History of Concussions & Risks

It’s important to know that heart and metabolic diseases are common among former NFL players. Heart disease includes high blood pressure and/or high cholesterol, while diabetes or high blood sugar is considered a metabolic disease, a type of condition that disrupts the process by which the body converts food into energy. These conditions are also common among American men. When heart and metabolic diseases remain untreated over long periods, they can lead to conditions such as stroke, blood vessel diseases, and they can also impact thinking, memory, and concentration.

Smoking, weight gain, diabetes, aging, and identifying as Black* are all risk factors for the above diseases. However, the links between having a concussion during NFL play and experiencing these health conditions later in life are unknown.

Expanding on previous research, our study team examined survey responses from 4,080 former NFL players to see whether concussion history was also related to reports of hypertension, diabetes, and high cholesterol after playing years.

*This is believed to be related to experiences with discrimination, access, and racism, and not an indicator of genetics.

What we found:

• Players aged 40 or younger who reported high numbers of concussion symptoms during their playing years were three times more likely to report hypertension following their playing years.
• Concussion symptoms during playing years were correlated with later-onset hypertension and high cholesterol. No correlation was found with diabetes.
• When taking into account age, race, elevated body mass index (BMI), and smoking, players who reported higher numbers of concussion symptoms during playing years were also more likely to report one or more of the heart and metabolic diseases we examined.

It is important to note that whatever the cause may be, cardiovascular diseases such as hypertension, diabetes, and high cholesterol are treatable conditions.

What this may mean for you:

• Addressing high blood pressure, diabetes, and cholesterol at any age can protect long-term heart and brain health.
• Even brief experiences with cardiometabolic diseases in early adulthood can lead to later-life health issues, such as heart disease and problems with thinking, memory, and concentration.
• Players who recall a high number of concussions may want to consider regular preventive screenings for high blood pressure or high cholesterol.
• Our results suggest that screening and proactive hypertension treatment and cholesterol management, even in relatively young former players, may reduce heart disease and cognitive impairment.
• Former players who are concerned about cognitive impairment or heart health may want to have their blood pressure, blood sugar, and cholesterol checked and managed by a healthcare provider.

These results further underscore the importance of research to better understand the ways that concussion symptoms might relate to the development of high blood pressure and other cardiovascular conditions. Based on this study, future research should investigate whether some cognitive decline may be prevented or reduced in former NFL players through blood pressure medication and/or lifestyle changes.

Action items for former players:

• Know Your Numbers: It is important to monitor your blood pressure on a regular basis either at your doctor’s office or by using at-home blood pressure cuffs and discuss results with your doctor.
• Speak to your doctor about checking your cholesterol and blood sugar levels. Lifestyle changes (exercise, diet, etc.) and medications can have positive impacts on cardiometabolic health. Use our checklist designed specifically for former players when speaking with your medical care provider.
• Hypertension, high cholesterol, and diabetes at any age can have long-lasting implications for heart and brain health. It is important to be proactive about maintaining healthy blood pressure through exercise, regular sleep, maintaining a healthy weight and diet, as well following medication-related, and lifestyle recommendations from your healthcare providers. See recommendations from the American Heart Association for maintaining health blood pressure.
• If you think you may be experiencing symptoms of cognitive impairment, you can request a comprehensive neurocognitive evaluation through your primary care physician (PCP) which can be done by a neurologist or another highly trained specialist.
• If you are concerned about your heart health, do not hesitate to contact your primary care doctor, or another medical care provider. You can find a cardiologist through the TRUST powered by the NFLPA (check eligibility) or your primary care doctor.

If you have questions about this information, please email our team at players@footballplayershealth.harvard.edu or call us at 617-432-5000.

If you are in distress or require immediate assistance, please contact the NFL Lifeline at 1-800-506-0078 or visit their website to chat with a trained counselor.