1. Nonsteroidal Anti-inflammatory Drugs and Cardiovascular Risk in American Football
- Author
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Carla R. Gilson, Chang Liu, Ganesh Prabakaran, Ayman Alkhoder, Aaron L. Baggish, Arthur S. Miller, Jonathan H. Kim, Craig Clark, Gene Patterson, Mohamad Wehbe, Parker Nguyen, Casey Hollowed, Zaina Gowani, Jason Tso, Grace Nguyen, Angelo Galante, Morgan Dommisse, Thomas Marshall, and Arshed A. Quyyumi
- Subjects
Male ,Applanation tonometry ,medicine.medical_specialty ,Time Factors ,Adolescent ,Manometry ,Systole ,Football ,Blood Pressure ,Physical Therapy, Sports Therapy and Rehabilitation ,Context (language use) ,Pulse Wave Analysis ,Weight Gain ,Article ,Running ,03 medical and health sciences ,chemistry.chemical_compound ,Vascular Stiffness ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Longitudinal Studies ,Students ,Pulse wave velocity ,Swimming ,Analysis of Variance ,Nonsteroidal ,biology ,business.industry ,Athletes ,Anti-Inflammatory Agents, Non-Steroidal ,030229 sport sciences ,Odds ratio ,biology.organism_classification ,United States ,Confidence interval ,chemistry ,Echocardiography ,Heart Disease Risk Factors ,Case-Control Studies ,Hypertension ,Cohort ,Physical Endurance ,Seasons ,business - Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with adverse cardiovascular outcomes and reportedly overused in American-style football (ASF). However, assessment of ASF NSAID use in the context of cardiovascular risk has not been performed. We sought to characterize NSAID use patterns and the association with cardiovascular risk in a diverse cohort of high school and collegiate ASF athletes. METHODS A total of 226 ASF athletes, 60 endurance athletes, and 63 nonathletic controls were studied pre- and postseason with echocardiography, vascular applanation tonometry, and clinical data assessment. Qualitative NSAID use throughout the season was recorded at postseason. RESULTS ASF athletes gained weight (Δ0.86 ± 3.9 kg, P < 0.001), increased systolic blood pressure (SBP, Δ3.1 ± 12 mm Hg, P < 0.001) and pulse wave velocity (Δ0.2 ± 0.6 m·s, P < 0.001), and decreased E' (Δ-1.4 ± 2.8 cm·s, P < 0.001) across one athletic season. Seventy-seven percent (n = 173) of ASF athletes reported that sport-specific NSAID use began in middle school. ASF NSAID use was more frequent with "weekly" (n = 42.19%) and "daily" (n = 32.14%) use compared with endurance athletes (P < 0.001) and controls (P = 0.02). ASF NSAID use increased in parallel with postseason SBP and weights. "Daily" ASF NSAID users demonstrated the highest postseason SBP (137 ± 13 vs 128 ± 13 mm Hg, P = 0.002) and weight (109.0 ± 18.6 vs 95.8 ± 20.5 kg, P = 0.002) compared with "never/rare" users. Adjusting for player position, SBP, pulse wave velocity, and E', increased weight (odds ratio = 1.04, 95% confidence interval = 1.0-1.08, P = 0.037) was associated with more frequent NSAID use. CONCLUSIONS Habitual NSAID use commonly begins during adolescence, before full physical maturation, and is associated with cardiovascular risk, particularly increased weight, in ASF athletes. NSAID use frequency should be considered when risk stratifying high-risk ASF athletes.
- Published
- 2020
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