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Hypertension in professional football players likely results from trauma on the field

The regular physical trauma that appears to put professional football players at risk for degenerative brain disease may also increase their risk for hypertension and cardiovascular disease, researchers say.

The frequent hits football players experience, particularly frontline defenders such as linemen, likely continually activate the body’s natural defense system, producing chronic inflammation that is known to drive blood pressure up, according to a study in The FASEB Journal.

While strenuous physical activity clearly has its benefits, it also produces skeletal muscle damage, which literally tears some cells apart, said Dr. R. Clinton Webb, cardiovascular researcher who chairs the Department of Physiology at the Medical College of Georgia at Georgia Regents University.

As an example, long-term, muscle cell tears actually help build muscle, but short term they spill cell contents, including damage-associated molecular patterns, or DAMPs, which capture the attention of the immune system, said Cam McCarthy, a fifth-year graduate student working in Webb’s lab and the study’s corresponding author.

DAMPs activate what should be a short bout of inflammation to deal with the danger, but in football players, this likely happens over and over again in just a single game. “We think that this increase in blood pressure we see in football players is due to the repeated trauma and immune system activation,” McCarthy said.

The trauma can be significant. The sheer size and strength of linemen today mean that those on the offensive and defensive line repeatedly smash into each other at a force equivalent to about a 30-mph car crash, the researchers write. Resistance training done off the field to improve lean muscle mass, likely results in more torn cells and additional activation of the immune response.

Higher blood pressure has been associated with professional and even college football, but exactly why remains unclear, Webb said. He noted that the cause is likely multifactorial and not simply the obesity found in the preponderance of players. While players’ blood pressure tends to drop toward normal after each season, a long-term impact is likely, the researchers said. Professional football players, for example, have a higher incidence of cardiovascular disease than the general population and live, on average, 10 years less.

The researchers hope that by fully understanding the cause, preventive strategies, maybe even something as simple as taking a daily baby aspirin to reduce inflammation, can reduce the short- and long-term impact of higher blood pressure.

Webb and his team have evidence that – at least in rats – circulating levels of DAMPs are increased in hypertension and increasing evidence of their direct role in hypertension. DAMPs appear to raise blood pressure by activating toll-like receptors on endothelial cells, which comprise the single-cell-thick lining of blood vessels. Toll-like receptors are located in all tissue and cell types and these pattern-recognition receptors are always on the lookout for danger and invaders, such as bacteria, McCarthy said.

The researchers theorize that toll-like receptors are activated a lot in football players, particularly linemen, who may be involved in literally a 100 hits per game. Results include arteries that are stiffer, less able to dilate, and higher blood pressure.

The researchers suspect that release and downstream effects of DAMPs likely play a role as well in the damage to the brain, called chronic traumatic encephalopathy, which can occur in these athletes from years of blows to the head.

While increased hypertension in professional athletes may seem like a paradox, the researchers note that hypertension is the most common cardiovascular complication seen in competitive athletes, even ultramarathon runners.

In fact, reports in the lay literature of elevated blood pressure in football players prompted McCarthy and Webb to do a scientific literature search where they found more evidence of the problem, but not the complete cause behind it. That led to their published hypothesis and to their current pursuit of funding to measure DAMPs levels before, during and after season in college football players.

A 2009 study in the Journal of the American Medical Association looking at the prevalence of cardiovascular disease risk factors among NFL players compared with their peers in the general population showed significantly higher blood pressures. However, other cardiovascular risk factors, such as lipid and cholesterol levels, were mostly similar despite the fact that the players were generally taller and heavier. The study also noted an increase in the past three decades in body mass index for linemen.

Fat, particularly in the abdominal area, is a known risk factor for hypertension and other cardiovascular diseases. A 2005 JAMA study showed that the percentage of NFL players with a body mass index of 30 or greater, which is considered obese, was double that of their non-football-playing peers. Offensive and defensive linemen had the highest BMIs. However, despite the pervasiveness of overweight, particularly among linemen, labeling body weight as the only culprit, is premature and doesn’t take into account the complexity of hypertension, the MCG researchers write.

Related studies looking at cardiovascular risk factors among NFL players in different positions showed linemen tend to have higher total cholesterol and triglyceride levels than other players in addition to higher blood pressures. A 2013 study in the journal Circulation showed that even college football players had elevated blood pressures that categorized them as pre-hypertensive and that, particularly linemen, were showing signs of unhealthy increases in the size of their heart related to pumping against increased blood pressure.

Webb and McCarthy’s FASEB study was supported by the American Heart Association and the National Institutes of Health.

Veteran turns 100, celebrates life, America

He may have been born in Italy, but World War II veteran Dante Antonacci – who turns 100 today – lives and breathes red, white and blue.

“America is the best place in the world to live,” said Antonacci from his small room in the Georgia War Veterans Nursing Home. “We take our freedom for granted, but there are so many opportunities here.”

Antonacci’s family fled his Italian homeland in 1925 to escape the fascism that was gaining momentum. He recalls many days at sea and several stops along the way aboard the Leonardo da Vinci when he was just 10 years old.

He quickly learned to speak English, survived the Great Depression and attended Penn State following high school. Antonacci was drafted into the U.S. Army shortly after marrying his childhood sweetheart Lida, the mother of his four children.

“She taught me to be an American,” he said.

He served in the Pacific Theatre during World War II – as an American – which made him an enemy of former Italian comrades and even his own cousin.

“It was emotional,” Antonacci said. “But I was American all through that.”

His 30th birthday on Aug. 7, 1945, should have been a milestone for him, but it was overshadowed by the dropping of the first atomic bomb in Hiroshima the day before.

“We didn’t celebrate my birthday,” he said. “We were thinking about the bombing of Hiroshima. I never thought about having a birthday.”

Then, a second atomic bomb hit Nagasaki two days after Antonacci’s 30th birthday.

“We realized that the war was over after the second bomb went off,” he said. “It was a happy day. Happy day and happy birthday.”

100th birthday party

 The Georgia War Veterans Nursing Home staff organized a birthday luncheon for him on the eve of his 100th birthday, serving two Italian specialties – lasagna, spaghetti and meatballs. The meal was topped off with a huge patriotic-colored birthday cake, and his great-grandson Max leading a roomful of family and friends in the “Happy Birthday” song.

When it was his turn to take the microphone during the festivities, Antonacci was overwhelmed with emotions.

He expressed his thanks for his family and all those gathered around him. He was most thankful to be an American, calling the United States “the greatest place on Earth to live.”

Philips expands global reach of diagnostic X-Ray solutions

 

Philips News Release: Philips expands global reach of diagnostic X-ray solutions

Georgia Regents Medical Center is the only U.S. hospital featured in a global PR campaign and news release about Philips diagnostic technologies.

“With Philips, we’ve moved from ordering a piece of equipment to an established long-term partnership. That partnership allows us to take a long view of how we will improve care,” said Dr. James V. Rawson, Chief of Radiology, Georgia Regents Medical Center. “When we replaced the digital portable X-ray units in the ICU, we completely changed the workflow. After an X-ray was taken in the ICU, the image was immediately available at that bedside for the physician to be able to see. That allowed real-time decisions and corrections or repositioning of lines and repeating at the X-ray, and cut our cycle-time down substantially.”

This release was published in more than 150 news markets around the world, including the Boston Business Journal, NBCRightNow.com, Morningstar.com (Canada), and the Providence Journal (Rhode Island).

Read: Philips expands global reach of diagnostic X-ray solutions

Don’t miss GPB’s Cherry Tree Listening Project

If you missed Georgia Public Broadcasting’s Cherry Tree Listening project stories, which culminated this week on WACG 90.7 FM, you can listen to them here https://soundcloud.com/gpbradioaugusta

The 20-part project, a collaboration between GPB and the Greater Augusta Arts Council, features stories of people who lived in Augusta’s oldest housing project. Listen to them tell stories about how living in Cherry Tree impacted their lives in every way.

“There were crazy things that happened in Cherry Tree, guns and gangs, drugs and violence, but that’s only one small part of the story,” said WACG Station Manager, Drew Dawson. “We want to tell the whole story.”