footballplayerORLANDO, Florida – Freshmen playing lineman for their college football teams had higher blood pressure and hearts that didn’t pump blood as well as non-lineman over the course of a single season, according to a study presented at the American Heart Association Scientific Sessions 2015.

When the football season started, none of the 87 freshman football players studied had high blood pressure, also known as hypertension. By season’s end, 27 of 30, or 90 percent, of lineman – players on the line of scrimmage, blocking opposing players with their strenth and size – had pre-hypertension or hypertension.

Just 28 of 57 non-linemen, or 49 percent, had pre-hypertension or hypertension.

Eighty-three percent of the linemen’s hearts didn’t pump blood as well as non-linemen after the season, although their hearts still functioned within the normal range. Nine out of 30 linemen had thicker hearts.

Ten out of the 57 non-linemen had structural changes in which part of the heart expanded without much thickening of the heart wall, similar to endurance athletes.

Jeffrey Lin, M.D., lead study author and former cardiology fellow at Massachusetts General Hospital in Boston said that the structural changes in the heart were similar to people with early stages of high blood pressure.

The study findings have important implications for college athletic trainers and team doctors, said Lin, now a cardiac imaging fellow at Columbia University in New York City. “We need to be more vigilant about screening [players] during the football season, and thinking about treating them with medication if they get to the level of hypertension,” he said.

About 80 million U.S. adults have been diagnosed with high blood pressure and it can be deadly if it’s not treated.

It’s important for linemen to get their blood pressure checked regularly and make good lifestyle choices, like not smoking and eating less salt, Lin said.

Although the study did not specifically measure the effect of weight, it may be another factor affecting linemen’s blood pressure, said Lin. Linemen, whose size matters on the field, weighed more when the study started and gained more over the course of the season.

“Body weight plays a role, just like in high blood pressure in older adults,” Lin said. “It’s part of the story, but not the whole story.”

Tim Neal, a certified athletic trainer for 36 years and a member of the National Athletic Trainers Association said in the last 20 years, football lineman have gotten heavier, with many topping 300 pounds. He said weight gain can also lead to sleep apnea which could also elevate blood pressure.

“The current theme of being a good lineman is you have to be fat and fit,” said Robert Eckel, M.D., former AHA president and professor of medicine at the University of Colorado Anschutz Medical Campus. “It may be the linemen are feeling more pressure because the quarterback and backs can blame the lineman if they aren’t opening holes or protecting the passer.”

Lin said the three biggest predictors of high blood pressure were whether players were linemen or non-linemen, increases in body weight, or a family history of heart disease.

Questions remain, Lin said, including whether linemen took more ibuprofen than non-lineman. Ibuprofen is in a class of drugs that could increase the risk of heart attack and stroke 10 percent to 50 percent if taken regularly, according to the Food and Drug Administration.

Lin also wondered whether the pumping ability of freshman football linemen’s hearts would worsen over time. He said a research group at Massachusetts General is studying the hearts of senior football players.

A 1994 study of retired NFL players by the National Institute for Occupational Safety and Health found that linemen had a 52 percent higher risk of death from heart disease than the general public and nearly four times greater risk of developing heart disease than other positions.

“It’s hard to know what this means for the future,” said Lin. But he said these are very young players — 18 or 19 years old who are developing high blood pressure, which we know is not good for them long term.

Photo by Amie Vanderford