Links between concussion history, hypertension, and hypertension contributing factors among adolescent football athletes.

Abstract

Objective: Recent studies show that former professional football players have an increased mid-life risk of cardiovascular disease (CVD), including hypertension related to their prior concussion exposure while playing football. Adolescent football players at risk of concussion are exposed to biopsychosocial risk factors of CVD that increase the likelihood of stroke in adulthood. This study aims to examine the association between concussion history and hypertension among adolescent football athletes, adjusting for health-related anthropometric measures, post-concussion symptoms, and behavioral/environmental factors.

Methods: Data were drawn from a prospective cohort study's cross-sectional baseline containing self-reported concussion history. A total of 390 adolescent football athletes (mean age = 15.8 ± 1.2 years) in secondary schools participated in the study. The primary exposure included concussion history (yes/no). Other independent variables included post-concussion symptom scale (PCSS) severity, subjective social status (SSS), sleep disturbance score, and anthropometric measures (waist circumference, BMI, body fat, obesity level). The main outcome variable was blood pressure in the hypertensive range, defined as a binary-coded variable (SBP  ≥130 mmHg, DBP  ≥80 mmHg). A multivariable logistic regression model was conducted with complete cases (n = 327).

Results: A total of 31.4% of individuals (n = 121) had blood pressure in the hypertensive range. The multivariable logistic regression analysis showed that body fat is significantly and positively associated with blood pressure in the hypertensive range (AOR = 1.06, p = 0.03). However, concussion history, PCSS severity, SSS, sleep disturbance, waist circumference, and obesity level were not significantly associated (all ps > 0.05).

Conclusion: Body fat percentage was positively associated with blood pressure in the hypertensive range in this sample, whereas no association with concussion history was observed. The results suggest that risk factors noted in former professional football athletes may not strongly impact blood pressure in adolescence but could raise concerns for increased CVD risk as these athletes move through the lifespan.