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Assessing Cardiovascular Risk Factors in National Football League Players

Neil Coplan, MD
JAMA. 2009;302(11):1166-1166. doi:10.1001/jama.2009.1327
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To the Editor: In their study of cardiovascular risk factors in professional football players, Dr Tucker and colleagues1 found a higher prevalence of hypertension compared with a group of similar-aged men in the general population. However, 3 factors need to be noted regarding the validity of the blood pressure measurement and whether an elevated blood pressure in this study represents a cardiovascular risk factor.

First, only 1 measurement of blood pressure was made, and the diagnosis of hypertension should only be made after repeated measurements.2 3 Second, automated blood pressure measurement may be inaccurate in persons who have heavy musculature and large arm size.4 Third, the time of year the blood pressure was assessed may have influenced the measurement. The blood pressure was taken during mini-camps in the spring, and the training period (which includes periods of dehydration, large amounts of electrolyte repletion, and muscle pain) may not be the best time to make a reliable assessment of hypertension.

The effects of these factors may have contributed to a finding of elevated blood pressure that does not really represent a chronic condition, which could explain the lack of hypertrophy on echocardiography. It would be interesting to assess the blood pressure of the football players in the pretraining period and compare the results with the data reported in this study.

AUTHOR INFORMATION

Financial Disclosures: None reported.

REFERENCES

Tucker AM, Vogel RA, Lincoln AE,  et al.  Prevalence of cardiovascular disease risk factors among National Football League players.  JAMA. 2009;301(20):2111-2119
PubMedCrossRef
Spranger CB, Ries AJ, Berge CA, Radford NB, Victor RG. Identifying gaps between guidelines and clinical practice in the evaluation and treatment of patients with hypertension.  Am J Med. 2004;117(1):14-18
PubMedCrossRef
Cohen DL, Townsend RR. Hypertension: in the clinic.  Ann Intern Med. 2008;1491-16
Pickering TG, Hall JE, Appel LJ,  et al.  Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.  Circulation. 2005;111(5):697-716
PubMedCrossRef

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Tucker AM, Vogel RA, Lincoln AE,  et al.  Prevalence of cardiovascular disease risk factors among National Football League players.  JAMA. 2009;301(20):2111-2119
PubMedCrossRef
Spranger CB, Ries AJ, Berge CA, Radford NB, Victor RG. Identifying gaps between guidelines and clinical practice in the evaluation and treatment of patients with hypertension.  Am J Med. 2004;117(1):14-18
PubMedCrossRef
Cohen DL, Townsend RR. Hypertension: in the clinic.  Ann Intern Med. 2008;1491-16
Pickering TG, Hall JE, Appel LJ,  et al.  Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.  Circulation. 2005;111(5):697-716
PubMedCrossRef
September 16, 2009
Andrew M. Tucker, MD
JAMA. 2009;302(11):1166-1166.
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