I reported on the results on the recent update to the Football players health study at Harvard University. The study analyzed more than 4,000 former National Football League (NFL) League players. The researchers looked at each NFL brain injury, for high blood pressure risk factors. The study’s author, Dr Rachel Grashow is the Director of the Epidemiological Research Initiatives. Also, she is a research scientist for the Football Players Health Study. She has kindly agreed to answer my questions:
Question 1: NFL brain injury study’s most surprising findings
The most surprising or unexpected findings that emerged from your studies. Those that link the elevated blood pressure and the professional football. What are they?
We had worked on previous projects in patient populations that had shown that single head injuries (both mild, and moderate or severe). We chose the associated with a number of cardiovascular and cardiometabolic outcomes. However, we but did not know whether these associations would hold in populations exposed to repetitive head injury. Then, we used a cohort of 4,000 former NFL players, where we analyzed every NFL brain injury. Our aim was to see whether those with higher concussion burdens were more likely to report post-career hypertension.
We were surprised to see such a strong relationship between repetitive head injury and self-reported hypertension. The fact that a dose-response relationship persisted. Each increase in concussion burden was associated with a similar increase in risk of hypertension. It persisted even after adjusting for cardiovascular risk factors like age, race, BMI, smoking, and diabetes. And it was striking to us.
Question 2: NFL brain injury study’s impact
How the results of your study may impact the treatment? That is way doctors and healthcare professionals screen and treat hypertension in post-care NFL players?
We believe that these data could motivate former players to ask for high blood pressure screening and treatment. The same goes for physicians treating any patient at risk of head injury (single or multiple) to pay particular attention to blood pressure. Even short exposures to high blood pressure even in young and otherwise healthy individuals result in later cognitive and cardiovascular dysfunctions. Hence, treating patients of all ages when hypertension has long term positive impacts for both quality and length of life.
Question 3: The Next Steps
What are the next steps for research in this area? What questions do you hope to answer in future studies?
If hypertension is contributing to the increased cardiovascular mortality seen in former NFL players, it would be important to understand which former players are most at risk of hypertension. Also, we need to look into whether conventional treatments for hypertension (both lifestyle and pharmacological interventions) are effective in delaying or preventing cardiovascular dysfunction. There is a very strong relationship between heart health and cognitive health. Therefore, we are interested to know whether treating hypertension regardless etiology could prevent later life cognitive dysfunction as well.
Question 4: Relevance to other sports
How might the findings of your study be relevant to other sports?
Since the patient data have shown that even a single head injury can increase risk of hypertension, we believe that the relationship shown in this study between multiple head injuries and hypertension likely applies to others with concussion risk such as European-style football players, rugby players, ice hockey players as well as military populations. We hope to collaborate with sports medicine researchers who work on other elite contact sport athletes on this important question, and to continue to contribute to enhancing the lives of former players, military workers and individuals at risk of chronic effects of head injury.
