Did you know that December 26th (celebrated as our Boxing Day holiday in the UK, Australia, Germany, Greenland, New Zealand, Hong Kong, and here in Canada) is historically one of the most dangerous days of the year for people vulnerable to cardiac problems?
And many of these Merry Christmas Coronaries will hit people who didn’t even realize they were at risk when they unwrapped their gifts the day before.
Dr. Samin Sharma, director of interventional cardiology at Mount Sinai Medical Center in New York, says:
“This time of year is notorious for heart attacks, heart failures and arrhythmias.”
It’s widely accepted that the holiday season tends to see increased numbers of cardiac events. One study by researchers at the University of California, San Diego and Tufts University found that heart-related deaths increase by 5% during these holidays. Another study found that daily visits to hospitals for heart failure increased by 33% during the four days after Christmas.
Anecdotally, cardiologists often report that their hospital Emergency Departments stay relatively quiet on Christmas Day itself. Then, come December 26th, they see a surge of cardiac traffic.
Most cardiac deaths reported in those two studies involved outpatients rather than inpatients, suggesting that treatment-seeking delay may be a factor. People may not want to make a fuss during family celebrations even when they are experiencing distressing symptoms, or they may misinterpret these symptoms as just indigestion brought on by too much eating and drinking.
One of my blog readers told me the story of her first (dramatic) heart attack signs on the morning of Christmas Eve, so when her family urged her to call 911, she refused, saying: “I have 12 people coming for Christmas dinner tomorrow! I can’t go to the hospital today!”
What role does winter weather play in the Merry Christmas Coronary? Colder temperatures have been associated with an increase in vascular resistance, coronary vasospasm and blood pressure, as well as seasonal variations in levels of vitamin D and cholesterol.
Do the Christmas holidays have a similar effect during summer in the southern hemisphere where Decembers are typically warm? A 2016 study included an analysis of 25 years of death records from New Zealand clearly showed more heart attack deaths in winter. These researchers also noted another odd finding:
“Christmas holidays are not the only event linked to higher rates of heart attacks. Other studies have shown higher rates after earthquakes and during times of war. And sporting events, such as penalty shootouts for World Cup soccer matches and losing matches in World Cup rugby tournaments, are also associated with higher rates of heart attack.”
Dr. Robert Kloner of the Heart Institute at UCLA also tells of a study that his research group did that examined whether there are seasonable winter variations in cardiac mortality in balmy Los Angeles, California.
During the period studied, there were consistently more deaths from ischemic heart disease during the winter than there were during the summer. One third more heart disease deaths were recorded in December and January than from June through September in Los Angeles. Dr. Kloner explains:
“We initially thought that this phenomenon might be explained by cold weather. But winter temperatures in Los Angeles, although colder than during the summer here, are still mild compared with other geographical climates.
“We were struck by an increase in heart disease deaths starting around Thanksgiving, climbing through Christmas, peaking with the Happy New Year Heart Attack, and then falling. But daily average temperatures remained constant throughout December and January.”
The researchers’ conclusions? That this peak in cardiac deaths during the holidays might result from other factors like the emotional stress of the holidays, over-indulgence, or both.
Vanderbilt University cardiologist Dr. Keith Churchwell says a “hurricane of factors” can tip someone at risk of a heart attack over the edge during this busy time of year.
“You can’t be too busy to ignore your cardiovascular health – but that’s a key excuse I hear from patients.”
He suggests the following issues might add to the Merry Christmas Coronary risk:
- Busy revelers tend to skip their medications, forget them when travelling or be unable to get refills far from home.
- What dieter can resist holiday goodies? The few extra pounds so many people gain will haunt you longterm. Right away, a particularly heavy meal, especially a high-fat one, stresses the heart as it is digested. Blood pressure and heart rate increase. There’s even some evidence that the lining of arteries becomes temporarily more clot-prone.
- Too much salt has an even more immediate effect, causing fluid retention that in turn makes the heart have to pump harder.
- Alcohol in moderation is considered heart-healthy. But if a round of holiday parties leaves you tipsy, that, too, makes your heart pump harder to get blood to peripheral arteries.
- Worse is something called “Holiday Heart Syndrome,” where alcohol literally irritates the heart muscle to trigger an irregular heartbeat called paroxysmal atrial fibrillation. If a-fib goes unchecked for too long, it in turn can cause a stroke.
- People say they’re too busy to exercise, especially as it gets cold and darkness falls earlier. It can take months to build back up to pre-holiday exercise habits.
Find out more about this seasonal phenomenon and some steps you can take to avoid a holiday heart attack.
NOTE FROM CAROLYN: I wrote more about triggers for cardiac events in my book, “A Woman’s Guide to Living with Heart Disease“, published by Johns Hopkins University Press. You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher (use their code HTWN to save 20% off the list price of my book)
Merry Christmas – have a safe and healthy holiday season!