It's typically the most-watched television event of the year, and this year's Super Bowl is expected to be no exception. The showdown between the Kansas City Chiefs, seeking a three-peat, and the Philadelphia Eagles looking to take back the Lombardi Trophy is likely to spur a lot of emotions on both sides of the gridiron and everyone watching from the couch at home.

What the millions of viewers of the Super Bowl may not realise, as they tune into the game this Sunday, is they are potentially increasing their risk of having a heart attack.

Research shows cardiac incidents increase around the Super Bowl, especially in the hometown city of the losing team. A 2021 study found psychological stress, even that of your favourite sports team losing the big game, is associated with heart issues including myocardial infarction, symptomatic arrhythmias, and sudden cardiac death. Similar patterns have been found with big soccer matches, including the World Cup finals, and sports like hockey and baseball.

"Significant stress of any kind can play a role in exacerbating a pre-existing heart condition," said Brett A. Sealove, M.D., chief of Cardiology, at Hackensack Meridian Jersey Shore University Medical Center. "People who are already at risk with symptoms including high blood pressure, cholesterol, diabetes, and obesity are at an increased risk for a cardiac event during times of stress." Cardiac events can include anything from heart attacks, strokes and heart palpitations.

Strong emotions can mess with the body's hormones and nervous system. This can affect blood vessels, making them work improperly and changing blood flow. These changes can increase the chance of a dangerous type of heart blockage (plaque) bursting. When the body's "fight or flight" system gets kicked into high gear, it can damage the lining of your blood vessels and temporarily make a person's blood more likely to clot.

This can starve the heart muscle of oxygen (ischemia) by making it harder to pump blood. We're still figuring out exactly how strong emotions cause this increased clotting tendency, but it seems like the adrenaline rush might be stimulating both clotting and anti-clotting factors at the same time, creating an imbalance.

The foods fans tend to eat while watching the Super Bowl, if consumed year-round, play a significant role in the increased risk of cardiac incidents. People's diets that are high in fat, salt and sugar, especially in the high quantities typically consumed while watching the Super Bowl or other events, are not good for patients with heart disease.

Other activities including drinking alcohol and smoking further put people at risk. "All of these are taxing on the heart," Dr. Sealove said. Drinking too much alcohol can weaken your heart's pumping chambers, leading to irregular heartbeats like atrial fibrillation (a-fib). Smoking raises triglycerides in the blood, lowers good cholesterol and makes blood more likely to clot, increasing a patient's risk of a cardiac incident.

Doctors say it is important for patients to recognise the risks, and not dismiss their symptoms including persistent chest pain, shortness of breath, dizziness, lightheadedness and nausea. "Do not dismiss these serious symptoms as heartburn from the Super Bowl buffet table," Dr. Sealove explained. "If you are experiencing the above symptoms it is important to get it checked out immediately."

People with heart disease risk factors can limit their risk by changing their diet and taking simple steps, including swapping out water for alcohol and sugary beverages, and snacking on vegetables and healthier options rather than processed foods high in fat, salt and sugar. They should also avoid smoking and binge drinking, and finally, this Super Bowl Sunday, take a calming breath and remember that despite the Lombardi Trophy and bragging rights on the line, it's just a game.

Provided by Hackensack Meridian Health