Abstract 17373: The Association of Professional American-Style Football Career Length With Left Ventricular Geometry in Retired National Football League Players

Abstract

Introduction: There is widespread interest in the long-term cardiovascular (CV) implications of professional football. Studies have suggested that retired National Football League (NFL) players have a high prevalence of hypertension, which may increase risk for left ventricular hypertrophy (LVH). However, it is unknown if football-specific factors, such as professional football career length (NFLYrs), are associated with long-term CV outcomes, including changes in left ventricle (LV) geometry. Thus, we examined the association of NFLYrs with LV geometry patterns in a retired NFL player cohort. Methods: We analyzed data on 1349 retired NFL players (aged 53.1 ± 12.8 years, 55.1% African-American) that underwent comprehensive health screening with the NFL Player Care Foundation. Echocardiography was used to estimate LV mass, which was then indexed to height 2.7 . Relative wall thickness was computed to classify LV geometry patterns into normal, concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH). Three binary logistic regression models (Model 1: CR; Model 2: EH; Model 3: CH), using normal geometry as reference, were fitted to assess the association of NFLYrs with each LV geometry pattern, adjusting for traditional cardiometabolic risk factors. Results: Increasing NFLYrs was independently associated with CR (odds ratio [OR]: 1.48, 95% confidence interval [CI] 1.03 – 2.11, p = 0.0334), while no associations were observed with EH (OR: 0.49, 95% CI 0.22 – 1.09, p = 0.0801) or CH (OR: 1.04, 95% CI 0.61 – 1.77, p 0.8927). Mean arterial pressure was independently associated with increased odds of CR (OR: 1.03, 95% CI 1.01 – 1.05, p – 0.0017), EH (OR: 1.06, 95% CI 1.02 – 1.09, p = 0.0013), and CH (OR: 1.06, 95% CI 1.04 -1.09, p < 0.0001). Conclusion: NFL career length is not associated with increased odds for EH and CH later in life. In contrast, increased NFLYrs is associated with CR, likely an adaptive response to intense athletic training. Cardiovascular risk factors such as high blood pressure in the retirement period appear to be more important for long-term LVH risk in NFL athletes, underscoring the need for preventive initiatives aimed at decreasing risk for future CV outcomes in athletes transitioning out of professional sports.