Tuesday, December 20, 2011

Winter Holidays are Peak Time for Heart Attacks

It's the grimmest of holiday statistics: Heart-attack deaths peak on three days of the year, and one of them is Christmas. The other two are the day after Christmas and New Year's Day.EnlargeClose
Talk about your lump of coal.
And it gets worse. The holiday peak is just part of a larger, well-established pattern: More people die of heart attacks in winter than at any other time of year. In other words: It's truly the season to know your risks — and reduce them, if you can. But first, it may help to ponder why these days are so deadly.
The seasonal link
In the USA, cardiac deaths peak in December and January, says Robert Kloner, a cardiologist at Good Samaritan Hospital in Los Angeles. In Australia, he says, they peak in July — winter there.
So there's something about winter. But what?
"Nobody knows," says David Phillips, a sociologist at the University of California-San Diego who studies death patterns. Flu and pneumonia, which are tough on people with heart disease, clearly play roles in the high rate of all natural deaths in the winter, he says.
Shorter, darker days might matter, too, says Kloner, who has studied the winter link. Cold alone, he says, can make blood vessels constrict, blood pressure rise and the heart work harder. It also might trigger changes in the blood that produce clotting and inflammation.
And what about snow shoveling? In many areas, it might be a factor. One recent study found that 7% of winter heart-attack victims in one Canadian hospital had been shoveling snow.
Then there's Christmas. David John, an emergency-room physician for 20 years, can't say that he's noticed the holiday death surge, which was first documented in a 30-year study led by Phillips and published in 2004. But one explanation rings true to him: People feeling sick around Christmas or New Year's may put off getting help — and end up dead.
A final suspect: Holiday stress
"People are in denial," says John, who works at Johnson Memorial Medical Center in Stafford Springs, Conn. "They don't want to spoil Christmas dinner by going to the hospital." They also might forget to take medications and may be away from their usual doctors and pharmacies, he notes.
Kloner says: "The stress. Facing relatives, buying gifts, trying to find a parking space in a busy mall."
And now add one more stressor: Worrying about having a holiday heart attack.
But worrying won't help. Taking these steps throughout the winter just might:
Keep taking your medicines and showing up for medical appointments if you have heart disease or risk factors such as high blood pressure or high cholesterol.
Get a flu shot, if you haven't already.
Keep warm. If it's freezing where you are, wear layers of clothes and a hat and cover your mouth with a scarf when you step outside.
Know your strength. If you are not fit or have heart disease, leave the heavy snow-shoveling to others.
Keep up other good habits, such as exercising, eating well and not smoking.
Never ignore the warning signs of a heart attack — even if it's Christmas Day.
Heart attack warning signs
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath, with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
Source: American Heart Association

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