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The Truth Behind More Holiday Heart Attacks

Why cardiac problems spike during the holidays and how to stay heart healthy.
By
WebMD Magazine - Feature
Reviewed by Louise Chang, MD

Your heart may leap with delight at the electronic gizmo or emerald bracelet that you’ve just unwrapped from under the Christmas tree. But you can’t say the same for that nasty holiday surprise known as the “Merry Christmas coronary” or “Happy Hanukkah heart attack.”

For many years, researchers have been intrigued by a disturbing pattern: Deadly heart attacks increase during the winter holiday season. One study even found distinct spikes around Christmas and New Year’s Day.

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“We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smoking, hypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age,” says Robert A. Kloner, MD, PhD, a researcher at Good Samaritan Hospital in Los Angeles and a professor at the Keck School of Medicine at the University of Southern California.

“But we’re also learning that there are certain triggers for cardiovascular events,” he adds, “including time of the year and seasons. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease.”

Heart Attack Weather?

Coronary artery disease stems from atherosclerosis, a condition in which fatty plaques narrow the arteries to the heart. When a plaque ruptures, it can trigger a blood clot that leads to a heart attack.

In a national 2004 study published in Circulation, researchers at the University of California, San Diego, and Tufts University School of Medicine examined 53 million U.S. death certificates from 1973 to 2001. They discovered an overall increase of 5% more heart-related deaths during the holiday season. When researchers looked at individual years, they found varying increases in cardiac deaths for every holiday period they studied, except two.

Doctors have long known that cold weather is hard on the heart. Blood vessels constrict, which raises blood pressure. Blood also clots more readily. Frigid temperatures increase strain on the heart, and too much physical exertion can worsen the burden and trigger a heart attack. For example, doctors have treated many patients whose heart attacks followed strenuous snow shoveling.

Holiday Heart Attack Triggers

But cold extremes don’t really explain why fatal heart attacks peak on Christmas and New Year’s Day, especially among the most rapidly stricken patients. According to the Circulation study, “The number of cardiac deaths is higher on Dec. 25 than on any other day of the year, second highest on Dec. 26, and third highest on Jan. 1.”

Adding to the mystery, why do holiday heart attacks shoot up consistently across the country, even in balmy climes such as Los Angeles, where winter weather stays mild and no one ever wields a snow shovel?

In Kloner’s own research, he found one-third more coronary artery disease deaths in December and January than in June through September during a 12-year period in Los Angeles County.

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