This study, says that men with known coronary heart disease should be really really careful about watching a stressful football match.....it could finish them off!
Cardiovascular Events during World Cup Soccer
Background The Fédération Internationale de Football Association (FIFA) World Cup, held in Germany from June 9 to July 9, 2006, provided an opportunity to examine the relation between emotional stress and the incidence of cardiovascular events.
Methods Cardiovascular events occurring in patients in the greater Munich area were prospectively assessed by emergency physicians during the World Cup. We compared those events with events that occurred during the control period: May 1 to June 8 and July 10 to July 31, 2006, and May 1 to July 31 in 2003 and 2005.
Results Acute cardiovascular events were assessed in 4279 patients. On days of matches involving the German team, the incidence of cardiac emergencies was 2.66 times that during the control period (95% confidence interval [CI], 2.33 to 3.04; P<0.001); for men, the incidence was 3.26 times that during the control period (95% CI, 2.78 to 3.84; P<0.001), and for women, it was 1.82 times that during the control period (95% CI, 1.44 to 2.31; P<0.001). Among patients with coronary events on days when the German team played, the proportion with known coronary heart disease was 47.0%, as compared with 29.1% of patients with events during the control period. On those days, the highest average incidence of events was observed during the first 2 hours after the beginning of each match. A subanalysis of serious events during that period, as compared with the control period, showed an increase in the incidence of myocardial infarction with ST-segment elevation by a factor of 2.49 (95% CI, 1.47 to 4.23), of myocardial infarction without ST-segment elevation or unstable angina by a factor of 2.61 (95% CI, 2.22 to 3.08), and of cardiac arrhythmia causing major symptoms by a factor of 3.07 (95% CI, 2.32 to 4.06) (P<0.001 for all comparisons).
Conclusions Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.
NHS Choices do a nice analysis of this research. They are often quite sceptical about much research, but in this case they explain that this was a well constructed and well analysed piece of work:
Overall, this study provides good evidence that stressful events and emotions can trigger heart attacks and provides a warning for people who already know they have heart disease.
I think being healthy includes being psychologically "well". We often limit fitness to physical fitness, but your mind has big effects on your body too. You cannot be fit if your mind is not well! We need to get our stressors sorted out, to relax, to have good social interaction for example.
Stress and Heart Disease
One of the things I've written about before is stress. While I am a sceptic regarding the supposed danger of high cholesterol, I do find myself sympathetic to what Malcolm Kendrick hypothesises as a (maybe the?) major cause of heart disease - stress and its hormonal effects (primarily on the HPA axis) as he explains in this video:
If you don't want to watch it, the message is fairly simple - stress and HPA dysfunction are strongly associated with heart disease. (He explains a lot more - with lots of references in his book ) You get stressed and your hypothalamus, pituitary gland and adrenals start kicking out all these hormones which have a load of dodgy effects on your metabolism. Other things are important too - e.g. smoking, carb intake (not cholesterol), but stress is a problem. (I've just noticed that he plugs Taubes' book at the end of the video! Hope that doesn't upset anyone out there....)