds us that weight loss, nutrition, and management of CAD risk factors need to be discussed with patients, even if they are retired athletes at the highest level.
Some of this research has already been done. This is an addition to the maladaptive profile that we are beginning to see. Jonathan H. Kim, MD, MSc; Associate Professor of Medicine in the Department of Cardiology and Director of Sports Cardiology at the Emory Clinical Heart and Vascular Institute at Emory University School of Medicine, writes about aortic characteristics and blood pressure in terms of their characteristics. Dermot Phelan, MD, PhD, FASE, FACC, He is director of the Gragg Cardiovascular Performance Center, medical director of cardiovascular imaging, and director of the Hypertrophic Cardiomyopathy Center at Atrium Health Sanger Cardiovascular Institute. I am writing about this. Our team, in collaboration with the University of Florida, wrote a paper showing high blood pressure in young female college athletes.
The challenging message is that there are concerns about some of the data the researchers used. The cutoffs used for the ECG were error-prone and had many false positives. His ASE guidelines for echocardiography show that false positives occur for left ventricular size, right ventricular size, wall thickness, and left atrial diameter. We are also concerned that the overall message should not be that all patients over 50 should undergo an electrocardiogram or echocardiogram. What we need to do is talk about primary prevention and remember that retired athletes are not bulletproof.
Dr. Matthew W. Martinez
Atlantic Health System Director of Sports Cardiology
Morristown Medical Center, Morristown, NJ
Disclosure: Mr. Martinez serves as team cardiologist for the New York Jets and as cardiologist for the National Basketball Players Association and Major League Soccer, and has received consulting fees and honoraria from Bristol-Myers Squibb, Cytokinetics, and Viz.ai. It is reported that.
Information source/disclosure information
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Amponsah M et al. Clinical and research perspectives. Presentation location: American College of Cardiology Scientific Sessions. April 6-8, 2024. Atlanta.
Disclosure: This study was sponsored by Edwards Lifesciences. Mr. Amponsah and two other researchers report financial relationships with Edwards Lifesciences.
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