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 in 2004 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 in 2008 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 the 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.
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. But Dr. Robert Kloner of the Heart Institute at UCLA tells of a 1999 study that his research group did that examined whether there are seasonable variations in cardiac mortality in a location where winter weather is mild – like in 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.
- “Alcohol Helps Heart Bypass Patients!” – good news or bad reporting?
- ‘Holiday Heart Syndrome’ in Women
- Is Alcohol Unsafe for All Women?
Merry Christmas – have a safe and healthy holiday season!