Rugby World Cup makes women’s hearts stop

Rugby isn’t for the fainthearted: researchers have found a lost match can lead to a lost life.

According to their study, rugby fans are at risk of heart failure if their national team lose in the knockout round of the Rugby World Cup (RWC). Women are most at risk of heart failure during these tense matches, especially if they’re made to feel stressed or angry.

Emotions will be rife in this year’s RWC, starting 18 September. It’s one of the largest international sporting events and broadcast to billions of people worldwide. New Zealand’s national team, the All Blacks, will be defending their championship title, and their fans – the subjects of the study – are sure to be on the edge of their seats. With so much at stake, and an increasing female audience, we asked the researchers to explain the risks of a passionate fan.

The research team consists of sports scientists Peter Olsen (Christchurch Polytechnic Institute of Technology, New Zealand), and Paul Bradley (Leeds Beckett University, UK), cardiologist John Elliott and biostatistician Chris Frampton (University of Otago, New Zealand). Their paper analyzed the past four RWC tournaments between 1999 and 2011.

ResearchGate: The last Rugby World Cup (RWC) broke net broadcasting ground with a cumulative audience of four billion people. According to your research, what health problems are these fans at risk of, and when?

Passionate fans with pre-existing or undiagnosed heart conditions are most at risk.  If their team loses a close match they can get stressed or angry, which are emotions known to aggravate cardiac conditions.

These health problems are more likely during the knockout stages of the RWC. Tense or close matches where the fans’ team loses elicit the most emotions. For example, when New Zealand lost to Australia in the 2003 semi-final, cardiac hospital admissions more than doubled in male and females. In contrast, when New Zealand won a similar semi-final in 2011 against Australia, there was no significant increase in cardiac hospital admissions.

RG: Who’s more at risk – men or women? Why do you think that is?

Interesting enough, our research shows both are at risk but from different cardiac conditions. Women are at greater risk of heart failure, and men are more susceptible to arrhythmias, which is an irregular heartbeat. Women appear more likely to suffer from heart failure due to diastolic impairment or abnormal filling secondary to hypertensive heart disease and ventricular hypertrophy. For example, the stress of watching a sporting event may increase blood pressure and impair filling of the heart, leading to increased heart failure in women.

RG: Why was your analysis restricted to New Zealand spectators? What prompted your interest in this audience?

New Zealand is renowned for having very enthusiastic fans with high expectations that the All Blacks will win every match. Consequently, with such a passionate fan base, New Zealand hosting the 2011 RWC, a TV audience share of 98% for the final match, and successive failures to win the tournament since 1987, we thought it would be interesting to determine the relationship between RWC matches and cardiac hospital admissions. If a relationship was found this could also be used to inform those at risk, and ensure adequate hospital and emergency staffing during large sporting events.

RG: In your opinion, do you think this outcome is similar worldwide? Why, why not?

Yes, if a fan is passionate and is pre-disposed or has an existing heart condition, we believe they would be at greater risk if there team loses a tense game in a knockout situation.

RG: What is it about rugby and the Rugby World Cup in particular that elicits such strong emotions and ill-health?

Rugby is like any sport in that it’s capable of generating a wide range of emotions - especially in die-hard or passionate fans who are deeply invested in the outcome of the game. Acute emotional triggers, such as anger, have been shown to increase the likelihood or risk of a cardiac event.

However, the risk to the general population is probably elevated but still very low overall. It is probably the same level of risk as driving a car on a long weekend: the likelihood of having an accident is higher, but still quite small overall for the general population.

RG: Has similar research been conducted on other sports? Do you results align with a common trend?

Yes, there was some very good research in Germany when the country hosted the Soccer World Cup. The researchers  found even higher cardiac events during world cup games than our research – in theirs, fans were at three to four times greater risk. Some research indicates large sporting events have no effect on the cardiac hospital admissions. Nevertheless, we believe a limitation of these studies is generally they did not compare hospital admission over a long enough time frame, or similar teams when the team of interest won or lost in knockout stages of a tournament. For example, we compared data in October/November from 1999-2011 and also compared this to another, less emotional large audience for a TV event: The Opening ceremony of the Sydney Olympics in 2000.

RG: Are you analyzing this year’s Rugby World Cup?

Yes, we will do a follow-up study examining the New Zealand data to determine if the trends observed in our study persist for the 2015 RWC. This year’s Cup is hosted by England and Wales so, given the nature of the rivalry between these two rugby nations and the knockout nature of the games, it would be interesting to determine the outcome of their games in a very tightly contested pool in the 2015 RWC.

Feature image courtesy of Sonya & Jason Hills.

This story also featured in the New Zealand Herald.