Do the holidays increase your risk for a heart attack?

It’s been called the most wonderful time of the year, but the holiday season can be a dangerous time of year for some. Especially for those already at a higher risk for heart disease.

Researchers in San Diego and Boston published data in the journal Circulation that looked at from 53 million deaths for every day of the year from 1973 to 2001. Here’s what they learned:

• Deaths from heart disease gradually increased from July through January, with a sharp spike between Christmas and New Year’s Day, and then deaths start to decline again.
• The most fatal day for heart attacks was on Christmas Day. December 26 was the second most fatal day and New Year’s Day came in third.
• Interestingly, this pattern also occurred with non-cardiovascular deaths.

“We have learned from several observational studies in the past, including the large SWEDEHEART registry published in 2018, that Christmas/New Year’s holidays were associated with a higher risk of heart attacks, especially in more vulnerable, older patients who had other cardiovascular risk factors such as diabetes or known history of coronary artery disease,” says Dr. Patrycja Galazka, a cardiologist with Aurora Health Care.

Why is there such a big spike in heart attacks between Christmas and New Year’s Day? Doctors aren’t sure of the exact cause. However, there are many possibilities, some surprising and some not-so-surprising.

• Holiday food splurge: Extra-tempting foods high in salt, fat, and added sugars contribute to an increase in blood pressure, cholesterol and blood sugars as well as weight gain.
• Alcohol overload: This can lead to a heart rhythm problem dubbed “holiday heart syndrome”. High amounts of alcohol can throw the heart’s electrical system out of whack and lead to a higher heart rate, heart palpitations (skipping beats), heaviness in the chest, or shortness of breath.
• Lack of exercise or sudden/unusual levels of exertion: Exercise often drops during the holiday season, but then we sometimes go overboard. Think shoveling heavy snow or carrying a sled up a steep hill several times in an afternoon.
• Holiday stress: The holidays are a fun kind of stress, but even this stress can affect the heart. Stress can fire up chest pain, increase blood pressure, cholesterol and blood stickiness, and trigger heart attacks. Stress also increases cortisol. People with high cortisol levels are 5 times more likely to die of a heart attack, stroke, or other cardiovascular causes.
• Respiratory disease: Coughs, colds, and the flu are more common during winter than summer. These can cause extra trouble for people with heart failure and other forms of heart disease.
• Short days, long nights: Less daylight alters levels of hormones such as cortisol, melatonin, and vasopressin, each of which can affect the heart and mood.
• Cholesterol cycles: In the northern hemisphere, levels of total and LDL (“bad”) cholesterol and triglycerides peak in December and January and are at their lowest around July. A rise in fibrinogen in winter also makes blood clot faster.
• Medication lapses: The busy holiday season sometimes leads to missed medications. Taking an extended medication holiday can spell trouble, especially for people with diabetes, heart rhythm problems, or heart failure.
• Delays in seeking medical care: No one wants to “ruin” a holiday with a trip to the emergency room.  Yet, if you procrastinate in seeking care for chest pain, a heart attack, a stroke, or heart failure, it can lead to death or irreversible damage to the heart or brain that could have been prevented.

“It is extremely important for all of us but especially those who have known cardiovascular conditions to have a healthy plan for the holidays,” Dr. Galazka says. “This includes being aware of any new symptoms and not ignoring them, seeking medical care when needed, making sure to have enough medications if traveling, keeping a regular exercise routine, and eating and drinking in moderation”.