Winter and the heart: Addressing the trend of increasing cardiac issues in winter

Winter brings a noticeable increase in heart-related issues, with incidents of heart attacks, cardiac arrests, and heart failures rising by approximately 14-20%. This surge is mainly due to the physiological impact of cold temperatures. Exposure to extreme cold or sudden temperature changes can trigger vasoconstriction, leading to elevated blood pressure. This constriction can potentially rupture atherosclerotic plaques, causing vessel blockages and subsequent cardiac events.

Who Are At Risk?
People with pre-existing heart conditions, like coronary artery disease, high blood pressure, or diabetes, and the elderly population are vulnerable during winter.

What Happens to Our Body During Winter?
1. Appetite and Unhealthy Food habitsProblem: Appetite typically increases in winter due to hormonal changes and by popular culture, food habits tend to grow unhealthy with excess consumption of fried foods (fritters, etc.), sugary treats, and high-calorie substances.
Solution: Individuals can beat apatite by splitting meals into frequent small portions, constituting low-calorie food substances like fresh veg salads and fruits along with healthy snacks made of almonds, walnuts, flax seeds, and chia seeds.

2. Excessive Smoking and Alcohol UseProblem: Many people think smoking and alcohol keep the body warm and help beat the winter.
Solution: Excess smoking and alcohol in any weather is dangerous for all well-known reasons and should be tackled at any cost. Explore healthier ways to stay warm during colder months. Frequent consumption of beverages like coffee, tea (either black or made of low-fat milk and low or no sugar), and veggie-loaded soups can help you beat the winter.

3. Physical Activities and Weight GainProblem: Winter makes us low on mood, dull, and lethargic, and shorter daylight hours lead to decreased physical activity. This, coupled with increased appetite and potentially poor-quality sleep, can contribute to weight gain.
Solution: Typically, physical activities and outdoor activities are reduced in winter. Safe use of electric room heaters, blankets, and warm clothes can improve sleep quality. Dress warmly and layer clothing to enjoy outdoor activities like brisk walking. You can also maintain a higher level of physical activity through indoor exercise options like walking on a treadmill, cross-trainers and practicing yoga like Surya namaskar, etc.




4. Increased Blood PressureProblem: During winter, blood pressure tends to increase gradually due to constriction of blood vessels and other hormonal changes.
Solution: plan a pre-winter consult with your doctor to understand how your regular medications can be altered and dose adjusted through the winter when you notice higher BP levels upon periodic self-monitoring at home.

5. Increased Heart attack eventsProblem: Every year, we observe a sudden increase in heart attacks and sudden cardiac deaths through the winter. This is due to a combination of factors, including increased blood pressure, exposure to cold weather, and potentially increased stress levels.
Solution: Plan a pre-winter health check, particularly for those who are 30+ and have never done it before, to know your cholesterol and blood sugar levels, which can be effectively managed. For self and elderly members of the family, avoid long outdoor activities like long rides in 2-wheelers, hiking, etc. Stay well protected with warm clothes and the elderly members may delay their morning walk to a time after sunrise.

6. Heart failure hospitalization Problem: We also notice a sudden surge in heart failure hospitalization and sudden cardiac deaths in winter. People with heart failure experience worsening of their condition during winter due to factors like increased infections (like the flu) and exposure to cold weather.
Solution: All patients with diagnosed cardiac problems, particularly with LV dysfunction (low LVEF) and those with risk factors like hypertension, diabetes, and obesity should be cognisant of such possibilities. Discuss with your doctor during regular consults about revision and dose adjustment of medications to sail through the winter safely. We know that the risk of chest and lung infections increases during winter. Pre-winter flu shots may help reduce infections and their severity and protect you from sudden decompensated heart failure, leading to emergency admissions and sudden deaths.

(Dr. Pradeep Haranahalli, Consultant - Interventional Cardiology, Manipal Hospital Whitefield)