Montreal men take hockey to heart

(Reuters health) - Canadians are passionate about the sport of hockey, but getting too excited by a big game may put men at higher risk for heart attack, researchers say.

Tracking hospital admissions for heart attacks over a five-year period in Montreal, researchers found that men, but not women, were at 20 percent higher risk of having a heart attack the day after the city’s beloved Montreal Canadiens hockey team won a match.

The risk was most pronounced in men under age 55, who had 40 percent higher odds of a heart attack the day after a victory compared to other days, the study team reports in Canadian Journal of Cardiology.

“Hockey is our national pastime and a lot of (good and bad) emotions can be attached to this. Importantly, behaviors in young males may be the likely mechanisms for this increase in heart attacks,” said senior study author Dr. Hung Ly of the Montreal Heart Institute.

The study adds to previous research around heart attacks and strokes related to major sporting events such as the Rugby World Cup in New Zealand, World Cup soccer in Europe and Super Bowl football championship in the United States.

“Sports is part of our culture,” Ly said in an email. “However, healthy life habits remain the best preventive measures to ensure a cardiovascular-event free life while enjoying our national pastimes.”

Ly and colleagues analyzed data from the Montreal Heart Institute between 2010 and 2014 to find hospital admissions for so called acute ST-elevation myocardial infarction (STEMI), the most common type of heart attack. They also gathered data on game schedules and outcomes from the Montreal Canadiens’ team website.

Of about 2,200 STEMI admissions during the study period, three quarters were men and half were 63 years or older. While in the hospital, nearly all the patients, 98 percent, underwent a procedure to clear a blocked heart artery and place a stent to support the blood vessel.

Overall, hospital admissions for STEMI cases increased on the day after a hockey game, though the difference was small enough that it could have been due to chance. When they looked only at men, and broke the results down by age, they did find statistically meaningful risk increases.

“We expected to find a link between hockey and the occurrence of heart attacks,” Ly said. “However, we expected negative outcomes to impact patients more than victories. To our surprise, it was the contrary.”

A limitation of the study is that researchers couldn’t ask or discover from the data whether the patients with heart attacks had watched a hockey game the day before. Additional studies should also investigate whether cold weather has an effect on heart attacks, and if there truly is a gender difference, Ly noted.

Researchers are also interested in healthy lifestyle behaviors for these hockey fans. Smoking, alcohol consumption, unhealthy eating habits, lack of exercise and high body fat could be related to the heart events. The study team notes that 69 percent of the men under 55 who had heart attacks were smokers, compared with 44 percent of the older men and 42 percent of the women.

The young men also had higher cholesterol levels, higher body mass index and higher rates of family history of heart disease.

“These smoking rates are high compared with many countries. I wonder if the number of cigarettes smoked on the day of a game is higher than other days?” said Dr. John Elliott, a cardiologist at the University of Otago in Christchurch, New Zealand, who wasn’t involved in the study.

“Despite their positive family history (which should be a warning of increased risk), they smoke more and weigh a little more,” Elliott said in an email.

Elliott and Ly recommend making changes to lifestyle and behaviors in general and watching for increased risks during major sports events.

“This is proof that you need to be fit to watch a sport as well as play it,” Elliott said. “Look after yourself so your body will cope better with emotional or physical stress. Start early in life, not waiting until middle age to do this.”

SOURCE: Canadian Journal of Cardiology, online March 28, 2018.