Jubilant Eagles fans scale a truck in Philadelphia
Eagles fans took to the streets of Philadelphia, Pennsylvania to celebrate their team’s 40-22 victory over the Kansas City Chiefs in Super Bowl LIX.
As Super Bowl pregame activities take place in California this week, another team is dealing with stress. It’s the American Heart Association’s mobile unit that provides CPR training.
Not a bad place to teach CPR. Sports and health experts say Super Bowl fans, whether in stadiums or at home, take the game so seriously that they often see spikes in heart attacks and other heart conditions amidst the rabid fans and binge drinking at the home of the participating teams.
The CPR training, part of the NFL’s Super Bowl Experience festival in San Francisco, does not suggest a direct correlation between the big game and heart attacks. An American Heart Association spokesperson told USA TODAY that the education campaign was inspired by an on-field incident in January 2023, when Buffalo Bills safety Damar Hamlin went into cardiac arrest and collapsed during a game against the Cincinnati Bengals.
However, a study by the National Institutes of Health found that Sunday’s Super Bowl was associated with up to a 20% increase in cardiovascular deaths.
“Even in modern times, the high drama and intensity of the Super Bowl may be associated with changes in cardiovascular mortality among fan bases with strong team attachment,” the report said. “Increased mortality can be associated with defeat, and decreased mortality can be associated with victory.”
Emotional stress is only part of the equation. Experts also point out foods and alcohol that are high in fat and salt.
And there is clearly an overreaction. Whether it’s a close game or a fateful goal-line stand, one team’s supporters may jump for joy while another team’s fans may slam the TV in rage or fall into a deep postgame funk.
“Sports fans have a very strong brand identity,” says Daniel Wang, a professor of psychology at Murray State University in Murray, Kentucky, and lead author of “Sports Fans: The Psychology and Social Impact of Fandom.” “People live and die through their sports teams.”
For NFL fans, Sunday’s Super Bowl matchup between the Seattle Seahawks and New England Patriots marks the culmination of this season’s high stakes and two weeks of hype. The stress of watching a game can pose cardiovascular health risks and can be a challenge for die-hard fans, especially if their team loses.
Doctors say people with a history of coronary artery disease should think twice about eating a Seattle dog or lobster roll for the second time, as it increases the chance of cardiac arrest. According to a study published in the journal Current Issues in Cardiology, “poor lifestyle habits” such as “binge drinking, eating fatty foods, and smoking abuse” contribute to the risk factors.
A 2021 study describes the intense passion and mental stress generated by the big game, rather than the easygoing one, as “trigger factors that affect the heart.” Researchers found that when you add injury to insult, fans of losing teams are at even higher risk.
An earlier study also looked at health data for Los Angeles County over a two-week period beginning with Super Bowl Sunday, when the city’s teams participated in the 1980 and 1984 championship games. The report, published in the American Journal of Cardiology in 2009, found that cardiac mortality rates rose after the Los Angeles Rams’ loss to Pittsburgh in 1980 and fell after the Los Angeles Raiders’ win over Washington in 1984.
Another study found similar findings related to 2008, when the Patriots lost to the New York Giants, and 2009, when the Pittsburgh Steelers beat the Arizona Cardinals.
This phenomenon isn’t limited to NFL fans. The authors of a previous study looked at health data from the 2006 World Cup, held in soccer-obsessed Germany, and hypothesized that matches involving national teams “may be a powerful enough trigger to increase the incidence of cardiac emergencies.”
Researchers reviewed reports of heart attacks and similar problems in Germany during the month-long tournament. They found that six out of seven national team World Cup matches were associated with a spike in cardiac emergencies when compared to a control period.
Their conclusion, published in the New England Journal of Medicine, was that attending a high-stakes soccer game more than doubles the risk of a heart attack or similar event.
Sports fans are ‘part of your identity’
Particularly for die-hard fans, the emotional attachments that fans have to their teams can be intertwined with hometown pride, family history, geographic loyalties, personal identity, and self-esteem.
In that sense, avid sports fans are much less likely to change affiliations than fans of other brands such as Nike or Pepsi, Wang said. For example, a fan of a particular airline might be able to imagine moving to another airline more readily than a Red Sox fan could imagine becoming a Yankees fan.
“Being a sports fan is part of your identity,” says Brandon Mastromartino, assistant professor of experiential marketing at San Diego State University. “When the team wins, it feels like a personal victory, but when the team loses, it feels like a personal loss.”
The irony of this self-imposed responsibility became ironic in one of Jerry Seinfeld’s signature stand-up comedy works. Seinfeld joked that fans often say, “We won! We won!” When the actual reality is like this, “No. they are I won. you I saw it. ”
The way this Sunday’s Super Bowl unfolds, the outcome could remain in doubt until the final minutes or even seconds of the game, creating drama and nerve-wracking uncertainty for the teams and the audience that is strongly aligned with them.
“We don’t know what the outcome will be,” Wang said. “If the game is tied with five minutes left and the game is on the line, they consider a team win a win and a team loss a loss, which puts their health at risk for the next few weeks.”
Complicating matters, Wang said, angry fans can’t do anything to influence the outcome.
“That’s the paradox of fandom,” he said. “You put your heart and soul into this thing and you can’t do anything about it. That’s when you have these incredibly intense emotional reactions, when you live and die with each play. When you talk to your doctor, it’s no surprise that sometimes it can be too taxing on your body.”
How to reduce Super Bowl stress
Tamara Horwich, a cardiologist and professor at the David Geffen School of Medicine at the University of California, Los Angeles, said the high emotions and stress of a dramatic game activate the body’s sympathetic nervous system, often called the fight-or-flight response. Stress hormones such as adrenaline spike, causing an increase in heart rate and blood pressure.
If the heart doesn’t receive enough oxygenated blood to function, it can cause a heart attack, she said. People with associated artery blockages are even more at risk. For others, increased epinephrine levels cause the heart to beat so fast that it becomes confusing and, if not slowed down, can lead to fainting and death.
Symptoms of a heart attack include chest pain or discomfort, shortness of breath, dizziness, unexplained sweating and jaw pain, Horwich said. People who experience such symptoms should seek immediate treatment, she said.
Super Bowl parties may be filled with nachos, chicken wings, and beer, but there are ways to reduce the risk. Horwich said players should keep their intake of alcohol and fatty foods to a minimum and remember to take heart-related medications and treatment for cholesterol and high blood pressure on game day.
If you’re feeling too stressed during a game, she said to take a break.
Mastromartino said that by controlling their viewing environment, passionate fans can reduce the emotional stress associated with loss.
“It means watching the game with someone who will support you, not someone who will stab you or give you a hard time when your team loses,” he said.
He also suggests avoiding social media after the game and resisting the urge to doomscroll in the heat of the moment. That may only increase anger.
Fans should remember that they’re fans for more than just the outcome of a single game, even if it’s the Super Bowl, they said. Only one team can be crowned champion each year. Keep in mind: at the end of the day, it’s just a game.
“I tell my patients, enjoy the game, but keep your eyes open,” said cardiologist Michael Chan, who directs the complex coronary intervention program at Providence St. Jude Medical Center in Fullerton, California. “We live and breathe our team, but you have to understand that there are more important things in life. You are more important to your family than any team.”
