乌鸦传媒

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Linemen are more likely to suffer from hypertension and associated secondary cardiac remodeling than other football players and other young adults are, according to a study online in .

Findings show "substantial risk" of hypertension and mesh with previous studies showing compromised health for linemen, the researchers wrote.

In an interview, the study's senior author, , associate director of the Cardiovascular Performance Program at Massachusetts General Hospital and for Harvard's Football Players Health Study, compared the phenomenon to another public health issue in football: "The cardiovascular signal we see in young linemen is as concerning and as interesting as what we see in the concussion issue. Changes in their body early in life are not working in their best interests."

Baggish and co-authors conducted a prospective, longitudinal cohort study of NCAA Division I players from 2008 to 2014 via the Harvard Athlete Initiative, using transthoracic echocardiography before and after the season. The researchers stratified by position for data analysis (30 linemen versus 57 non-linemen).

The linemen's blood pressure was found to rise quickly during the season, "in ways that look like older people with heart disease," Baggish said.

Writing in an , , chair in cardiovascular imaging at the DeBakey Heart & Vascular Center at Houston Methodist, noted that the study is the first to show changes in linemen's hearts.

"Their hearts thickened, similar to that of patients with hypertension," he told 乌鸦传媒. During a season, these athletes', "blood pressure goes up, and , and the pressure goes even higher, and the effect on the heart is what the researchers saw."

Among the findings in the study for all participants: Position, post-season weight, systolic blood pressure, average acquired left ventricular (LV) hypertrophy wall thickness, and relative wall thickness were all independently correlated with post-season global longitudinal strain, which was used to measure LV systolic function (i.e., deformation of the heart during contraction).

And while no linemen met the criteria for overt hypertension before the season, 90% met the criteria for pre-hypertension or stage 1 hypertension after the season. Playing on the line, the authors concluded, "may lead to a form of sports-related myocardial remodeling that is pathologic rather than adaptive."

The study confirmed previously reported associations between playing football, increases in systolic blood pressure, and developing concentric LV hypertrophy, the authors reported.

Both Baggish and Zoghbi said the overarching lesson for practitioners, including team doctors, is: Carefully monitor the blood pressure of linemen and other athletes, at all levels of play in all sports.

"The implication," Baggish said, "is to not overlook high blood pressure." Practitioners should also encourage affected athletes to make lifestyle changes and consider medication treatments.

Football leagues should also be alert. "There is a common conception -- a misconception across the board -- that pro athletes are healthy. Linemen are almost universally lumped in with athletes in general." But they undergo different training and dietary regimens, with a focus on enhancing mass as opposed to athleticism.

Added Zoghbi: "I think this is the first demonstration that not all sports are cardioprotective. It depends on the type of sport, the position, and the sport -- what may have some negative effect on the heart. Whether the adverse cardiac changes account predominantly or in part for the worse long-term prognosis of linemen compared with their non-linemen colleagues remains to be determined."

Baggish noted that the study could be linked to a t and to subsequent studies on the health of retired NFL players showing and exploring why most former players lived longer than the general population -- but linemen did not. The high blood pressure divulged in the new study could be the major cause; many linemen die from cardiomyopathy, Baggish pointed out, which is often caused by high blood pressure: "They are dying of a very specific problem."

The issue, however, "can be treated without impacting the game," he added, suggesting as a first step that linemen include conditioning in their training regimens, since aerobic activity sparks improved blood pressure even in heavier people. "It may also make them fitter and able to avoid injuries, and have an almost certain positive benefit on their health." That would benefit their teams as well.

Overall, "the message is not that football is bad for you," Baggish said. "The message is that hypertension can come along with certain positions in football," and practitioners should watch for it and address it.

Study limitations included the use of a longitudinal, "repeated measures" study design; subject attrition due to 54% of participants being excluded from the final analysis; and a "relatively brief" study duration -- "Carefully designed longer-term studies that capture blood pressure and cardiac parameters during more lengthy ASF [America Style Football] careers and in the post-ASF years are warranted," the authors wrote.