Canadian men suffer from (literally) heart-stopping hockey games

By John Murphy, MDLinx
Published April 27, 2018

Key Takeaways

Canadian men younger than age 55 have a significantly increased risk for heart attack the day after a winning, but not a losing, home team hockey game, according to a study in the Canadian Journal of Cardiology.

Over a 4.5-year period, researchers observed a significant association between hospital admissions for acute ST-elevation myocardial infarction (STEMI) and victorious hockey games. The highest admission rates occurred after home victories in men less than 55 years of age, with a 40% increase in admissions for this population after a winning game for the home team, the Montreal Canadiens.

“Our study is the first to evaluate the association between local hockey games and admission rates for acute STEMI,” said lead investigator Hung Q. Ly, MD, MSc, interventional cardiologist, Montreal Heart Institute, Montreal, Canada. “Since the inauguration of the National Hockey League in 1917, the Montreal Canadiens remains the team with the most Stanley Cup wins and is known for its extremely loyal and enthusiastic fan base. This historical role of the city of Montreal might explain in part the association between higher admission rates for STEMI.”

The thrill of victory?

For this study, Dr. Ly and coauthors included a total of 2,199 STEMI patients (74.2% male, 25.8% female; mean age 62.6 years) who were admitted to the Montreal Heart Institute between June 2010 and December 2014. The researchers collected data on the dates of games, wins and losses, and whether the Canadiens were playing at home or away.

They observed an increased risk for acute STEMI admission in the overall population (hazard ratio [HR] 1.15; P=0.037) on the days after the team won, but not when they lost.

“Our data point to the fact that the emotional response to a victory had a greater negative effect on patients with a higher cardiovascular risk profile than the emotional stress of a lost match,” wrote Dr. Ly and coauthors. “Indeed, positive emotions during pleasant and euphoric events have recently been reported to increase the risk for stress-induced cardiomyopathy.”

Although STEMI admissions increased significantly in men (HR 1.2; P=0.02), this effect didn’t occur in women (HR 1.0), even though prior research has shown that women are more susceptible to mental stress-induced myocardial infarction.

The researchers found no association between hockey matches and mortality. However, a higher proportion of patients admitted for STEMI on hockey days than on control days experienced an in-hospital major adverse cardiovascular event. “The latter might suggest a persistent hazardous effect of mental stress-induced neuroendocrine and vascular responses on the cardiovascular system after a hockey game,” they wrote.

Unhealthy behavioral changes

The hockey-heart attack effect was most significant in men younger than 55 years old (HR 1.4; P=0.009), and less so in men aged 55 years and older (HR 1.1).

“Previous studies have suggested that unhealthy behavioral changes—including increased alcohol consumption, heavy and fatty meals, smoking, drug use, or sleep deprivation—may have additive effects on the link between sporting events and increased cardiovascular risk in spectators,” Dr. Ly said. “Notably, among all demographic groups in our study, the highest proportion of obesity, dyslipidemia, and smoking was found in young males, pointing towards an increased risk behavior and unhealthy lifestyle in this subgroup.”

To lessen this risk, the authors recommended preventive measures targeting medical support or behavioral changes. Perhaps this advice implies not watching hockey, although the authors didn’t specifically recommend such drastic measures for their population.

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