Heart attack risks spike on Christmas Eve: How to Manage Risk Factors & React

Swedish researchers have found the risk of heart attack spikes on Christmas Eve.

If you think of the night before Christmas as a time for hot cocoa, cozy fires and Bing Crosby albums, a new discovery by Swedish researchers may well break your heart:

The risk of suffering a heart attack spikes on Christmas Eve.

That finding is based on a comprehensive database of hospital statistics that includes 283,014 cases of heart attacks over a period of 16 years. It was published recently in the BMJ (formerly the British Medical Journal).

The study would appear to put Christmas Eve in the same category as earthquakes, hurricanes, stock market crashes, wars and high-stakes World Cup soccer matches — after all of these events, scientists have documented that heart attacks are more likely to occur.

On Dec. 24, the risk of a heart attack is 37 percent higher than normal, the researchers found. On Christmas itself, the increase in risk dips to 29 percent. Even on Boxing Day (Dec. 26), it's still 21 percent above normal levels.

For the sake of comparison, Mondays are known to be a time of increased heart attack risk. But in Sweden, the risk was only about 10 percent higher on the first day of the workweek.

The BMJ study isn't the first to report an association between the holiday season and myocardial mayhem. A 2004 paper in the journal Circulation, for example, found that deaths due to all kinds of heart disease were higher in the U.S. on both Christmas and New Year's Day.

Previous studies were based on information from death certificates, ambulance records and other kinds of health data. They weren't able to say when, exactly, a patient's heart attack began.

To examine heart attack risk on Christmas Eve, the researchers tallied the number of myocardial infarctions (the medical term for a heart attack) on every Dec. 24 between 1998 and 2013, as well as for the two weeks before and after the holiday, to provide a baseline. On average, Swedes suffered 50.3 heart attacks per day during the baseline period, and 69.1 per day on Dec. 24.

With a little math, they determined that the risk of a heart attack was 37 percent higher on Christmas Eve. They were even able to pinpoint the hour of maximum risk: 10 p.m.

The team repeated the analysis with a range of other holidays. In addition to Christmas Eve, Christmas Day and Boxing Day, they found a significantly elevated risk on New Year's Day (by 20 percent) but not on New Year's Eve, Easter or Good Friday. (Heart attack risk was 12 percent higher on Midsummer, a Swedish holiday on the eve of the summer solstice that is celebrated with food, drink, song and maypole dancing.)

Mohammad and his co-authors said they didn't know why people would be more prone to heart attacks on Christmas Eve.

Previous studies have linked "acute experiences of anger, anxiety, sadness, grief, and stress" with an elevated risk. Of these, the team wrote that stress is the emotion most likely to come into play on Christmas Eve.

But medical researchers shouldn't be content to simply guess, the authors wrote — they should conduct further studies to see what's really going on.

"Understanding what factors, activities, and emotions precede these myocardial infarctions and how they differ from myocardial infarctions experienced on other days could help develop a strategy to manage and reduce the number of these events," they wrote.

This finding isn’t very surprising to cardiologists, ER doctors or even primary care physicians. Other research has found that deaths from heart disease shoot up around Christmas and New Year’s more than at any other time. “We call them ‘Christmas coronaries,’” says Darria Long Gillespie, an emergency department physician, national spokesperson for the American College of Emergency Physicians and author of the upcoming book Mom Hacks: 100+ Science-Backed Shortcuts to Reclaim Your Body, Raise Awesome Kids, and Be Unstoppable. There are a few reasons why:

Emotional roller coasters. ‘Tis the season for stress — whether it’s financial (how are you going to swing your share of the bill for the whole-family holiday cruise?) or emotional (are you really going to have to listen to your brother’s political ramblings for three hours again this year?). Depression, too, plays a role. “The holidays are hard for older adults, who may not have as much social support as they did when they were younger, and thus feel lonely and isolated,” says Waqar Khan, an interventional cardiologist in Houston and an affiliate faculty member at the Baylor College of Medicine. And the same emotions that leave you feeling anxious and frazzled can also raise levels of hormones such as norepinephrine and adrenaline, which in turn can raise your blood pressure and heart rate enough to boost your heart attack risk.

Subzero temperatures. Baby, it’s cold outside … and when you’re exposed to it, blood vessels in the exterior portions of your body constrict, which in turn raises blood pressure and increases strain on your heart, says Gillespie. Pair that with walking into a house filled with family drama, and it’s the perfect recipe to land you in the ER.

You put off care. "People are much more likely to ignore symptoms such as chest pressure or shortness of breath if they've got family visiting, or are out of town, because they don't want to disrupt festivities,” notes Gillespie. “They figure they'll deal with it once the holidays are over, but by then it may be too late."

But although research does show a higher chance of heart attack, experts say you shouldn't avoid Christmas festivities out of an overabundance of caution. “Even though I have anecdotally noticed an increased risk around the holidays, it’s still relatively low for those with very few risk factors for heart disease,” reassures Khan. If you are otherwise fit and healthy, you probably don’t need to think twice about rockin’ around the Christmas tree. If you do have a higher disease than you'd like, experts recommend a few sensible precautions this time of year:

Avoid overexertion. Unless you’re in great physical shape, leave the shoveling to your son-in-law. Otherwise, if something feels like a physical stretch for you, think twice about taking it on during the holiday red zone. 

Watch what you eat and drink. Resist the urge to pig out: Research has found a fourfold increase in heart attack risk in the two hours after eating a big meal. “Digesting a meal, especially a high-fat one, temporarily raises heart rate and blood pressure,” explains Gillespie. Lay off the booze, too: Binge drinking has been linked to what's called “holiday heart syndrome.” “When you drink too much alcohol, you can worsen atrial fibrillation,” a condition that causes irregular heartbeat that's present in many older adults, says Khan.

Take complaints seriously. If your partner is complaining of nonstop indigestion, pay attention. “Symptoms of a heart attack, especially in women, can be subtle,” explains Khan. Persistent pinching or burning in your chest, bad heartburn, or unexplained arm or back pain, can all signal the start of something bad, and you shouldn't hesitate to call your doctor — or head straight to the ER.

Don’t let your emotions get the best of you. This is particularly true if you often feel isolated or alone. “The holidays are a really important time to reach out to friends, family and neighbors, especially if you don’t already have a strong social network,” says internist Michael Hochman, the director of The Gehr Family Center for Health Systems Science at the University of Southern California.

But if the thought of spending an entire evening with your extended family makes you sick to your stomach, consider calling it a night with them a few hours earlier, and penciling in a little more time with friends or family whose company you enjoy. “Anything you can do that brings you joy will lower your stress levels and in turn lower your risk of heart disease,” says Gillespie.  

Thus, don’t despair, as heart ­attacks – when blood flow to the heart is blocked – can be avoided by managing the risk factors.

It is also possible to survive one and regain good health by ­getting the right treatment fast. Here are some tips:

Recognize the flags

Although a common sign is pain or discomfort in your chest that suddenly occurs and does not go away, this is not always the case.

It is still possible to have a heart attack without this classic chest pain.

This is more common in the elderly, women, or those with diabetes, as the condition can cause nerve damage which effects how you feel pain. The pain may spread to your left or right arm or to your neck, jaw, back or stomach. For some people the pain or tightness is severe, while other people just feel uncomfortable.

Women may have different symptoms to men, with more nausea, dizziness and anxiety.

During a heart attack there is also a risk of cardiac arrest –where the heart stops pumping and normal breathing stops. If someone is in cardiac arrest they will be unconscious and need CPR immediately.

Act quickly

Speed of reaction is absolutely critical to surviving a heart attack and going on to regain good health.

If unexplained chest pain lasts for more than a few minutes, do not delay, do not try to figure out the cause, call 911 and state you are dealing with a suspected heart attack.

Stay still

If you are having a heart attack, sit and rest while you wait for the ambulance. Do not get up and look around for aspirin as this may put unnecessary strain on your heart.

Chew an adult aspirin tablet – 300mg – if one is easily available, unless you are allergic to aspirin or you have been told not to take it.

If you are not sure whether you are allergic, just stay resting. If possible, get someone else to open the door for the paramedics when they arrive.

Understand the risks

If you are aged 40-74, ask your doctor or nurse for a heart health check to assess your risk of having a heart attack in the next ten years.

If you have diabetes, high cholesterol or hypertension, then you have a far higher risk of heart problems.

Source:

Hallie Levine, AARP. "Heart Attack Risk Spikes on Christmas Eve, New Study Shows."
Montreal News. "There are 15 per cent more heart attackson Christmas Eve than a typical day: study". 

Karen Kaplan. TribuneNews Service. 

Kelly Jenkins. “Christmas Eve at 10pm ismost likely time for heart attack - how to spot the signs”. Mirror (UK).