Study Led by Fellow Shows Heart Health Risks of “Die-Hard” Sports Fans

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Miguel Maturana, MD, was introduced to the sports world when his father took him to a soccer game at an early age. Witnessing the emotions of his father and other spectators in the stadium sparked his curiosity of the emotional impact of athletics.

Dr. Miguel Maturana

Dr. Maturana earned his medical degree from the University of Valparaíso, Chile, and completed his residency in Internal Medicine at the University of Tennessee Health Science Center. Now, Dr. Maturana, is a chief cardiology fellow in the Department of Internal Medicine in the UTHSC College of Medicine.

Dr. Maturana is the lead author, in collaboration with researchers in the UTHSC College of Medicine and Christian Brothers High School, of the research article, “Are Die-Hard Football or Other Sports Fans at Risk of Cardiovascular Events?” published in Current Problems in Cardiology. His research and knowledge in cardiovascular health was featured recently in the American Heart Association News, U.S. News & World Report, Health Day, and other media outlets.

“Relating one of the things I am very passionate about, which is soccer, with cardiology was very interesting. In Chile, there’s a very strong community of passionate fans of different sports, including soccer, which is very common,” he said.

Their study found that spectators of sports including soccer, rugby, baseball, and football, who experience strong emotional and psychological stress responses are associated with a risk of cardiac events, especially in individuals with a history of coronary artery disease. The strong emotional and psychological responses can lead to various outcomes including heart attacks, arrhythmias, and cardiac death. And they conclude, based on clinical evidence they analyzed, that it is better for an individual’s cardiovascular health to participate in sporting activities as an athlete than as a fan.

“Our goal was to investigate the risk of very emotional fans undergoing and visualizing sporting events to know whether or not being in the stadium or being strong fans of a sport increases your risks of cardiovascular events, compared to others who are not visualizing the game or experiencing that strong emotion of the sport,” Dr. Maturana said.

For this article, the team conducted a search and analysis of various randomized clinical trials and observational studies related to cardiovascular health risks. In addition to soccer, rugby, baseball, and football, the team also reviewed previous literature that studied cricket, hockey and other sports.

“When fans undergo strong emotional experiences at the stadium or while watching television, the strong emotion itself can create a sympathetic stimulation with releases of epinephrine, norepinephrine, and catecholamines, and leads to a sudden increase in blood pressure and heart rate,” Dr. Maturana said.

Miguel Maturana, MD

“Also, this transient inflammatory response, that is mediated by cortisol, leads to inflammation, and if patients have a prior history of coronary artery disease, having inflammation in the coronary vessels increases the risk of cardiac events,” Dr. Maturana said.

Coronary artery disease is the most common type of heart disease and is caused by a buildup of plaque in the walls of the arteries that supply blood to the heart, according to the Centers for Disease Control and Prevention. In addition, current lifestyle behaviors including consuming alcohol, eating fatty meals, and tobacco use, is connected to an increased risk of cardiovascular events.

“During sporting events people tend to drink more alcohol, which raises blood pressure, and eat fatty food, which increases the risk of inflammation and increases LDL,” Dr. Maturana said. “People tend to smoke more, and drink more, and those environmental factors related to the event are contributing to the emotional response.”

With their review, the team also noticed a relation in emotional responses towards the end of the athletic event or during a specific time in the sport when the competition is more intense. Additionally, environmental factors such as atmospheric pressure are considered to have some correlation, said Dr. Maturana.

As the research has gained recent media responses, Dr. Maturana said conducting research and educating others is a valuable contribution. “Sharing this with the community is one of the most valuable things we can do as physicians working in research,” he said. “I am very happy and proud to contribute.”

Dr. Maturana collaborated with Sean Dornbush, DO, resident in the Internal Medicine-Pediatrics program, John Alexander, DO, second-year cardiology fellow, Rami Khouzam, MD, professor in the Department of Medicine at UTHSC; Elizabeth Glover, BA, Joel Raja, MD, and Courtland Blound, MD; and Nadim Khouzam and Amir Khouzam at Christian Brothers High School.

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