Retired NFL players, particularly linemen, may be at high risk of undiagnosed, untreated coronary artery disease (CAD) that often occurs without symptoms, according to preliminary independent research presented at the American Heart Association’s Scientific Sessions 2026 in Chicago. The study of 200 former NFL players found that 85% had coronary plaque, yet only 13% had a prior CAD diagnosis, and fewer than 10% reported symptoms like chest pain or shortness of breath.
CAD occurs when cholesterol plaque deposits in the heart arteries, limiting blood flow and oxygen delivery to the heart muscle. Plaque buildup can lead to a heart attack. The research used coronary computed tomography angiography (CCTA) and Heartflow AI coronary plaque analysis (AI-CPA) to visualize and measure plaque. The AI analysis creates a personalized 3D model of heart arteries and quantifies plaque volume, type, and impact on blood flow.
Key findings show that 42% of former players had a blockage narrowing at least one heart artery by more than 50%, and about 1 in 5 had blockages in multiple arteries. Nearly 90% of detected plaque was soft (noncalcified), which is associated with higher risk and cannot be detected by traditional calcium scores. Retired linemen had significantly more plaque and severe blockages compared with players of other positions, sitting above the median for total plaque volume when compared to an age- and sex-matched reference group.
“We expected to find plaque, but we did not expect to find such a striking gap between how much significant disease these former football players had and how few of them had any symptoms,” said study co-author Campbell Rogers, M.D., chief medical officer at Heartflow, Inc. “These results are consistent with the fact that 1 in 3 former NFL players dies from heart disease.”
The study is believed to be the first assessment of coronary plaque in retired professional football players. Lead author David Maron, M.D., noted that participants were eager to take preventive action: nearly 90% of those not already on cholesterol-lowering medications said they were ready to start treatment after seeing their results. “When CAD is found early, it is very treatable, often with medication and lifestyle changes rather than a medical procedure,” Maron said.
The findings underscore that being an elite athlete does not guarantee heart health later in life. “Plaque can build up in the artery walls for years without affecting blood flow enough to cause symptoms,” said American Heart Association volunteer expert Michael Shapiro, M.D., MPH, FAHA, who was not involved in the study. “Feeling fine does not necessarily mean the arteries are healthy.” Shapiro emphasized that everyone should know their cholesterol, blood pressure, and family history, and seek treatment when needed.
The research has limitations, including voluntary enrollment and lack of a prospectively enrolled control group of non-athletes, so findings may not apply to all retired NFL players or the general public. The study abstract is available in the Online Program Planner, and additional materials can be found on the release link. As abstracts presented at scientific meetings are not peer-reviewed, the findings are considered preliminary until published in a peer-reviewed journal.
