title: Blood pressure and left ventricular hypertrophy during American-style football participation.
abstract: BACKGROUND
  Hypertension, a strong determinant of cardiovascular disease risk, has been documented among elite, professional American-style football (ASF) players. The risk of increased blood pressure (BP) and early adulthood hypertension among the substantially larger population of collegiate ASF athletes is not known.
  
  
  RESULTS
  We conducted a prospective, longitudinal study to examine BP, the incidence of hypertension, and left ventricular remodeling among collegiate ASF athletes. Resting BP and left ventricular structure were assessed before and after a single season of competitive ASF participation in 6 consecutive groups of first-year university athletes (n=113). ASF participation was associated with significant increases in systolic BP (116±8 versus 125±13 mm Hg; P<0.001) and diastolic BP (64±8 mm Hg versus 66±10 mm Hg; P<0.001). At the postseason assessment, the majority of athletes met criteria for Joint National Commission (seventh report) prehypertension (53 of 113, 47%) or stage 1 hypertension (16 of 113, 14%). Among measured characteristics, lineman field position, intraseason weight gain, and family history of hypertension were the strongest independent predictors of postseason BP. Among linemen, there was a significant increase in the prevalence of concentric left ventricular hypertrophy (2 of 64 [3%] versus 20 of 64 [31%]; P<0.001) and change in left ventricular mass correlated with intraseason change in systolic BP (R=0.46, P<0.001).
  
  
  CONCLUSIONS
  Collegiate ASF athletes may be at risk for clinically relevant increases in BP and the development of hypertension. Enhanced surveillance and carefully selected interventions may represent important opportunities to improve later-life cardiovascular health outcomes in this population.
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
authors.forename: Francis
authors.initials: F
authors.lastname: Wang
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Isaacs
authors.forename: Rajeev
authors.initials: R
authors.lastname: Malhotra
authors.forename: Brant
authors.initials: B
authors.lastname: Berkstresser
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Kim
authors.forename: Adolph M
authors.initials: AM
authors.lastname: Hutter
authors.forename: Michael H
authors.initials: MH
authors.lastname: Picard
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Baggish
mesh_terms: D000293:Adolescent; D056352:Athletes; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D005538:Football / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D013334:Students; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: blood pressure; cardiomegaly, exercise-induced; exercise; hypertension; hypertrophy, left ventricular