Are Rugby Fans Putting Their Heart At Risk?

This Sunday the All Blacks and South Africa will face off, in what is according to World Rugby Men’s Rankings the closest RWC final yet. There’s no doubt the game is going to be a stressful and exciting affair!

A 2015 study looking at cardiovascular admissions in New Zealand during past Rugby World Cup tournaments has some startling statistics. In this article we will look at their findings for the 1999, 2003, and 2011 RWC tournaments. Then examine the effects of intense sport on the heart, who is at risk, and what the warning signs are.

Heart Attacks and Stress

33% increase in heart failure admissions on match day.1

The 1999 RWC semi-final between France and New Zealand left a nation stunned. At 45 minutes the All Blacks had seemingly placed France in an impossible position leading 24-10, with an on-form side featuring an unstoppable Jonah Lomu, and accurate Andrew Mehrtens. However out of the blue came an uninterrupted run of 33 points from the French side. By games end France had achieved one of the greatest comebacks in RWC history with a result of 43-31. 

60% increase in heart failure admissions on match day, and for the 2 days after the game.1

The stakes were high, and tempers were short. The acute emotions of this game against Australia may have further increased the risk of cardiovascular events. The fierce rivalry between Australia and New Zealand was on full display for the 2003 semi-final. The game saw a confident All Blacks team off the back of a strong performance against South Africa in the quarterfinals sitting as favourites. However, the Wallabies played aggressive, taking points whenever they had a chance leading to a final score of 22-10, only scoring one try and kicking five penalties. The loss was the third time in four tournaments that the All Blacks had been defeated in the semi-finals and left the nation devastated.

40% decrease in heart failure admissions the day after the game.1*

One of New Zealand’s greatest sporting moments was not followed by a rise of heart failure admissions. On the back of the previous three RWC results most kiwis were on a knifes edge. A nail-biting game at Eden Park played between France and New Zealand was full of memorable moments. In a game where each side would score just one try the outcome was determined by a penalty in the 46th minute. Stephen Donald summoned to the All Blacks side amid an injury crisis would make arguably one of the most important kicks in NZ rugby history taking the team to 8 points. By the end of the night the All Blacks led 8-7 and Richie McCaw lifted the Rugby World Cup, the first time for the team in 24 years.

*This reduction coincided with the Labour Day public holiday. This is a potential confounding factor as cardiovascular admissions were lower on Labour Day Mondays v non-Labour Day Mondays. However there was no significant increase in any acute cardiac admissions after 2011 RWC win which aligns with previous findings on winning results.

The rollercoaster of live sport leads to a surge of stress, excitement, and anxiety that leaves our hearts racing, palms sweating, and pulse pounding. When we are highly invested in a sporting event the physiological changes caused by stress can be significant, leading to increases in heart rate and blood pressure.

A Canadian study of hockey fans found heart rate increased by 110% when watching a live game, and by 75% when watching a televised game.2 This change is like that seen with moderate to vigorous exercise. A Scottish study of spectators at football games also saw dramatic rises in heart rate and blood pressure, with them peaking after their team had scored a goal.3

The acute emotional stress and increase in heart rate and blood pressure can in some cases lead to cardiovascular events such as heart attacks, particularly for those of higher risk.

You may be at more risk of a heart attack or stroke if the following risk factors apply to you:

  • have high blood pressure or elevated cholesterol levels,
  • have diabetes (type 1 or 2),
  • have kidney disease,
  • are overweight (BMI of 30 or more),
  • smoke and/or drink alcohol in excess,
  • have a heart condition such as atrial fibrillation,
  • have a family history of diabetes, high cholesterol, heart attack or stroke.


Source: Healthify New Zealand

When to seek medical attention

Heart attacks usually start slowly with mild pain and discomfort, but some may occur suddenly and with intensity. Symptoms of a heart attack can include:

  • chest pain lasting more than a few minutes,
  • pain in one or both arms (left is more common),
  • pain radiating to neck, jaw, and abdomen,
  • shortness of breath, squeezing, and tightness,
  • nausea and/or vomiting.


If you notice the signs of a heart attack, act immediately. Dial 111, ask for an Ambulance, and tell them you are possibly having a heart attack.

Source: Healthify New Zealand


1 – Olsen P, Elliott JM, Frampton C, Bradley PS. Winning or losing does matter: Acute cardiac admissions in New Zealand during Rugby World Cup tournaments. Eur J Prev Cardiol. 2015 Oct;22(10):1254-60. doi: 10.1177/2047487314539433. Epub 2014 Jun 12. PMID: 24924743.

2 – Khairy LT, Barin R, Demonière F, Villemaire C, Billo MJ, Tardif JC, Macle L, Khairy P. Heart Rate Response in Spectators of the Montreal Canadiens Hockey Team. Can J Cardiol. 2017 Dec;33(12):1633-1638. doi: 10.1016/j.cjca.2017.08.002. Epub 2017 Oct 5. PMID: 28987521.

3 – Elder AT, Jyothinagaram SG, Padfield PL, Shaw TR. Haemodynamic response in soccer spectators: is Scottish football exciting? BMJ. 1991 Dec 21-28;303(6817):1609-10. doi: 10.1136/bmj.303.6817.1609. PMID: 1773191; PMCID: PMC1676237.