Screening tackles hidden cardiovascular disease in retired football pros

The colossal linemen of the National Football League and large folks in general may have more in common than their size. Everyone who weighs more than 300 pounds is more than twice as likely as a lighter person to die from a heart attack or stroke, according to a study sponsored by the Living Heart Foundation.

The organization, which offers cardiovascular screening to retired football pros, hopes the study's findings and the screening program itself help raise awareness about the risks for cardiovascular disease associated with obesity. Dr. Arthur "Archie" Roberts, a former quarterback with the Cleveland Browns and Miami Dolphins and retired cardiac surgeon, founded the foundation in 2001.

The organization held its annual cardiovascular screening event from Jan. 31 through Feb. 1 in Scottsdale, AZ, to coincide with the Super Bowl at the same location. More than 60 former NFL players in town for the game participated in the screenings. Siemens Healthcare announced a one-year partnership with the Living Heart Foundation at the event by loaning three high-end ultrasound systems.

Anecdotal accounts about retired NFL players dying from heart attacks and strokes led Roberts to do a study to identify prevalent risk factors in this population. The preliminary leg of the Living Heart Foundation study, which includes Mount Sinai and Mayo Clinic researchers, found that major risk factors include metabolic syndrome, sleep apnea, elevated cholesterol, cardiac enlargement, and left ventricular hypertrophy.

Researchers also found these risk factors make players, particularly linemen who often weigh more than 300 pounds, twice as likely as the average person to suffer heart disease, stroke, and other cardiovascular conditions. The study will be published soon in the Journal of the American College of Cardiology.

"NFL players actually reflect the risk factors in the general population, which is growing in size. What we learn from the players is quite applicable to the general population as well," Roberts said.

The imaging part of the screening protocol includes CT-based coronary calcium scoring and ultrasound for carotid artery studies. It also involves echocardiography for the assessment of myocardial size and function. Subjects undergo clinical and blood tests to check for blood pressure, cholesterol levels, plaque quality, body mass, and signs of diabetes. After screening, subjects get a report they can take to their referring physicians, who make the management call.

"Most of our efforts in heart disease are like throwing a Hail Mary at the end of the game," said Dr. Jeffrey Boone, founder of ProHeart MD based in Denver. "Our physicians are always trying to save us at the end of the cardiovascular disease continuum, whereas these imaging techniques allow us to find problems early and change the course of the disease."

Boone's group mirrors in the western U.S. what the Living Heart Foundation does along the East Coast.

Living Heart Foundation and ProHeart MD physicians have already screened retired players in Fort Lauderdale and Seattle and plan more screening dates in San Diego, Phoenix, Los Angeles, Indianapolis, and Cleveland during 2008. Together, the two groups hope to screen about 9000 retired NFL players over time.

Many players, like the population in general, ignore risk factors that put them at increasing danger of a heart attack or stroke. The program could save their lives, said Leroy Mitchell, 63, president of the NFL Alumni Rocky Mountain chapter and director for ProHeart MD in Colorado. Mitchell played defensive back for the then-Boston Patriots in 1967 and retired as a Denver Bronco in 1973.

"If you can get professional football players to stand up across the country and say what this program has done for them by getting early preventive care as far as heart disease and stroke is concerned, then the average population is going to listen," he said.

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