September marks the beginning of football season, which culminates in the Super Bowl—one of the most widely viewed events in the world, with an estimated 108 viewers.1 

Commonly associated with excitement, fun, and camaraderie between friends who watch the big event together, Super Bowl Sunday has a darker side. It is associated with higher rates of alcohol-related accidents2 and increased risk of cardiovascular (CV) deaths.3

RELATED: Cardiovascular Disorders Resource Center

The catalyst for Super Bowl-related CV deaths appears to be the emotional stress associated with defeat of the favored team in a “high intensity/dramatic” game.4 

This pattern has been observed in other sporting events—for example, during the one-month long 2006 Fédération Internationale de Football Association (FIFA) World Cup. On days when the German team played, the incidence of cardiac emergencies was 2.66 times higher than the incidence during a one-month control period.5

Earlier studies3 found a similar association in Super Bowl viewers. In the two weeks following the “dramatic” 1980 Super Bowl loss of the Los Angeles Rams to the Pittsburgh Steelers, death rates in Los Angeles county significantly increased, due to circulatory, ischemic heart disease, and myocardial infarctions.3 Conversely, all-cause mortality significantly decreased in Los Angeles County in 1984 following the victory of the Los Angeles Raiders.3

A recent study4 investigates whether the trend of increased CV death following the defeat of a favorite team still occurs, in light of contemporary interventions and treatments for cardiovascular disease (eg, statin therapy, newer antiplatelet agents, drug-eluting stents, and implantable cardioverter defibrillators). The purpose of the study was “to examine the association between CV mortality and the Super Bowl in the contemporary era.”

The authors analyzed daily death certificate data during the eight consecutive days beginning with two “high drama and intense” Super Bowls: the 2008 defeat of New England Patriots at the hands of the New York Giants, and the 2009 Arizona Cardinals loss to the Pittsburgh Steelers. They compared these data to death certificates during eight consecutive days beginning with “non-case period” Super Bowls from 2005 to 2009.

RELATED: Psychiatric Disorders Resource Center

The researchers found that in the eight-day period following the unexpected loss of the New England Patriots in 2008, circulatory deaths in Massachusetts increased by 20 percent (P = 0.0004), and ischemic heart disease deaths increased by 24 percent (P = 0.01), compared with the eight-day periods following other Super Bowls. 

When compared with the prior week and the prior year, circulatory deaths increased by 14 percent (P = 0.004) after the Super Bowl loss in Massachusetts.

In contrast, during the eight-day period following the Pittsburgh Super Bowl victory in 2009, circulatory deaths in Pittsburgh decreased by 25 percent (P = 0.046), ischemic heart disease deaths decreased by 31 percent (P = 0.03), and myocardial infarction deaths decreased by 46 percent (P = 0.03), compared with the eight-day periods following other Super Bowls.