TORONTO - Football fans may have something else to worry about this Super Bowl Sunday besides the condition of New England Patriots quarterback Tom Brady's right ankle and who is bringing the chip dip.
A new and timely study suggests the stress and excitement of major sporting events can trigger a surge in heart attacks among fans, especially those with known heart conditions.
German researchers tracking cardiac emergencies during the 2006 World Cup of Soccer, which Germany hosted, found the rate of such events was more than two and a half times above the norm on days when Germany played.
Nail-biters - such as Germany's penalty shoot-out victory over Argentina in the quarter-finals - produced the sharpest spikes in cardiac emergencies, according to the study, published in this week's New England Journal of Medicine.
"We definitely believe that this is statistically highly significant," senior author Dr. Gerhard Steinbeck said from Munich, where he is a cardiologist and director of internal medicine at Ludwig-Maximilian University's Medizinische Klinik und Poliklinik.
On average, rates of heart attacks, cardiac arrests, attacks of unstable angina or cardiac arrhythmias that required emergency care and hospitalization increased 2.66 fold above baseline levels on days the German team played. A smaller increase among women - 1.82 times above average - offset a more than threefold increase in these events in men.
Among people who had previously experienced heart problems, the rate of these emergencies rose fourfold on days the home team played.
"It certainly does make sense in what we see coming through the emergency room," said Dr. Scott Delaney, an emergency room and sports medicine physician with the McGill University Health Centre in Montreal.
Delaney said in hockey-crazy Montreal, surges in cardiac cases are seen when Team Canada plays in the Olympics - though generally people wait till after the game is over to seek care.
Dr. Donald Redelmeier, director of clinical epidemiology at Sunnybrook Health Sciences Centre in Toronto, said the findings make some sense.
"It's an extremely plausible idea, namely that exuberant entertainment and excitement might lead to all sorts of lifestyle indiscretions in terms of alcohol or smoking or skipping medication or other imprudent behaviour," said Redelmeier, who in 2003 published findings in the same journal showing that motor vehicle fatalities rise by 41 per cent in the hours after the Super Bowl Game, making Super Bowl Sunday a more dangerous time to drive than New Year's Eve.
But Redelmeier noted that earlier studies looking at the same issue have produced a confusing picture, with some finding an increase and others not.
Steinbeck acknowledged that the previous evidence was inconclusive, but said he thinks this study carries more weight. For one thing, much of the previous work looked at only a single match, where this study tracked cardiac emergencies throughout Munich and its environs over the weeks of World Cup play, comparing rates to those that occurred over the same time period in 2005 and in 2003.
He suggested there is little doctors can do at this point to minimize the risk for engaged fans, but suggested study should be done to see if there are ways to mitigate the impact of game day stress on them.
