Lifestyle Habits and Structural Heart Abnormalities Among Former Athletes and Their Families: HUDDLE Subanalysis

Introduction: Cardiovascular disease is the leading cause of death globally. Understanding the association between lifestyle habits, risk factors, and structural heart abnormalities is crucial for developing preventive strategies, especially among understudied populations. Methods: The HUDDLE trial was a cross-sectional study of National Football League alumni and their family members aged ≥50 years who self-reported health histories and underwent noninvasive cardiovascular disease screening, including transthoracic echocardiography. Cardiovascular disease risk factors were evaluated using a modified American Heart Association Life's Simple 7 (physical activity, tobacco use, obesity, hypertension, diabetes, alcohol intake, and hyperlipidemia) and assessed as ideal, intermediate, or poor. Results: Of 498 participants, 92.4% had at least 1 poor health metric, with 15.9% having ≥3. Former National Football League players aged <65 years had a higher prevalence of ≥3 poor metrics compared with other participants. Non-White former National Football League players exhibited nearly double the prevalence of having 3 or more poor health metrics as their White counterparts (23.9% vs 12.0%). Compared with those with no poor metrics, participants with 3-7 poor metrics had the highest odds of having structural heart abnormality (OR=2.40; 95% CI=1.08, 5.32), followed by those with 2 (OR=2.39; 95% CI=1.16, 4.92) and 1 (OR=1.79; 95% CI=0.87, 3.66) poor metric. Conclusions: This subanalysis of the HUDDLE study identified a high prevalence of poor health metrics among former National Football League players and their families. Younger, non-White participants were more likely to have worse lifestyle habits than their counterparts. Increasing number of poor health metrics was associated with structural heart abnormalities.Trial registration: This study is registered at http://www.clinicaltrials.gov (NCT0500958).