More than four years ago I made the following comment about chronic traumatic encephalopathy (CTE) which was then being diagnosed in professional football players (see: NFL Physician Says Diagnosis of "Chronic Traumatic Encephalopathy" Lacks Validity):
I think that I already know how this story is going to turn out. Neurologists, pathologists, and radiologists are going to develop tests and imaging procedures that will provide earlier evidence of concussive injury for both amateur and professional football players. This will result in many players having to sit on the bench for longer periods of time after such injuries. This will cause some fans and league owners a lot of anxiety. Meanwhile, the NFL will do whatever it can to delay the development of faster and more accurate CTE diagnostic tools.
Well, it looks like professional football is alive and well although there are periodic reports that game attendance is sagging (see: The NFL can't seem to shake a season of sluggish ratings). The last news that the professional football leagues need is a new health scare. Guess what? One may be on the horizon in the form of enlarged aortas in former NFL players (see: CT shows 30% of ex-NFL players have enlarged aortas). Below is an excerpt from this article:
Former National Football League (NFL) players have significantly larger aortas than similarly aged men in the general population, potentially putting them at higher risk for aortic rupture or dissection [according to a recent study]....Nearly 30 percent of former NFL athletes met the threshold for an enlarged aorta...compared to 8.6 percent of the control group. The ex-players had an average aortic diameter of 38 mm, compared to 34 mm for non-NFL participants....But, after adjusting for size, age and other factors,...researchers found former NFL players were twice as likely to have ascending aortic diameters of 40 mm or more. Because coronary artery calcium scores were similar between the two groups, the differences in aortic dilation were likely not associated with atherosclerotic cardiovascular disease....“I think this study is really just scratching the surface to the whole idea of cardiovascular remodeling among athletes,” ...[according to one of its authors]. I think what the data are showing...is that strength training may lead to this phenomenon, especially given the observation that linemen tend to have this more than non-linemen—larger patients doing heavy lifting over time. We know that actually does cause concentric remodeling of the heart, so it stands to reason that the proximal aorta should dilate over time with that.....Anecdotally, I don’t think there have been a lot of reported cases of former elite athletes dying from aortic rupture, but is it something that we should be following and are we doing the sport service by not recognizing that this is a risk factor?”
I certainly have no intention to turn this into an alarmist report. An enlarged aorta might not be construed by the general public as life-threatening. It also seems reasonable to say that such a change in the anatomy might be the result of strength training and without any other adverse consequences. The author of the report goes on to say that, anecdotally, he is not aware of a higher incidence of aortic rupture among ex-football players. However, once you start seriously looking for cases of X or Y in a certain population, they sometimes appear in great numbers. There may be more serious consequences to all of this than now suggested. We will see.