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Whether repetitive head injury among professional athletes impacts cardiovascular risk is unknown. We investigated associations between concussion burden and postcareer hypertension, high cholesterol, and diabetes among former professional American\u2010style football (ASF) players.<\/jats:p><\/jats:sec>Methods<\/jats:title>In a cross\u2010sectional study of 4080 professional ASF players conducted between January 2015 and March 2022, we used an mulitsymptom concussion symptom score (CSS) and the number of loss\u2010of\u2010consciousness (LOC) episodes as a single severe symptom to quantify football\u2010related concussion exposure. Primary outcomes were hypertension, dyslipidemia, and diabetes, defined by current or recommended prescription medication use.<\/jats:p><\/jats:sec>Results<\/jats:title>The prevalence of hypertension, high cholesterol, and diabetes among former players (52\u2009\u00b1\u200914\u2009years of age) was 37%, 34%, and 9%. Concussion burden was significantly associated with hypertension (lowest vs. highest CSS quartile, odds ratio (OR)\u2009=\u20091.99; 95%CI: 1.33\u20132.98; p<\/jats:italic>\u2009<\u20090.01) and high cholesterol (lowest vs. moderate CSS, OR\u2009=\u20091.46, 95%CI, 1.11\u20131.91; p<\/jats:italic>\u2009<\u20090.01), but not diabetes. In fully adjusted models, the prevalence of multiple CVD was associated with CSS. These results were driven by younger former players (\u2264\u200940\u2009year of age) in which the odds of hypertension were over three times higher in those in the highest CSS quartile (OR\u2009=\u20093.29, 95%CI: 1.39\u20137.61; p<\/jats:italic>\u2009=\u20090.01). Results were similar for LOC analyses.<\/jats:p><\/jats:sec>Interpretation<\/jats:title>Prior concussion burden is associated with postcareer atherogenic cardiovascular risk profiles among former professional American football players.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52045","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T12:39:22Z","timestamp":1716986362000},"page":"1604-1614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Concussion burden and later\u2010life cardiovascular risk factors in former professional American\u2010style football players"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9673-9907","authenticated-orcid":false,"given":"Can Ozan","family":"Tan","sequence":"first","affiliation":[{"name":"RAM Group, Department of Electrical Engineering, Mathematics, and Computer Science University of Twente the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6961-0243","authenticated-orcid":false,"given":"Rachel","family":"Grashow","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Environmental Health Harvard T. 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Chan School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Roland","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Program of Research on Men's Health, Hopkins Center for Health Disparities Solutions Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Department of Health Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University Harvard Medical School Boston Massachusetts USA"},{"name":"Neuroendocrine Unit Massachusetts General Hospital and Harvard Medical School Boston 02114 Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University Harvard Medical School Boston Massachusetts USA"},{"name":"Diabetes Research Center Massachusetts General Hospital and Harvard Medical School Boston 02114 Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saef","family":"Izzy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Radmanesh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"},{"name":"Division of Neurocritical Care, Department of Neurology University of New Mexico Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-9834","authenticated-orcid":false,"given":"Marc G.","family":"Weisskopf","sequence":"additional","affiliation":[{"name":"Football Players Health Study at Harvard University Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Environmental Health Harvard T. 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