American-Style Football and Cardiovascular Health.
American-Style Football and Cardiovascular Health.
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DOI：
10.1161/jaha.118.008620
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发表时间：
2018-04-04
影响因子：
5.4
通讯作者：
Baggish AL
中科院分区：
文献类型：
--
作者：
Kim JH;Zafonte R;Pascuale-Leon A;Nadler LM;Weisskopf M;Speizer FE;Taylor HA;Baggish AL
美式足球（ASF）是美国最受欢迎的有组织的团队运动，每年有100万高中、17万大学、2万和2000名专业人士参加。尽管年轻的竞技运动员通常被认为是健康和活力的典范，但围绕ASF参与的长期健康影响的不确定性最近已成为一个相当有趣和有争议的话题。5,6具体来说，关于非洲猪瘟参与对心血管和神经认知健康的影响的担忧在科学文献、主流媒体和监督非洲猪瘟规章制度的管理机构中引起了激烈的争论。参与非洲猪瘟的内在生理是复杂的，与大多数其他流行的运动形式不同。包括高负荷静态血流动力学压力、相对较低的有氧调节、故意增加体重、心理压力和常规使用非甾体抗炎药8在内的因素对心血管健康有潜在影响。在健康的非运动人群中，ASF运动员典型年龄的早发性心血管风险和伴随的亚临床病理可预测晚年心血管发病率和死亡率。虽然这一现象尚未在ASF参与者中得到明确证实，但越来越多的观察数据表明，ASF运动员的大体重、早期高血压、亚临床病理性心血管表型15 - 18与大体重、早期高血压12 - 14和亚临床病理性心血管表型15 - 18之间存在关联。此外，来自前职业ASF运动员的流行病学结果数据表明，前一线球员心血管死亡率加快。19,20生命早期ASF参与与随后心血管健康之间的确切关系仍不完全清楚；然而，多项证据表明，参与非洲猪瘟可能会增加患心血管疾病的风险。本综述旨在描述我们对ASF参与者心血管健康的当代理解，这是临床心血管实践中经常遇到的人群。为此，我们对ASF与心血管健康进行了全面而广泛的科学文献检索。本文对符合这一描述的研究进行了详细的回顾和引用。初步讨论了ASF参与的基本生理学。接下来，详细介绍了先前对高中、大学和专业ASF队列的研究，这些研究描述了心血管危险因素概况、心血管表型和结果数据，并强调了当前可用数据的关键局限性。最后，提出了未来研究的必要性和心血管专家的临床战略方法的框架。
—Vince Lombardi American-style football (ASF) is the most popular organized team sport in the United States, with% 1 million high school, 1 70 000 collegiate, 2 and 2000 professional participants annually. 3, 4 Although youthful competitive athletes are classically regarded as the paradigm of health and vitality, uncertainties surrounding the long-term health implications of ASF participation have recently become a topic of considerable interest and controversy. 5, 6 Specifically, concerns about the impact of ASF participation on cardiovascular and neurocognitive health7 have generated lively debates in the scientific literature, in the mainstream media, and within governing bodies that oversee ASF rules and regulations. The physiology inherent in ASF participation is complex and differs from most other popular forms of sport. Factors including high loads of static hemodynamic stress, relatively low amounts of aerobic conditioning, deliberate body mass gain, psychological stress, and routine NSAID8 use carry potential implications for cardiovascular health. In healthy nonathletic populations, early onset cardiovascular risk and attendant subclinical pathology at ages typical of ASF athletes predict later life cardiovascular morbidity and mortality. 9–11Although this phenomenon has not been firmly established among ASF participants, a growing body of observational data documents associations among large body mass, 12, 13 early life hypertension, 12, 14 and subclinical pathologic cardiovascular phenotypes15–18 in ASF athletes. In addition, epidemiologic outcomes data from former professional ASF athletes suggest accelerated cardiovascular mortality among former linemanposition players. 19, 20 The precise relationship between early life ASF participation and subsequent cardiovascular health remains incompletely understood; however, multiple lines of evidence suggest that ASF participation may impart increased risk for the development of cardiovascular disease. This review was constructed to delineate our contemporary understanding of cardiovascular health among ASF participants, a population that is commonly encountered in clinical cardiovascular practice. To do so, a comprehensive and broad scientific literature search targeting ASF and cardiovascular health was conducted. Studies matching this description were reviewed in detail and referenced in this review. The basic physiology accompanying ASF participation is initially discussed. Next, prior studies of high school, collegiate, and professional ASF cohorts that describe cardiovascular risk factor profiles, cardiovascular phenotypes, and outcomes data are detailed, along with an emphasis on key limitations of the currently available data. Finally, a framework for future research imperatives and clinical strategic approaches for cardiovascular specialists is proposed.