As you watch the Packers take on the Steelers at this year's Super Bowl, you might want to take some deep breaths and channel as much calmness as you can, especially if the game isn't going your way.
The stress of rooting for the losing team, found a new study, may substantially increase the chances that fans will die from heart attacks. Risks are most likely highest for people who already suffer from heart problems and are susceptible to cardiac events.
But the findings point to one of the ways that emotional events can have serious impacts on our health.
"Fans develop emotional ties to their teams," said Robert Kloner, director of research at the Heart Institute of Good Samaritan Hospital in Los Angeles and professor of medicine at the University of Southern California. "For especially avid fans, the team in a way becomes a part of their family. And when there's a loss in the family, there's emotional stress."
Doctors have long known that these kinds of feelings can lead to cardiac distress in some people. That's because high levels of stress often trigger a fight-or-flight response. Heart rate and blood pressure soar, increasing the heart's need for oxygen, while other physiological reactions limit the amount of oxygen that can get there.
In people who are prone to cardiovascular problems, all the extra heart-thumping anxiety can lead to irregular heartbeats known as arrhythmias. Atherosclerotic plaques can rupture, too, ultimately shutting off the flow of oxygen to the heart muscle.
In a previous study, Kloner and colleague documented a rise in heart-related deaths after the 1994 North Ridge earthquake in L.A. European studies have also shown a rise in cardiac events after intense World Cup soccer games, particularly among male fans.
Kloner wanted to know how American football games might measure up.
For a 2009 study, he and colleagues analyzed death certificate data acquired from the Los Angeles County health department. They looked at the two-week period in 1980 after the L.A. Rams lost to the Pittsburgh Steelers in a close game in which the Rams lost their lead in the fourth quarter. They also looked at the two-week period in 1984 after the L.A. Raiders led the whole game and ultimately beat the Washington Redskins.
Compared to post-Super Bowl periods that did not involve a local team, the researchers reported in the American Journal of Cardiology, the total number of deaths in L.A. after the 1980 loss rose from about 2.1 per day per 100,000 people to 2.4 per day per 100,000 people -- a spike of 17 percent. Deaths related to heart and circulatory issues rose 22 percent.
After the win in 1984, on the other hand, there was a slight decrease in deaths.
To follow up, the scientists separated their findings by age, gender and race—and turned up some surprising results.
In men, for example, circulatory deaths rose by 15 percent after a loss, they report today in the journal Clinical Cardiology. But in women, contrary to the European soccer studies, deaths leaped up by 27 percent.
For people of both genders who were 65 or older, there was a 22 percent rise -- a much bigger spike than they saw in younger people.
"One possibility is that the Super Bowl could elicit an emotional response that's similar in males and females," Kloner said. "Another thought is that when males react to the Super Bowl, that adversely affects the emotional state of his female partner."
The findings should not spoil anyone's Super Bowl-watching fun, said Adolph Hutter, a cardiologist at Harvard Medical School and Massachusetts General Hospital in Boston. But for people who know they're prone to heart problems and tend to get nervous while viewing sporting events, he suggested talking with their physicians beforehand about how best to control their stress.
Advice could include taking an extra beta-blocker or other heart medicine, Kloner said. Deep breathing and muscle relaxing programs can help people reduce stress, too.
You might also want to watch what you eat. Super Bowl snacks are notoriously salty and high in fat, which can rapidly reduce the ability of heart vessels to dilate. Drinking and smoking don't help, either.
Hutter offered another strategy: Tape the game and wait to hear the results. If your team wins, you can watch it without worrying about all the fumbles. It may be a less exciting, but more heart-friendly way to go.
"I'm not only a football fan, but I've been the physician for the New England Patriots since 1982, so I've been through this a lot," Hutter said. "I enjoy it, but I do get upset when they're not doing well."
"I think it's a very, very enjoyable thing, and I want everyone to enjoy it," he added. "But enjoy it safely."