Studies have found that retired pro football players may have an increased risk of heart disease. But new research shows that while they are still in the game, there are no signs of trouble in the players' arteries.
After retirement, pro football players tend to have more heart risk factors, like high blood pressure, unhealthy cholesterol levels and obesity, than the general public.
And former linemen, with their super-sized bodies, seem to be particularly vulnerable.
One of the questions has been whether "there's something about being athletic" that creates the increased risk, according to Dr. R. Todd Hurst, a cardiologist at the Mayo Clinic in Scottsdale, Arizona.
So Hurst and his colleagues looked for potential early signs of heart trouble in active football players in their 20s and 30s.
Using ultrasound scans, the researchers measured the thickness of the walls of the carotid arteries in 75 players from two pro football teams.
The carotid arteries run through the neck to supply blood to the brain. Thickening in those artery walls can be a sign of "subclinical" atherosclerosis -- that is, a hardening and narrowing of the arteries that causes no symptoms, but may signal an increased risk of heart disease or stroke down the road.
Hurst's team compared the players' ultrasound results with those from 518 U.S. men who had taken part in an earlier heart-health study. Overall, when the men were matched for age and race, the football players showed no particular signs of artery trouble.
"They actually looked as good, or even better than, the general population," Hurst said.
That's in contrast to an earlier study where Hurst's team found that retired NFL players did have substantial narrowing of their carotid arteries -- on par with what's seen in obese men who've spent most of their time on the couch watching football.
So what happens after retirement to change football players' heart outlook?
One likely culprit is the reduced physical activity. Not only are they not training and competing, Hurst noted, but many retired players may have physical limitations from past injuries that keep them from exercising.
Then there's diet. While in the game, football players need a lot of calories to meet their physical demands, Hurst said. But if they keep eating that way after retirement, the calories that were once burned may instead be stored as fat.
"Can we do something about it?" Hurst said. "I think we can -- even if it's just through education."
That, he said, could include changing pro players' "mindset," because they often have an attitude that they are invincible. But they clearly are not, Hurst pointed out.
"They have the same issues that we all do -- obesity, too many calories," he said. And those issues get amplified, Hurst added, because football players start off with bigger bodies than the average person, and they end their careers at a young age.
More health screenings for current and former players could help spot those heading for trouble, according to Hurst.
There has been some response to the issue already. Since 2007, the NFL Player Care Foundation has funded free heart health screenings for retired players, as part of a larger research project.