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Holidays and Winter Vacation Season Increase
Heart Attack Risk

 Cautions from Doctors at Texas Heart Institute  

Houston, Texas (updated July 2015) – Physicians at the Texas Heart Institute (THI) repeated cautions about how the holiday season can put heart patients, and those with undiagnosed conditions at greater risk for a heart attack.  

"Yes, this story gets unwrapped each year, but it's true, and while we haven't exactly pinpointed the causes, research shows that the incidence of heart attacks does tend to spike during the holiday period," said Dr. James T. Willerson, a cardiologist and THI President and Medical Director. "In combination, overeating, overdoing alcoholic consumption, being too sedentary, and even the stress of the season can contribute to or trigger heart attacks. The risk is there for people with known heart conditions and for people with undiagnosed conditions as well."  

A key is to be aware of the risk and modify any high-risk behavior, doctors advise.  

Willerson also reiterated warnings about increased heart attack risks for people headed to the ski slopes this winter. These risks are related to the combination of high altitudes, freezing temperatures and inadequate physical conditioning -- for skiers, snow boarders and other winter tourists.  

Doctors advise some pre-vacation conditioning and not jumping into strenuous activities too quickly at the beginning of a winter vacation.  

Research has shown these factors present added risks. In fact, a study of heart attack victims presented to the European Society of Cardiology last year by cardiologists at the Medical University of Innsbruck, Austria, showed that the risk for tourists in the Austrian Alps were greatest during the first two days of vacation. 

"This certainly indicates that beginning intense physical activity under harsher winter conditions can put you at risk, especially for flat-landers from Texas" said Willerson. "We've known for some time that things like simply shoveling snow can strain a person's heart because the body diverts blood flow to the heart away from vulnerable areas, potentially causing heart attacks or abnormal heart beats with isometric exercise like shoveling."    

In addition, Willerson pointed out, cold weather constricts the arteries which reduces blood flow to the heart and can often raise blood pressure and place added stress on the walls of the heart. This, in turn, requires more oxygen for the heart, and that can be an issue in cold weather even at sea level. The relatively low oxygen levels at altitude is yet another factor than can make it even more complicated and risky, he added. It makes the heart beat faster and work harder.  

The Austrian study looked at 1,500 patients admitted to the hospital with cardiac conditions between 2006 and 2010. Of these, 170 had suffered a heart attack during their winter sports vacation and this group formed the basis of the detailed study.   Some 56 percent of those heart attacks occurred during the first two days of their winter vacation, yet just 19 percent had a known cardiac condition. The study's authors also pointed out that prior to their vacations, more than half of the patients got less than the minimum levels of physical activity recommended by the Cardiology Society. 

The American Heart Association has warned on its web site that people outdoors in cold weather should avoid sudden exertion."Even walking through heavy, wet snow or snow drifts can strain a person's heart," the AHA has said. 

THI doctors and the authors of the Austrian study recommend that those planning a winter ski trip get regular physical conditioning before they head to the mountains and that once they arrive, they take it slow and increase activity more gradually over the first couple of days. For tips on exercising safely in cold weather, read the topic in the Heart Information Center.   

This is also a good time of the year to think about taking a basic CPR course, advised Henry Aceves, Director of THI's Heart Information Center. "Everybody is busy, but it's a good and lasting investment of your time and we all know about that proverbial ounce of prevention."

For THI media profile, see Public Affairs.

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