It’s no secret that as the temperature drops, heart attacks go up: Frigidly cold temperatures plus overexertion (shoveling a foot of snow off of your car’s roof, anyone?) are to blame. But so, too, may be another of winter's gifts: the holidays. The risk of having a heart attack is a whopping 37 percent higher on Christmas Eve, peaking at 10 p.m., according to a new analysis published earlier this month in the British Medical Journal.
The researchers analyzed over 280,000 heart attacks in Sweden over a 16-year period. While the biggest spike was on Christmas eve, there was also increased risk on Christmas day, Boxing Day (December 26), New Year’s Day and Midsummer (an important Swedish summer holiday). People over the age of 75, and people with chronic health conditions such as heart disease or diabetes, were at even higher risk.
This finding isn’t very surprising to cardiologists, ER doctors or even primary care physicians. Other research has found that deaths from heart disease shoot up around Christmas and New Year’s more than at any other time. “We call them ‘Christmas coronaries,’” says Darria Long Gillespie, an emergency department physician, national spokesperson for the American College of Emergency Physicians and author of the upcoming book Mom Hacks: 100+ Science-Backed Shortcuts to Reclaim Your Body, Raise Awesome Kids, and Be Unstoppable. There are a few reasons why:
Emotional roller coasters. ‘Tis the season for stress — whether it’s financial (how are you going to swing your share of the bill for the whole-family holiday cruise?) or emotional (are you really going to have to listen to your brother’s political ramblings for three hours again this year?). Depression, too, plays a role. “The holidays are hard for older adults, who may not have as much social support as they did when they were younger, and thus feel lonely and isolated,” says Waqar Khan, an interventional cardiologist in Houston and an affiliate faculty member at the Baylor College of Medicine. And the same emotions that leave you feeling anxious and frazzled can also raise levels of hormones such as norepinephrine and adrenaline, which in turn can raise your blood pressure and heart rate enough to boost your heart attack risk.
Subzero temperatures. Baby, it’s cold outside … and when you’re exposed to it, blood vessels in the exterior portions of your body constrict, which in turn raises blood pressure and increases strain on your heart, says Gillespie. Pair that with walking into a house filled with family drama, and it’s the perfect recipe to land you in the ER.
You put off care. "People are much more likely to ignore symptoms such as chest pressure or shortness of breath if they've got family visiting, or are out of town, because they don't want to disrupt festivities,” notes Gillespie. “They figure they'll deal with it once the holidays are over, but by then it may be too late."
But although research does show a higher chance of heart attack, experts say you shouldn't avoid Christmas festivities out of an overabundance of caution. “Even though I have anecdotally noticed an increased risk around the holidays, it’s still relatively low for those with very few risk factors for heart disease,” reassures Khan. If you are otherwise fit and healthy, you probably don’t need to think twice about rockin’ around the Christmas tree. If you do have a higher risk of heart disease than you'd like, experts recommend a few sensible precautions this time of year:
Avoid overexertion. Unless you’re in great physical shape, leave the shoveling to your son-in-law. Otherwise, if something feels like a physical stretch for you, think twice about taking it on during the holiday red zone.
Watch what you eat and drink. Resist the urge to pig out: Research has found a fourfold increase in heart attack risk in the two hours after eating a big meal. “Digesting a meal, especially a high-fat one, temporarily raises heart rate and blood pressure,” explains Gillespie. Lay off the booze, too: Binge drinking has been linked to what's called “holiday heart syndrome.” “When you drink too much alcohol, you can worsen atrial fibrillation,” a condition that causes irregular heartbeat that's present in many older adults, says Khan.
Take complaints seriously. If your partner is complaining of nonstop indigestion, pay attention. “Symptoms of a heart attack, especially in women, can be subtle,” explains Khan. Persistent pinching or burning in your chest, bad heartburn, or unexplained arm or back pain, can all signal the start of something bad, and you shouldn't hesitate to call your doctor — or head straight to the ER.
Don’t let your emotions get the best of you. This is particularly true if you often feel isolated or alone. “The holidays are a really important time to reach out to friends, family and neighbors, especially if you don’t already have a strong social network,” says internist Michael Hochman, the director of The Gehr Family Center for Health Systems Science at the University of Southern California.
But if the thought of spending an entire evening with your extended family makes you sick to your stomach, consider calling it a night with them a few hours earlier, and penciling in a little more time with friends or family whose company you enjoy. “Anything you can do that brings you joy will lower your stress levels and in turn lower your risk of heart disease,” says Gillespie.