Why Do More People Get Heart Attacks In Winter?

Introduction

Heart attacks are worrisome in their own right, but did you know that data shows heart attacks (and strokes) are more common in the winter? Several studies over the years have confirmed that this statistic is certainly not a fluke, which has led to further investigation.

Why more heart attacks in winter? What could be causing this phenomenon and is there any way you can lower your risk? The great thing is that since its discovery, many doctors and cardiology experts have put forth the potential causes for this rise. Let’s understand the issue and later look at what you can do to stay away from this health issue.

What is Causing more Heart Attacks in Winter?

Before we get into the probable causes, first we need to understand what it means when we say that there are more heart attacks in the winter months. Let’s take an imaginary hospital as an example. If we make a list of all patients who come to this hospital during 1 year, for some reason we will see that during the colder months more people had heart attacks. According to some studies (conducted in the real world), there may be a 31-33% higher incidence of heart attacks in winter and every 1-degree Celsius drop in temperature came with a 0.49% increase in deaths from all causes. 

Most heart attacks occur in the morning, a phenomenon that researchers have linked to circadian rhythm. In the morning hours, increasing the circadian-driven secretion of certain hormones, which may be a trigger for subsequent increases in oxygen demand and blood pressure, a pattern with the season is also known in the literature.

Dr. Ashish Bajaj – M.B.B.S, M.D. in Clinical Pharmacology and Toxicology

With that out of the way, let’s delve into the reasons this may be happening:

• The cold may be the main culprit here, leading to physiological changes that accumulate to eventually cause a heart attack. When it gets cold, the body needs to keep staying warm. To do this, our blood vessels constrict (tighten/become narrower) and this requires blood to be pumped harder through the blood vessels. This means that blood pressure is almost universally higher during the cold season.  
• The higher blood pressure may also work with the coronary arteries constricting, this can reduce the flow of blood and oxygen to the heart and its muscles. This can lead to a heart attack.  
• Your blood volume is also higher in winter, unlike in summer when we experience more sweating. More fluid being retained inside the body also leads to higher blood pressure.  
• On a deeper level, the body experiences hormonal changes in response to the colder weather, this may include higher cholesterol levels as well as increased levels of clotting factors. Since platelets tend to aggregate more, this can increase the risk of a blood clot. Blood clots can cause both heart attacks and strokes (strokes happen due to loss of blood supply to the brain). These small clots block the already constricted blood vessels, this blockage prevents blood from getting to where it needs to go. If the blockage is on a vessel that supplies blood to the heart, it can lead to a heart attack or even heart failure.
• In a broader sense, the winter months also bring behavioural changes. This includes lower levels of physical activity and weight gain. Both these can contribute to higher chances of developing complications that may lead to a heart attack. People may also increase their food consumption which further compounds the weight gain issue.  
• Another important factor is the lower levels of sun exposure. Either due to being indoors more often or because some places simply get less sunlight, this reduced exposure to the sun can lead to deficiencies in Vitamin D. There have been numerous studies investigating the relationship between cardiovascular diseases and Vitamin D deficiency. Although there isn’t any data that suggests vitamin D supplementation can reduce cardiac issues, it is seen that lower levels of vitamin D are indirectly associated with more heart problems.  
• There are higher chances of catching a cold and flu during winters. A persistent cough can be a source of exertion for patients advised rest (limited physical activity) due to some heart ailments.

The cold causes blood vessels to contract. This can raise your blood pressure and increase your risk of heart attack and stroke. Angina, or chest pain due to coronary heart disease, can also worsen in winter when coronary arteries constrict in the cold so keeping yourself warm is very important.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Does This Mean I am at Risk?

While the above reasons and mechanisms are universal to humans, it’s not that any one of them can cause a heart attack. Rather, each factor plays a part in successively increasing the risk but even all these things together may not be enough. It comes down to being at risk for a heart attack before the cold weather. People who are already at risk may find their bodies pushed to the limits during winter, which may potentially lead to a higher risk of a cardiac incident. 

Who is at a Higher Risk for a Heart Attack in Winter?

Most cardiologists suggest that older people, those who smoke or drink regularly and those who do not get any regular activity are most at risk. By limiting your exposure to colder temperatures and keeping up a regular amount of daily physical activity, these people may be able to lower their risk of a heart attack in winter.

Sudden chest pain, chest discomfort or fullness should not be confused with acidity or gas especially when the pain spreads to your left arm and if they are accompanied by sweating or breathing difficulty. Seeking urgent attention in such situations without any delay can be helpful to save a life.

Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

The Upcoming Winter-Looking Forward

With winter coming around soon, we want to stress that the purpose of this post is not to cause fear and alarm. There are plenty of things you can do to stay fit-

1. Stay warm to protect yourself from cold weather
2. Get plenty of physical activity (as per your doctor’s recommendations) 
3. Follow up with your doctor for a routine health checkup and review of ongoing medications.
4. Healthy eating habits
5. Stay away from smoke and alcohol as much as possible

If you are someone who is at risk, you may want to do blood pressure and blood sugar check-ups regularly and maintain them in a healthy range. Additionally, you can always speak with your doctor if you are worried about how to handle the upcoming season. Don’t forget that staying happy and stress-free is always recommended for good health.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851242/
2. https://www.heart.org/en/news/2019/12/11/cold-heart-facts-why-you-need-to-watch-out-in-winter

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