# 5971
Although the reasons are less than entirely clear, every year during the winter months - more specifically from Thanksgiving to just after New Years Day – we see an increase in the rate of heart attacks and coronary related deaths.
This spike in `winter mortality’ has been blamed on a variety of factors.
Colder temperatures, increased respiratory infections (including influenza & Pneumonia), over indulgence in food and alcohol, diminished activity levels, forgetting to take prescription medicines, and the combined stressors of shopping, running up debt for gifts, traveling, meal preparation, and/or the stress that comes from dysfunctional family gatherings.
My guess is all play some part.
But as a former paramedic, I can tell you that the holiday season always meant a lot of emergency calls. Everything from cardiac arrests and car accidents to domestic violence and overdoses.
The rate of heart attacks in the winter run as much as 53% higher than during the summer.
Spencer FA, Goldberg RJ, Becker RC, Gore JM.
While cold weather combined with strenuous physical activity (like clearing snow from sidewalks) has often been blamed for this spike, even in balmy Southern California, studies have shown a 33% increase in heart attacks over the holidays.
When Throughout the Year Is Coronary Death Most Likely to Occur?
A 12-Year Population-Based Analysis of More Than 220 000 Cases
Robert A. Kloner, MD, PhD; W. Kenneth Poole, PhD; Rebecca L. Perritt, MS
Additionally, outcomes during the winter are worse – on average – than during the summer. Again, there are theories as to why this might be so.
One idea is that during the holidays, people are more likely to delay getting treatment so as not to `ruin the holidays’ for friends and family. They ignore chest pains, or other symptoms, hoping they will pass.
Another area of concern is that while hospital censuses are typically higher in the winter, the holidays may contribute to temporary staffing shortages.
A Duke University study looked at records of 134,609 heart attack patients admitted to the hospital in the middle 1990s.
They found that those hospitalized between December 15th and January 15th were slightly less likely to receive proven life saving procedures (angioplasty, beta blockers, even aspirin upon admission) than patients during the rest of the year.
And it isn’t just the time of the year that can affect the severity, frequency, and outcome of heart attacks, studies show that the time of day plays a major role as well.
Earlier this year, in A Bad Way To Start Your Day, we looked at research that appeared in the BMJ Heart Journal that found that STEMI (ST segment elevation myocardial infarction) were more likely to occur during the dark-to-light transition period (6:00–noon).
STEMIs are serious heart attacks that affect a large portion of cardiac muscle and show up on EKGs (ST segment elevation) and produce a spike in cardiac enzymes (indicative of muscle damage).
The peak levels of cardiac enzymes released - Creatine kinase (CK) and troponin-I (TnI) – provide a good indication of the amount of coronary muscle damage.
By comparing peak enzyme levels in patients with their time of coronary onset, researchers were able to determine what time of day the most severe heart attacks occurred.
And the results showed that heart attacks that began during the dark-to-light transition period (6:00–noon), showed roughly 20% more tissue death, compared with heart attacks with onsets between 6pm and midnight.
The current theory as to why this might be is that the body’s circadian rhythm influences the production of cardio-protective proteins called salvage kinases, which are released in greater quantities later in the day.
All of the above I hoping will inspire my readers to exercise a little moderation this holiday season, to remember to take your prescribed medications, and to pay attention to the signs and symptoms of a heart attack.
From the CDC’s Heart Attack Information page:
Symptoms of a Heart Attack
The five major symptoms of a heart attack are—
- Pain or discomfort in the jaw, neck, or back.
- Feeling weak, light-headed, or faint.
- Chest pain or discomfort.
- Pain or discomfort in arms or shoulder.
- Shortness of breath.
If you think that you or someone you know is having a heart attack, you should call 9–1–1 immediately.
And while you are thinking about gifts for your family and friends this year, one gift you can give them is to take a CPR course – so you can help save their life if their heart should stop due to a heart attack, electrocution, anaphylactic reaction or drowning.
Compression-only CPR is now the standard for laypeople, and is easier to do than the old way. The American Heart Association has produced this short video showing the importance of learning this life saving technique.
(Click Image to View on YouTube)
Taking a class only requires a few hours of your time, and it could end up helping you save the life of someone you love.
To find a local CPR course contact your local chapter of the American Red Cross, the American Heart Association, or (usually) your local fire department or EMS can steer you to a class.
