by Carolyn Thomas ♥ @HeartSisters
“Baby, it’s cold outside . .🎵” Even here on the typically balmy west coast of Canada (where our brave daffodils valiantly poke through winter soil each January), we’ve had snow and freezing rain this month. But cold weather can feel even worse for those of us living with angina (from the Latin, “strangling in the chest”) which is the chest pain linked to coronary heart disease). Here’s why: .
The pain of stable angina typically worsens with exertion and then improves with rest. But we know that chest pain can often feel worse during winter months when coronary arteries constrict due to the cold.
As the British Heart Foundation explains:
“Whatever the weather outside, our bodies fight a constant battle to keep internal conditions pretty much the same. We have a range of reflexes that kick in to keep our core temperature steady at around 37.5°C (98.6°F) so that our cells and vital organs are protected from damage.
“When it gets cold, our bodies adjust to hold onto our core heat and stay warm. This adjustment can be harder for those with a heart condition.
“Blood vessels narrow in our skin and fingers and toes, so that less heat is lost. But this narrowing (called ‘vasoconstriction’) creates more pressure in the rest of the circulation, meaning the heart has to work harder to pump blood around the body, increasing heart rate and blood pressure. This is a normal response to the cold, but the extra strain can lead to heart symptoms for people who have an existing condition – especially during exercise.
“In recent years, researchers have shown that the effects on health of a cold day or cold spell can be seen for two weeks or more afterwards.“
If you live with heart disease, it’s important to know these effects of cold weather on your body, and potential risks for your heart health. Elderly people, for example, are especially vulnerable in winter months.
When people over 60 in the UK, Ireland and the Netherlands were studied, researchers learned that heart attacks and strokes were more than twice as likely to happen during cold spells lasting at least four days (meaning a period of time that was particularly cold compared to the rest of the month). But rather than the specific low temperature on the thermometer, it was actually the fall in temperature compared with previous days that seemed to be the biggest culprit for older individuals.
According to the U.K. Health Security Agency, when we start to get cold, our blood can also becomes thicker, which can cause clotting. Clotting is one of the reasons we see more heart attacks and strokes in the days following colder weather. Cold also affects our body’s ability to fight off infection, which can result in more deaths from infections like pneumonia, as lung conditions and coughs can develop into a more serious problem.
One of my readers who has lived with stable angina for several years wrote about one important way she helps to ward off chest pain caused by winter cold:
“I found the dreamiest silky soft pashmina scarf: creamy white, light weight yet so warm and cozy too. Pashminas can be dressed up or down, worn loosely or folded in half before draping. As a heart girl with cold weather angina, I love covering my chest with the protection of a scarf that doesn’t make me look sick.”
It’s not, however, only the cold weather outside that affects angina.
Since my own heart attack, every time I go grocery shopping, I can feel an odd chest pain that starts when I enter the frozen food aisle, and eases up by the time I leave the store. So no more dawdling in the frozen food aisle for me anymore.
And not surprisingly, people who spend much of their workdays in very cold conditions may also be at higher cardiac risk. A 2015 study published in the journal, Safety and Health at Work, for example, researched people who worked in the frozen food industry to observe the effects of repeated cold exposure on employees’ health.(1) The study compared employees who spent most of their work time in warehouses packing frozen foods with those who had office jobs in the same companies. Temperatures averaged −18.0°C (1F) in the warehouse, and 25°C (77 F) in the office areas. Over 1/3 of the warehouse staff were found to have cardiovascular symptoms (including chest pain or abnormal heart rhythms).
Cardiologist Dr. Gosia Wamil shared these additional potential contributors to winter-related angina symptoms in her interview with the Irish Times last month:
- extra stress on the body caused by the cold
- inflammation from winter respiratory infections
- vitamin D deficiency because of the lack of sunlight
And as the American Heart Association warns, besides cold temperatures, high winds, snow and rain also can steal body heat. Wind is especially dangerous because it removes the layer of heated air from around your body. At 30°F in a 30-mile-per-hour wind, the cooling effect is equal to 15°F. Similarly, dampness causes the body to lose heat faster than it would at the same temperature in drier conditions.
Like many other spoiled West Coasters, I’ve been wearing at least three cozy fleecy scarves around my neck this month, and more importantly, I fold each one flat over my chest to help protect my precious heart.
So bundle up, heart sisters!
♥
1. Thetkathuek A. et al. “Cold exposure and health effects among frozen food processing workers.” Safety and Health at Work. 2015 March 6(1):56-61.
Snowy dog image: ClaudiaWollesen, Pixabay
Q: What’s your favourite cold weather tip to stay warm?
NOTE FROM CAROLYN: I wrote more about managing angina symptoms in my book A Woman’s Guide to Living with Heart Disease (published by Johns Hopkins University Press). You can ask for this book at your local library or favourite bookstores (please support your local independent booksellers!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from Johns Hopkins University Press (use their code HTWN to save 30% off the list price when you order).
Heart Sisters 
Hello Carolyn,
I just had my 2-year Heart-iversery. I have to park in the parking deck floor 3 for work. I always take the stairs up and down.
When it’s cold or windy, I put a mask on and I do love a nice Pashmina that is a staple of most of my outfits when the weather gets chilly.
They never get the temperature right in our office. I seem to have more trouble in the warmer months. I just move a little slower. I will take warmer-slower over colder-faster.
Waiting on Spring!!!
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Hello Susan – I’m with you! I’m counting the sleeps until spring finally arrives – although where I live, the daffodils are already poking their pointy green tips up through the soil…
It is tricky to get indoor temperatures feeling right for everybody. I too prefer slightly cooler weather generally (we can always pile on another sweater or pashmina – or try to avoid the frozen food aisle!!) but once you’re hot, you’re HOT!
You have now passed a real milestone! Congrats on your 2nd Heart-iversary!! ❤️
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Yes! Extreme temp is a huge trigger! Cold is always the worst for me.
Thank you for your advocacy Carolyn! ❣️
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Hello Annette – lovely to hear from you!
But not lovely about that painful response to cold temperatures. After my heart attack, I was so surprised by how my heart reacted to extreme cold (and to extreme heat, too!)
Our bodies are always working hard to regulate temp to protect our major organs – it’s a full-time job balancing hot and cold.
Take care – stay warm out there! ❤️
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Hi, Carolyn. It’s Kathy Webster, WomenHeart Champion, Mayo class of 2006.
Can you add me to your weekly distribution?
Thank you!
Kathy Webster
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Hello Kathy! Always so nice to hear from another Mayo grad – and especially when that grad is the Past Board Chair at WomenHeart: The National Coalition for Women with Heart Disease!
You can subscribe by scrolling down the right-hand sidebar to the section that says FOLLOW HEART SISTERS – and when you add your email address, you’ll automatically be notified every Sunday about each week’s new articles.
Thanks in advance for your interest and support! ❤️ ❤️ ❤️
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Carolyn, I really appreciate this writing. When I was in cardiac rehab, way back before the pandemic, the instructor warned me that I might get increased angina in cold weather. He was right. Especially cold plus wind. I understand the why better after reading this today.
I recently came back from visiting my daughter in Virginia to minus 9 days in Wisconsin. I wore many layers to walk my dog, Mamita, and needed to get boots for her to walk outside. I even wore a balaclava outside and still felt increased chest pressure. I asked for extra dog walking help many mornings.
Reading this, I understand why I was extra tired with more chest pressure than usual.
Then on a day with freezing rain, I slipped on sheet ice and fell. Happened so fast! Fortunately nothing in my 80-year old body was broken but I was shaken up.
As always, thank you for writing.
Sara
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Hello Sara – Slipping and falling on sheet ice, in freezing rain – that’s my worst nightmare! My girlfriends and I often say that we feel like we’re just one fall away from being admitted to the long-term care hospital! I’m sure hoping my years of doing balance exercises can help prevent that fate.
No wonder you were shaken up when you fell – even if you don’t break a bone, falling down DOES shake you up. I watch my little grandkids repeatedly falling down and bouncing right back up again (they’re closer to the dirt in the first place!) but we adults rarely have much experience at falling down anymore – we hope!
I can just picture your poor Mamita with her little doggie boots on slippery snow and ice.
I hope you stay warm and safe!! ❤️
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I find heat more intolerable, cardiac-wise, than cold. Probably because I avoid going out on cold gloomy days. However, when the sun is bright it lures me outdoors and I find I get into trouble if I match my physical activity level to the level of my enthusiasm.
In cold weather, if I MUST go out it is from home to my underground parking to car to store, and I only expose myself to the cold between car and store.
I dress in layers under a coat that has a hood and wind breaking material on the outside. Then in the car or the store, I can “un-layer” if I get hot.
I also found that in really cold weather, putting on one of my cloth masks, from the COVID days, is very helpful in providing warmed air to the lungs.
Denver is 60 degrees F and sunny today – Yay!
Blessings!
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Hi Jill – I’m with you! I find the heat much worse to cope with compared to cold – but as the British Heart Foundation explains “our bodies fight a constant battle to keep internal conditions pretty much the same, with reflexes that kick in to keep our core temperature steady…”
Last summer, we had what meteorologists here on the west coast called a “heat dome” (caused when atmosphere traps hot ocean air as if bounded by a lid or cap). It was brutal – I felt not just hot, but physically ill for six days. Very few of us on the coast have air conditioning – and in our province – British Columbia – over 600 seniors died during the heat dome!
Cold weather, by comparison, has an immediate effect on chest pain specifically. Your strategies (house to car to store) are good ways to manage extreme weather, plus of course LAYERING – just like our mothers advised us!
I too find that masks do make a real difference – especially on cold windy days!
Stay warm – enjoy your 60 degree days! ❤️
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