It’s not just shoveling that raises heart risks in the winter

When the temperature goes down, it’s even more important to pay attention to symptoms that might indicate a heart attack. Many people know that shoveling snow increases the risk of a heart attack, but any other type of outdoor activity can also raise your risk.

A large study of more than 280,000 people in Sweden published in JAMA Cardiology indicated that the coldest days over the 16-year period of the study also saw a significantly higher number of heart attacks than warmer days. Another study published in PLOS One indicated a nearly 31 percent higher rate of heart attacks in the coldest months.

Cape Cod Hospital cardiology hospitalist Jennifer Ladner, MD, said that even though she hasn’t noticed more heart attacks in winter, in general, the risk is real. Snow shoveling in particular is a double whammy for heart attacks because exercise that involves the upper extremities is more taxing on a person’s heart than exercise like walking that just involves the legs.

“It’s not only the cold weather, which is definitely a factor, but then using your arms to lift heavy snow is also an issue,” she said. “Also, cold weather raises your blood pressure because when it’s really cold your vessels constrict in an effort to keep your core warmer. Your vessels constrict so you are not releasing as much heat. In the summertime, your blood vessels dilate and that’s how you sweat and release heat. That is what you want to do so you don’t get overheated in the summer, but in the winter it’s the opposite.”

Higher blood pressure puts more strain on the heart and is a big risk factor for both heart attacks and strokes. Another important risk factor for heart attacks and strokes is high cholesterol, which also tends to go up in the winter. The most obvious reason for the seasonal rise in cholesterol is that our diet and exercise habits change.

“In the wintertime we tend to eat more what we call comfort food,” Dr. Ladner said. “They tend to be heavier, fattier foods and so our cholesterol is naturally going to go up because of our diet. And we also tend to be less active during the winter just because it’s cold outside and so we’re not going out and doing as much outdoor activity.”

Shivering is another factor that increases risk, Dr. Ladner said. It creates more work for your heart because the muscle contractions add stress to your heart.

So, What to Do?

The simplest solution: Bundle up.

“It’s very important to make sure you have something around your neck to keep your neck warm,” she said. “It makes a big difference. And wear a hat because that helps keep the heat in and obviously you want to wear gloves.”

It’s critical for people to know the symptoms of a heart attack and to take them seriously.

Warning signs of a heart attack include:

• Chest pain or discomfort
• Lightheadedness
• Nausea or vomiting
• Discomfort or pain in arm or shoulder
• Shortness of breath

Women and men tend to have slightly different symptoms. For both sexes, chest pain or discomfort is the most common symptom sign, but women are more apt to have the other common symptoms as well.

If you do suspect you are having a heart attack, time is incredibly important, Dr. Ladner said. Call 911 immediately and chew a regular strength aspirin. Oftentimes, people are afraid of being embarrassed if they are not actually having a heart attack, but doctors would much prefer you be safe rather than sorry.

“I tell patients all the time, don’t feel bad if it turns out to be nothing,” she said. “That’s something to be happy about. It’s not a waste of time. It’s being safe.”