Heart Institute, Good Samaritan Hospital, Los Angeles, CA, USA.
Am J Med. 2010 Nov;123(11):972-7. doi: 10.1016/j.amjmed.2010.03.026.
Physiologic and clinical triggers, including mental stress, anxiety, and anger, often precipitate acute myocardial infarction and cardiovascular death. Sporting events can acutely increase cardiovascular event and death rates. A greater impact is observed in patients with known coronary artery disease and when stressful features are present, including a passionate fan, a high-stakes game, a high-intensity game, a loss, and a loss played at home. Sporting events affect cardiovascular health through neuroendocrine responses and possibly an increase in high-risk behaviors. Acute mental stress increases the activity of the hypothalamic-pituitary-adrenocortical axis and the sympathetic-adrenal-medullary system while impairing vagal tone and endothelial function. Collectively, these mechanisms increase myocardial oxygen demand and decrease myocardial oxygen supply while also increasing the risk of arrhythmias and thrombosis. Measures can be taken to reduce cardiovascular risk, including the use of beta-blockers and aspirin, stress management, transcendental meditation, and avoidance of high-risk activities, such as smoking, eating fatty foods, overeating, and abusing alcohol and illicit drugs. Sporting events have the potential to adversely affect spectators' cardiovascular health, and protective measures should be considered.
生理和临床触发因素，包括精神压力、焦虑和愤怒，常常会引发急性心肌梗死和心血管死亡。体育赛事会急剧增加心血管事件和死亡率。在已知患有冠状动脉疾病的患者中，以及在存在压力特征时，如狂热的球迷、高风险的比赛、高强度的比赛、输球以及在主场输球时，影响更为明显。体育赛事通过神经内分泌反应，以及可能增加高危行为，影响心血管健康。急性精神压力会增加下丘脑-垂体-肾上腺皮质轴和交感神经-肾上腺髓质系统的活动，同时损害迷走神经张力和内皮功能。这些机制共同增加心肌需氧量，减少心肌供氧量，同时增加心律失常和血栓形成的风险。可以采取措施降低心血管风险，包括使用β受体阻滞剂和阿司匹林、压力管理、冥想和避免高危活动，如吸烟、食用高脂肪食物、暴饮暴食以及滥用酒精和非法药物。体育赛事有可能对观众的心血管健康产生不利影响，应考虑采取保护措施。
