Super Bowl: Which City Can Better Survive a Loss?

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Football fans across the country will watch the Packers battle the Steelers Sunday in the 45th annual Super Bowl. And for fans in Green Bay or Pittsburgh, the big game could be a heart-stopper, literally, in light of research suggesting that Super Bowl defeat might boost the risk of cardiac death.

"Fans can develop an emotional attachment to their favorite team," said Dr. Robert Kloner, professor of medicine at the University of Southern California's Keck School of Medicine and director of research at Good Samaritan Hospital's Heart Institute in Los Angeles.

"And when there's an emotional response, the sympathetic nervous system gets jazzed up and releases adrenaline, causing a surge in heart rate, an increase in blood pressure and an increased demand for oxygen by the heart."

Kloner and colleagues had previously reported in April 2009 an increased incidence of heart-related deaths in Los Angeles two weeks after the city's 1980 Super Bowl loss. The group has now taken a closer look at who was most vulnerable in a study published in Clinical Cardiology, released today.

"We've known for many years that there are chronic risk factors for cardiac death, such as high cholesterol, high blood pressure and smoking," Kloner said. "But we're becoming increasingly aware of certain acute risk factors, such as emotional stress. I think that these stressors may add up."

The much-loved L.A. Rams were the underdogs in 1980 in an intense and emotional game being played close to home at the Rose Bowl Stadium in Pasadena. The Rams had the lead going into the fourth quarter but lost 31-19 to the Pittsburgh Steelers.

Despite being sixth-seed in the National Football Conference playoffs this year, the Green Bay Packers are favored going into Sunday's game in Arlington. But Steelers fans might be less suited to handle a Super Bowl loss, according to a national survey.

Of 185 U.S. cities, Pittsburgh ranked 66 in emotional health, 123 in physical health and 106 in healthy behavior, according to Gallup-Healthway's 2009 Well-Being Index. Pittsburgh has also been cited by various reports as one of the worst cities for women's heart health and air pollution – a potentially nasty combination when it comes to the heartbreaking prospect of a Super Bowl loss.

Green Bay scored better, ranking 33 in emotional health, 25 in physical health and 84 in healthy behavior. Still, more than half of adults across Wisconsin are overweight or obese, according a 2009 state report. Not only does obesity boost heart disease risk directly, it also raises blood pressure and cholesterol levels.

Super Bowl Win: Protective?

While a Super Bowl loss may boost cardiac death risk, a win may actually be protective, according to Kloner and colleagues, who also observed a decrease in death two weeks after L.A.'s 1984 Super Bowl win.

"Negative emotions, such as anger, depression and anxiety have been linked to heart problems," said Dr. Redford Williams, professor of medicine and director of Duke University Medical Center's Behavioral Medicine Research Center in Durham, N.C. "But, more recently, there has been increasing evidence that positive psychological emotions, such as optimism, self-efficacy and the belief that you're going to be alright, are associated with a reduction in heart problems."

For many, Super Bowl Sunday is a day of eating and drinking in excess. But exercising moderation can help minimize the extra stress on the heart, Williams said.

"Eating pizza and buffalo wings can raise the level of fat circulating in the blood and make circulation more sluggish," he said. "So when you do get angry and you try to pump more blood, your blood pressure is going to go up even more.

"We also know every drink above a couple increases your blood pressure."

And when the game gets intense and emotions rise, Williams said, one should ask: Is this situation important? Is this an appropriate reaction? And is there anything I can do to modify this situation? Such questions will help put things in perspective.

"People should realize it's not all that important and there's nothing they can do to change it," Williams said. "Take deep a breath and let it out. If that doesn't work, say a prayer or sing a song. Say, 'We'll get them next year,' and just let it go."