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Many of us are anticipating the start of football season especially withFootball Player the talk of pro football camps starting this week. In addition many high school athletes will start two a day’s soon and very vigorous programs. Most doctors would encourage anyone to take part in exercise because of its numerous health benefits. The difference in benefits comes when you are comparing competitive sports and recreational exercise.

In this study of 113 freshmen on Harvard’s football team found that while none had high blood pressure at season’s start, 14 percent did by season’s end. All of the affected players were linemen.[1]At the conclusion of the football season 47% of all football players demonstrated prehypertension, and 14% demonstrated Stage 1 hypertension. Linemen were identified as having significantly higher blood pressures at preseason than other players; at postseason, 83% of linemen were either prehypertensive (58%) or hypertensive (25%). Players who were in other positions on the team maintained normal blood pressure and none demonstrated hypertension. Another significant finding was that the Linemen in the study demonstrated significantly greater increases in body mass during the season compared with non linemen. This could have been due to an increase in muscle mass and weight gain.[2]

Studies conducted in the past have found that, after retirement, former professional linemen have higher-than-average rates of high blood pressure and clogged heart arteries.[3] One of the most disturbing findings is that, “Sudden cardiac death is the leading medical cause of death and cause of death during exercise in National Collegiate Athletic Association student–athletes.”[4] A study conducted in 2006 on the prevalence of cardiovascular disease risk factors in active NFL players demonstrated that hypertension (13.8%) and prehypertension (64.5%) were significantly more common than in the general US population, and that large size measured by body mass index was associated with increased blood pressure.[5] A follow-up study conducted in 2010 confirmed that the mean systolic blood pressure and prevalence of prehypertension among linemen was higher than in other football position groups or the general population.[6]

 The journal of the American Academy of Pediatrics revealed that, “Individuals with hypertension, the most common cardiovascular condition seen in competitive athletes, can suffer complications when exercise causes their blood pressure to rise too high.”[7] The recommendations made included identifying potential players with hypertension through screening. A sports physical if done properly should reveal this finding.  Surprisingly, hypertension is the most common cardiovascular condition seen in people who engage in competitive athletics.[8] Recommendations include:

1)      Regular monitoring of the blood pressure and continued follow up with a physician at least every 2 months.

2)      Youth with severe hypertension should be restricted from play.

3)      Young athletes should be encouraged to develop a healthy lifestyle which would include avoiding the use of drugs, alcohol and performance enhancing drugs.

4)      Finally, Athletes should avoid at all cost drinks that are high in caffeine which are often marketed as energy drinks as these can exasperate their hypertension and lead to more severe cardiac problems.

[1] Norton, Amy. “College Football Players May Be At Risk of High Blood Pressure.” Health Day, July 29, 2013. http://consumer.healthday.com/circulatory-system-information-7/blood-pressure-news-70/college-football-players-may-be-at-risk-of-high-blood-pressure-678707.html

[2] Balady, Gary MD, Drezner, Jonathan MD, Tackling Cardiovascular Health Risks In College Football Players, Circulation. 2013; 128: 477-480

[3] Ibid- Health Day July 29th, 2013

[4] Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in national collegiate athletic association athletes. Circulation. 2011.

 [5] Tucker AM, Vogel RA, Lincoln AE, Dunn RE, Ahrensfield DC, Allen TW, Castle LW, Heyer A, Pellman EJ, Strollo PJ Jr., Wilson PW, Yates AP. Prevalence of cardiovascular disease risk factors among National Football League players. JAMA. 2009;30121112119.

 [6] Allen TW, Vogel RA, Lincoln AE, Dunn RE, Tucker AM. Body size, body composition, and cardiovascular disease risk factors in NFL players. Phys Sportsmed. 2010;382127.

 [7] Hypertension in the Child Athlete. American Academy of Pediatrics. 5/31/2010

 [8] Athletic Participation by Children and Adolescents who have systemic hypertension. Pediatrics Vol. 99 No. 4,
April 1, 1997 pp. 637 -638.