Monday, February 06, 2012

Superbowl Loss for Your Team? You May Be Dead in Two Weeks Research Suggests

If your team lost in the Superbowl last night, research suggests that you are at increased risk of dying in the next two weeks. One known risk of cardiac failure is acute stress, be it physical stress, emotional stress, or both. This is because puts part of the nervous system into overdrive and causes a release of chemicals known as catecholamines that prepare the body for the “fight or flight response.” The result can be increased heart rate, blood pressure, blood sugar (i.e., glucose), abnormal heart rhythms, too many platelets (leading to blood clots), and/or contractures of the heart’s ventricles (which pump blood to the body). Increased oxygen demand can occur and oxygen supply to the heart can be decreased. If a person has a buildup of plaque in the arteries (a condition known as atherosclerosis) increased blood pressure can shear off a piece of plaque and lead to a heart attack or ischemic stroke. In an ischemic stroke, there is a blockage of an artery, preventing enough blood from getting to the brain.   

Researchers have noted that there was an increase in total deaths and cardiac related deaths in Los Angeles when the L.A. Rams lost the Superbowl on 1/20/1980. Of note, that game was played locally in Pasadena, California. The game was high-intensity, involved 7 lead changes, and the game was decided in the last quarter (final score 31-19). The team was much loved by the fans and had been in the city since 1946. By contrast, the number of total deaths in Los Angeles decreased when the L.A. Raiders won the Superbowl on 1/22/1984. The L.A. Raiders had only been in the city since 1982 (having moved from Oakland) so there was less emotional attachment by the L.A. fans. The game was not played locally (it was played in Tampa, FL) and was also a blow-out, with the Raiders winning 38-9.

Researchers from Los Angeles studied the degree to which age (65 or older vs 65 or less), sex (men vs women), or race (white vs Hispanic) played a role in deaths shortly after the Superbowl. They examined death certificates from 1980 to 1988. They considered Superbowl days (days in which the effects of a the Superbowl may be felt) to be the date of the Superbowl and the next 14 days. The other days in January and February of 1980, 1981, 1982, and 1983 were considered non-Superbowl days. The same analyses were done for the 1984 Superbowl. Total and cardiac deaths from January 1 to January 14 were not analyzed due to a known increase in deaths around the holidays.

The researchers used statistical techniques to assess if there was a difference in total and cardiac related deaths on Superbowl days vs non-Superbowl days. They also used a statistical procedure known as regression analysis to determine which variables best predicted death rate: Superbowl days vs non-Superbowl days, race, sex, age, or combinations of race, sex, and age with Superbowl vs non-Superbowl days.

The results showed that after the Superbowl loss, daily death rates increased for both males and females. The circulatory death increase was 15% for men and 27% for women. People aged 65 or older had a larger increase in all causes of death during Superbowl days compared with those who were less than 65 years old. Whites and Hispanics had increased death rates on Superbowl loss days. There were statistical trends suggesting less death in older patients and females associated with a Superbowl win but the findings were not statisitically strong enough to state this association more firmly.

The researchers concluded that a Superbowl loss triggered increased deaths in both men and women and especially in older patients, whereas a Superbowl win reduced death more in those aged ≥65 years and in women.

However, Dr. Viktor Culic from Croatia was not so impressed with these conclusions based on a criticism with how the study was conducted. Specifically, he published a response saying that the 2-week post-Superbowl period was too long for one to reasonably be able to associate deaths during that period to the Superbowl. He stated that the true risk of death after an emotionally related stressor is one to two hours after the stressor. He stated that any extension of the period to two weeks would be purely based on hypothetical disease mechanisms. He stated that cold weather and air pollution could be associated with the increased deaths after the Superbowl, especially in the elderly. He stated that perhaps the weather was colder and the air more polluted in two weeks after the Superbowl loss than the comparison days. He also stated that there may have even been more deaths in the weeks that were excluded before the Superbowl because it may have been even colder then.

The authors of the original study replied that they picked a 14 day period after the Superbowl because they believed that the emotional effects may linger after the day of the game. They stated that most of the deaths occurred in the first week after the game. They disputed the usefulness of examining death rates in the weeks before the Superbowl. They stated that cold weather and air pollution could not explain their findings. They correctly point out that the two Superbowl games were played at nearly identical times of the year, yet there were different death rates. The temperatures were also mild in L.A. both times, with an average of 52.9 on the day of the 1980 Superbowl and 54.5 on the day of the 1984 Superbowl. Temperatures were also very close in January and February of 1980 and 1984. In addition, analysis of air pollution data did not show more air pollution in 1980 than 1984.

The reference for the original study is:

Kloner RA, McDonald SA, Leeka J, Poole WK. Clinical Cardiology. 2011 Feb;34(2):102-7. Role of age, sex, and race on cardiac and total mortality associated with Super Bowl wins and losses.

The reference for the response and author reply are:

Culić V. Clinical Cardiology. 2011 Jul;34(7):461-2; author reply 462. Response to 'Role of age, sex, and race on cardiac and total mortality associated with Super Bowl wins and losses'.

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