As sports fans await Super Bowl Sunday with great anticipation, it may be necessary to rein in the anxiety: a study published recently in The New England Journal of Medicine shows that a heart-pounding, thrilling football match could put the heart at risk.

The research tracked the incidence of heart attacks in Germany during the 2006 World Cup championships in soccer. The findings showed that cardiac emergencies increased substantially on days when the favorite team (in this case the German national team) played: for men, the rate more than tripled; for women, it was almost double the rate compared to normal times.

The incidences were particularly noticeable during the eliminations when the German team was still trying to qualify for the finals. The team performance, the overall importance of the match, and how the match outcome was determined were significant factors that had impact on the heart risks.

For instance, less important matches did not quite affect the rate of heart attacks as much as important games. Knockout games where only the winning team stays in the tournament appeared to cause the greatest amount of emotional stress and produced more cardiac events.

Fans who already suffered from heart disease were most at risk. The likelihood of having a heart attack or related cardiac events was four times as much during important games for those with heart disease, while it was two times higher for those without previous heart problems.

While acknowledging that European soccer fans may be different from other sports fans in their intense team loyalty and passionate involvement in the game, the study authors said that their findings may find parallels in fans of similar major sporting events — such as the Super Bowl.

There has not been any research conducted on American football fans, whether they definitively face similar risks. Heart experts say, however, that there may be reason to think so. The intense excitement of the Super Bowl could put some people at risk of acute heart problems, especially those with heart issues.

Numerous studies, though, have established a link between anxiety-laden situations or emotionally charged events and heart emergencies. The stress could come from the excitement of a sporting event, or natural disasters, family crises, and the like. In the U.S., such cardiac events are called stress-induced cardiomyopathy.

The high anxiety associated with major sports events can trigger a chain of physiological reactions that can lead to cardiac emergencies.

Safety Tips:

• Take an aspirin before the event. A cardiac surgeon says that those who think they may experience stress during sporting events or the like should consider taking aspirin beforehand.

• Exercise restraint at the tailgate party. Those with heart disease should avoid unhealthy high fat foods before the Super Bowl or similar sporting events.

• Avoid alcohol and cigarettes.

• Find a way to relax when the action gets too intense.

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