By: Rachel Andrew MD. Consultant Cardiologist

As we embrace the holiday season, many people anticipate joyful celebrations, family reunions, and a festive spirit. However, there is an often-ignored health concern linked to this cheerful time: a disturbing increase in cardiovascular incidents like heart attacks and strokes. Studies have indicated a notable rise in cardiovascular fatalities during the final two weeks of December, reaching its peak around Christmas and New Year’s Day. This occurrence, commonly known as “holiday heart syndrome,” calls for increased awareness and proactive steps to protect our health during this festive period.

The Statistics Behind Holiday Cardiovascular Risks

Numerous studies underscore the link between the holiday season and increased cardiovascular events. Data from a 2018 study published in Circulation revealed that cardiac deaths in the United States are about 4% higher in December and January compared to other months of the year. Similarly, research conducted in Sweden and New Zealand highlighted a notable increase in heart attack rates on Christmas Eve and New Year’s Day.

One pivotal study published in Circulation in 2004 examined 53 million deaths over a 26-year period in the U.S. and found that the number of cardiac-related deaths peaked on December 25th, followed by December 26th and January 1st. These statistics serve as a sobering reminder that the festive season, while joyful, can pose serious health risks, especially for individuals with pre-existing cardiovascular conditions.

Reasons Behind the Holiday Spike

Understanding why heart attacks and strokes are more prevalent during the holidays is key to prevention. Several factors contribute to this trend:

1. Increased Emotional Stress:
   • The holidays can be a time of joy, but they can also bring financial stressors, family tensions, and the pressure of planning and hosting events. This emotional stress can elevate blood pressure and heart rate, increasing the risk of cardiovascular events.
2. Dietary Indulgences:
   • Holiday feasts often feature high caloric-rich foods which puts chronic conditions out of control. Highly processed and salty food, such as ham can contribute to high blood pressure & elevated cholesterol levels. The sought-after “Fruit cakes”, also known as “ The Christmas Cake”, Sorrel juice, among others can be very high in sugar which causes sudden spikes in blood sugar levels. Overindulgence in alcohol is another common culprit, potentially triggering atrial fibrillation, an irregular heartbeat that can trigger a stroke.
3. Cold Weather:
   • Winter temperatures can cause blood vessels to constrict, even those who live in the tropics experience a relative drop in temperature during December to January.  This can lead to higher blood pressure and increased strain on the heart. This physiological response, coupled with holiday exertion, such as shoveling snow or intense physical activity, can heighten the risk.
4. Neglecting Medications:
   • Amid the hustle and bustle, people may forget to take their prescribed medications. More commonly though, many patients confess to deliberately, discontinuing medications in other to indulge in alcohol, further increasing their vulnerability.
5. Delayed Medical Attention:
   • During the holidays, individuals may delay seeking medical help due to simply prioritizing the festivities or “Sewo”, social obligations, travel, or the misconception that symptoms are minor. Unfortunately, this hesitation can have dire consequences.

Recognizing the Warning Signs

It’s crucial to recognize the warning signs of heart attacks and strokes to seek immediate medical attention.

Symptoms of a Heart Attack:

• Chest pain or discomfort (may feel like pressure, squeezing, or fullness)
• Pain or discomfort in one or both arms, the back, neck, jaw, or stomach
• Shortness of breath
• Nausea, lightheadedness, or cold sweats

Symptoms of a Stroke (BE FAST):

• Balance issues or dizziness
• Eyes: sudden vision changes
• Face drooping on one side
• Arm weakness or numbness, especially on one side of the body
• Speech difficulty or slurred speech
• Time to call for an ambulance immediately

Prevention Tips for a Heart-Healthy Holiday

The good news is that there are several strategies to mitigate the risks of holiday heart attacks and strokes. Here are some cardiologist-approved tips:

1. Maintain a Balanced Diet:
   • Enjoy holiday treats in moderation and prioritize heart-healthy options such as vegetables, fruits, whole grains, and lean proteins. Limit salt, sugar, and saturated fats.
2. Stay Active:
   • Incorporate physical activity into your holiday routine, such as walking after meals or engaging in light exercise. Avoid overexertion, especially in cold weather.
3. Manage Stress:
   • Practice relaxation techniques such as deep breathing, meditation, or yoga. Remember, it’s okay to say “no” to overwhelming commitments.
4. Monitor Alcohol Intake:
   • Limit alcohol consumption to prevent atrial fibrillation and other cardiovascular risks. Stay hydrated with water.
5. Adhere to Medications:
   • Set reminders to take medications as prescribed. Refill prescriptions in advance to avoid running out during the holidays.
6. Be Weather-Wise:
   • Dress warmly and avoid strenuous activities or activities in cold temperatures. If you are physically engaged outdoors take breaks frequently and pace yourself.
7. Prioritize Sleep:
   • Ensure adequate rest to help your body recover,  reduce stress levels and blood pressure.
8. Know When to Seek Help:
   • Do not ignore symptoms of heart attack or stroke. Seeking prompt medical attention can save lives.

Preparing for Emergencies

Preparation is essential for addressing emergencies effectively:

• Learn CPR: Familiarize yourself with basic life support skills to assist in emergencies.
• Keep Emergency Numbers Handy: Ensure that you and your family know how to contact local emergency services.
• Create a Health Checklist: Include essential items such as medications, medical records, and emergency contacts when traveling.
• Discuss Plans with a Cardiologist: If you have a history of cardiovascular issues, consult your doctor about precautions during the holidays.

Conclusion

The holiday season is a time to cherish with loved ones, but it’s also important to prioritize heart health. By understanding the risks, recognizing warning signs, and adopting preventive measures, you can ensure a safe and enjoyable festive season. A healthy heart is the best gift you can give to yourself for the new year!

References

1. Phillips, D. P., & Barker, G. E. (2010). Christmas and New Year as risk factors for death. Circulation, 121(6), 865-872. doi:10.1161/CIRCULATIONAHA.109.866194
2. Kloner, R. A., & Poole, W. K. (2004). Seasonal variation in cardiovascular disease. Circulation, 110(25), 3748-3753. doi:10.1161/01.CIR.0000150084.55756.A5
3. Swedeheart Study Group. (2018). Acute myocardial infarction during traditional holidays in Sweden. BMJ, 363, k4811. doi:10.1136/bmj.k4811