On the Monday following past Super Bowls, there has been a marked increased risk of heart attacks in Ontario. MILLY HONG/THE VARSITY

The broadcast of the Super Bowl has been linked to a heightened risk of cardiac events in Ontario, including heart attacks and heart failures, according to a recent U of T-affiliated study.

The NFL’s annual championship game, the Super Bowl, is frequently the most viewed television spectacle in Canada each year.

Using data drawn from health care records in Ontario, the researchers analyzed the number of emergency department visits and hospitalizations for heart attacks, heart failures, and atrial fibrillation — rapid, irregular heartbeat rhythm — over 10 years of Super Bowl weeks from 2008 to 2017.

The analysis showed that on the Monday following each Super Bowl, there is a marked increased risk of heart attacks in Ontario. For patients younger than 65, the risk of heart failure also spiked on the following Monday.

Interestingly, the researchers did not find a statistically significant increase in the relative risk of heart attacks, heart failures, and irregular heart rhythms on the day of the Super Bowl.

Possible explanations for the spike in cardiac events

Dr. Sheldon Singh, a cardiologist and cardiac electrophysiologist at Sunnybrook Health Sciences Centre, wrote to The Varsity that this finding may arise from the complex relationship between stress and cardiac events.

“Prior work has shown that stress can have residual effects with [heart attacks] occurring hours after a clearly identified stressor,” wrote Singh.

“In addition… there may also be issues with patients delaying when they seek medical care — such as ignoring symptoms when they occur hoping they will pass, misinterpreting symptoms, or not wanting to disrupt any social gathering they are at.”

“It’s also important to remember that Super Bowls occur late on Sunday evenings,” noted Singh, “so it would not be unexpected to see an increase in events on [the] following Monday.”

Psychological stress experienced by spectators, as well as an increased consumption of alcohol and salty foods are further factors that may contribute to the amplified risk of cardiac events during the Super Bowl.

However, Singh added that there may be other contributing factors that the study failed to identify due to its design.

“Our work is at a population level, not individual level, which makes it challenging to tease out the exact mechanism of the observed association,” wrote Singh.

Previous studies have shown that heart rates of Montreal Canadiens’ fans increase during hockey games. A spike in cardiac events have also been reported during FIFA World Cup soccer matches by other studies.

Singh wrote that it’s possible to generalize the findings for Super Bowl viewers to those of other sporting events, but it’s important to remember the distinction between a single critical match versus a series when making such assumptions.

Stress levels are more concentrated when the outcomes of a championship, such as the Super Bowl, depend on a single game.

However, the stress experienced during other types of sporting events, such as with hockey or baseball, is generally more distributed because the final outcome often depends on the best of a series.

“We have to appreciate that [increased] cardiac events also have been reported with single catastrophic or stressful events, such as severe snowstorms… earthquakes, and other natural disasters,” wrote Singh.

Health care providers may be able to better plan for a spike in admissions for cardiac-related events around the Super Bowl each year using the study’s findings.

Moreover, Singh believes that educating individuals on the association between emotional stress and dietary indiscretion on one’s overall health will have important implications for public health.

“Given the popularity of the Super Bowl, there is an opportunity for health care practitioners to reach a broad segment of the population, which may have impacts not only during the Super Bowl, but with other events as well,” wrote Singh.

“I am hopeful the general public will access information from our study and public health agencies use this to launch health care campaigns promoting healthy lifestyles.”

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