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Okoh AK, Amponsah MKD, Cheffet-Walsh S, Patel M, Carfagno D, Linton D, Dimeff R, Braunreiter D, Harrington P, Brennan FH, Kavinsky C, Everett M, Park B, Gunnarsson M, Snowden S, Mootz L, Koepnick T, Wheeler J, Clarke SE, Prince H, Sannino A, Grayburn P, Rice EL. Prevalence of Cardiovascular Disease and Risk Factors among National Football League Alumni and Family Members. J Am Coll Cardiol 2024:S0735-1097(24)00988-4. [PMID: 38593943 DOI: 10.1016/j.jacc.2024.03.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited. OBJECTIVE The HUDDLE trial aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events. METHODS HUDDLE was a multi-city, cross-sectional study of NFL alumni and family members aged 50 years and above. Subjects reported their health history and participated in CVD education and screening (blood pressure [BP], electrocardiogram [EKG], and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30-days post-screening to review results and recommendations. This analysis focuses on former NFL athletes. RESULTS Of 498 participants screened, 57.2% (N=285) were former NFL players, majority of which were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that HTN was a significant predictor of clinically-relevant structural abnormalities on TTE. CONCLUSION The HUDDLE trial identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by HTN, affirming the role of TTE for CVD screening in this over 50 population.
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Affiliation(s)
| | | | | | - Mehul Patel
- Methodist LeBonheur Healthcare / Sutherland Cardiology Clinic, Germantown, TN
| | | | | | | | | | | | - Fred H Brennan
- BayCare Health System / University of South Florida / Turley Family Health Center, Clearwater, FL
| | | | | | | | | | | | | | | | | | | | | | - Anna Sannino
- Baylor Scott & White Research Institute, Dallas, TX
| | | | - E Lee Rice
- San Diego Sports Medicine & Family Health Center / Lifewellness Institute, San Diego, CA.
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Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, Dimeff R, Douglas PS, Glover DW, Hutter AM, Krauss MD, Maron MS, Mitten MJ, Roberts WO, Puffer JC. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007; 115:1643-455. [PMID: 17353433 DOI: 10.1161/circulationaha.107.181423] [Citation(s) in RCA: 608] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
MESH Headings
- Adolescent
- Adult
- Cardiomyopathy, Hypertrophic/diagnosis
- Cardiomyopathy, Hypertrophic/diagnostic imaging
- Cardiomyopathy, Hypertrophic/epidemiology
- Cardiovascular Diseases/diagnosis
- Cardiovascular Diseases/diagnostic imaging
- Cardiovascular Diseases/epidemiology
- Cardiovascular Diseases/prevention & control
- Child
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/prevention & control
- Echocardiography/economics
- Echocardiography/statistics & numerical data
- Electrocardiography/economics
- Electrocardiography/statistics & numerical data
- Europe
- Female
- Guideline Adherence/legislation & jurisprudence
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/diagnostic imaging
- Heart Defects, Congenital/epidemiology
- Humans
- Male
- Mass Screening/economics
- Mass Screening/ethics
- Mass Screening/legislation & jurisprudence
- Mass Screening/standards
- Physical Exertion
- Prevalence
- Sports
- Sports Medicine/ethics
- Sports Medicine/legislation & jurisprudence
- Sports Medicine/standards
- United States/epidemiology
- Volunteers
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Abstract
Many clinical trials have evaluated the use of extracorporeal shock wave therapy for treating patients with chronic tendinosis of the supraspinatus, lateral epicondylitis, and plantar fasciitis. Although extracorporeal shock wave therapy has been reported to be effective in some trials, in others it was no more effective than placebo. The multiple variables associated with this therapy, such as the amount of energy delivered, the method of focusing the shock waves, frequency and timing of delivery, and whether or not anesthetics are used, makes comparing clinical trials difficult. Calcific tendinosis of the supraspinatus and plantar fasciitis have been successfully managed with extracorporeal shock wave therapy when nonsurgical management has failed. Results have been mixed in the management of lateral epicondylitis, however, and this therapy has not been effective in managing noncalcific tendinosis of the supraspinatus. Extracorporeal shock wave therapy has consistently been more effective with patient feedback, which enables directing the shock waves to the most painful area (clinical focusing), rather than with anatomic or image-guided focusing, which are used to direct the shock wave to an anatomic landmark or structure.
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Affiliation(s)
- Andrew Sems
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA
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Abstract
Turf toe and related injuries to the first metatarsophalangeal joint are common injuries that occur in several sports. Although often a clinical diagnosis, advanced imaging can help grade severity of sprain and evaluate for associated or unsuspected injuries. Without proper rest and conservative management, a treatable injury can have chronic sequelae and morbidity. Operative management is uncommon, but successful in returning high-level competitive athletes to their sport.
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