With the start of the matches of 8 Arab teams in the 2026 World Cup, vast audiences in the Arab world are experiencing hours of anticipation and enthusiasm. The matches do not start only at the referee’s whistle, but also hours before it of waiting and anxiety. Then, with every attack, opportunity and goal, they turn into a complete emotional state, with voices and heartbeats rising.
These feelings, despite the love, belonging and national joy they carry, may not always pass without a healthy impact. The match, which seems to some to be a moment of entertainment and encouragement, may represent a psychological and physical burden on others, especially those with a history of heart and arterial disease, and patients with high blood pressure and diabetes.
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This does not mean that football cheerleading is dangerous in itself, but it becomes more sensitive when the emotion turns into severe tension, or when watching is accompanied by excessive smoking, fatty foods, excessive stimulants, or ignoring medications and their appointments. Here it is no longer just a passing enthusiasm, but rather a physiological response that may put the heart under real pressure.
A match or a nervous test?
A fan is connected to his or her team or country in a way that transcends the boundaries of sports. He does not just watch 11 players, but rather sees them as a symbol of identity, belonging and collective memory. Therefore, sometimes a loss seems like a personal defeat, and a win seems like a special victory that does not concern the field alone.
This connection between cheerleading and identity was the focus of a study conducted by the University of Strathclyde in Scotland during the 2014 World Cup matches, and its results were published in 2020, to understand why some sports fans experience strong emotions while watching matches live, and the relationship of this to levels of the hormone cortisol in saliva.
The study showed that cortisol concentrations, one of the most prominent stress hormones, change while watching live football matches, and that these changes are related to the degree of fan integration with his team. The study also monitored an interaction between the result of the match and cortisol levels, as witnessing a loss was associated with a significant increase in the concentration of this hormone.
The researchers concluded that the integration of collective identity with the physical response to stress produces psychological and physiological patterns, especially during stressful sporting events. In simpler terms, a fan who is very attached to his team not only experiences the match with his mind and feelings, but also with his body.
In the same vein, in January 2020, researchers at Oxford University found a scientific link between the strength of group bonding between fans and their team and cortisol levels while watching football, without any clear differences in cortisol concentrations between men and women.
The importance of these results lies in the fact that high cortisol for long periods or recurring with psychological stress may be associated with multiple health effects, including weakening the immune system, increasing the body’s susceptibility to coughs, colds, and allergies, in addition to weight gain and high blood pressure, which may accompany a higher risk of heart disease in the most vulnerable groups.
From the stands to the emergency
Studies did not stop at measuring hormonal stress. Rather, other research attempted to track what happens after major matches in emergency departments. The Croatian Journal of Sports Medicine studied the relationship between watching the 2018 World Cup matches, in which the Croatian national team participated, and high rates of hospital admissions due to cardiovascular diseases.
The study relied on examining the hospital database during the days of the Croatian national team’s matches, in addition to the two days following each match, and then compared the results to the same time periods in 2017 and 2019. The review included 1093 cases.
The results showed that the infection rate among women increased by 1.30 times during the period of exposure to watching matches compared to periods of non-exposure. Heart rhythm disturbances and angina pectoris were the most common cardiovascular diseases in that period.
The study concluded that watching national team matches and intense cheering may represent an additional risk factor for cardiovascular disease, especially for those with pre-existing risk factors.
This does not mean that every fan is at risk of being hospitalized after the match, but it indicates that high-stress sporting events may have a tangible impact on the most vulnerable groups in health, especially if they are combined with factors such as chronic illness, extreme emotion, or unhealthy habits while watching.
What happens inside the heart during cheerleading?
When a fan is watching a crucial match, the body treats stress as if it were an alarm state. The nervous system begins to activate internal responses aimed at preparing the body to face stress. However, this response, which may be normal within its moderate limits, may become stressful for some patients.
In a study presented by the Department of Public Health and Preventive Medicine at Cairo University, on vascular health and risk management during hosting the 2022 World Cup in Qatar, researchers indicated that watching an important football match may cause what is known as acute psychological stress.
This stress leads to hyperactivation of the hypothalamic-pituitary-adrenal axis, as well as the sympathetic nervous system and adrenal medullary system. As a result, the heart rate increases, blood pressure increases, the force of heart muscle contraction increases, and heart rhythm disturbances may appear.
As the heart muscle’s need for oxygen increases, an imbalance may occur between what the heart needs and what it actually receives in terms of blood and oxygen, especially in people with atherosclerosis, angina, or previous heart disease. Here, a moment of strong emotion can turn into chest pain, severe palpitations, or more serious complications.
Habits that may increase the risk
The danger does not come from the match alone, but from the way some fans watch the matches. Staying up late, smoking a lot, eating fatty meals, excessive stimulants, and perhaps forgetting medications or delaying meals for diabetics are all factors that add a new burden to the heart and body.
In March 2021, the scientific journal ScienceDirect published a study that examined the relationship between cheering for sports teams and groups most at risk of developing cardiovascular diseases, including angina pectoris, acute coronary syndromes, and sudden cardiac death.
The study indicated that the psychological stress associated with watching matches may become more serious when it coincides with contributing factors, such as excessive drinking of alcohol, eating fatty meals, and heavy smoking, which are habits that may increase during major sporting events.
The study revealed that strong emotions and psychological stress are associated with myocardial infarction, symptomatic arrhythmias, and sudden cardiac death, especially among viewers with a known prior history of coronary artery disease.
She also indicated that transient hemodynamic changes, endothelial dysfunction, and excessive stimulation of the sympathetic nervous system may affect the balance of blood within the heart, and create an environment more susceptible to clotting and cardiac arrhythmia.
More sensitive categories
Dr. Mahmoud Abdel Qader, a specialist in cardiovascular diseases, says that cases of extreme tension and emotion increase among some fans, especially fanatical ones. He adds that simple clinical observation by cardiologists shows that measuring blood pressure during cheering may be at its highest levels, especially in patients with heart disease, high blood pressure, and diabetes.
Abdel Qader explains in his interview with Al Jazeera Net that tension and acute emotion during matches lead to the secretion of large amounts of stress hormones, such as adrenaline and noradrenaline, which causes an increase in the heart rate, high blood pressure, and an increase in the heart muscle’s need for oxygen.
In some patients, this may lead to chest pains or heart rhythm disturbances, and the risk of heart clots or strokes may increase in people who are most vulnerable to complications.
As for diabetics, Abdel Qader points out that severe psychological stress may raise blood sugar levels as a result of the secretion of stress hormones. Preoccupation with the match may also lead to irregular or forgotten medication schedules, or disruption of meal times, which increases the possibility of health problems occurring during or after watching.
How to watch matches safely?
The fan does not need to give up his enthusiasm or refrain from following his team, but he does need a degree of awareness, especially if he suffers from a chronic disease or has a history of heart disease, blood pressure, or diabetes.
Dr. Mahmoud Abdel Qader advises fans, especially patients, to reduce or stop consuming stimulants such as tea and coffee during and after matches, so that they are not a contributing factor in increasing heart rate and high blood pressure.
It also warns of the need to stop watching and seek medical help immediately when symptoms such as chest pain, shortness of breath, severe dizziness, or unusual palpitations appear.
It is also important for patients with heart, blood pressure, and diabetes to take their medications on time, avoid heavy, salty, and fatty meals during matches, and try to take short periods of calm and deep breathing if they feel that stress is out of control.
