Tips for Protecting Your Heart During the Cold, Dark Days of Winter

Short days and low temperatures can spell trouble for people with heart disease. Here's what you need to know to be safe.


The holidays are over, and now most of us face weeks of gloom and cold before the crocuses pop and robins sing.

Yes, we’ll be coping with deep winter for a while longer. If you have heart disease, you’ve already been warned that shoveling snow can cause a heart attack. But you may be surprised to learn that cold alone may be only partly to blame: There are dangers associated with winter itself that affect us, no matter where we live.

“Heart attack rates rise 50 percent in cold weather. But even in warmer climates, there is an uptick in events during the winter,” says Cleveland Clinic cardiologist Michael Rocco, MD. “Winter is a vulnerable period, but managing your risk factors can help minimize problems.”

How Your Body Responds to Cold


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Exposure to cold causes blood vessels throughout the body, including those in the heart, to constrict. This causes blood pressure to rise. When you exert yourself in an outdoor activity-shoveling snow, walking through deep snow or even cross-country skiing, for example-your heart rate increases, as well.

Healthy people can tolerate these changes. But when arteries narrowed by plaque further constrict and demand for oxygen increases, the heart may not be able to meet this demand. The result is angina.

Sudden changes in blood pressure with exertion also make plaque vulnerable and prone to rupture. This is how a heart attack occurs.

“The danger is always there, but when heart patients who have not adapted to the cold weather exert themselves, the risk is even greater,” saysDr. Rocco.

The Dangers of Winter Itself

During the holidays, many people overindulge in food and drink, while skipping their regular exercise routine.

Winter is also flu season, and getting the flu increases heart-attack risk.

In some studies, heart failure hospitalizations and deaths rose when the temperature dropped. “Seasonal changes, rather than cold, might be responsible,” says Dr. Rocco.

So might increasing darkness. “Changes in the light-dark cycle that make days shorter and nights longer trigger hormonal changes and increase the tendency for blood to clot,” says Dr. Rocco. “Older individuals are especially vulnerable to these changes.”

Protect Your Heart and Your Life

You don’t have to stay indoors all winter, but you should use common sense when you need to be outdoors. Here is some advice:

If you have coronary artery disease or its risk factors, ask your doctor if there are specific outdoor activities you should limit.

Because the abrupt change from warm to cold can be hard on your heart, cover your nose and mouth with a scarf to warm and moisturize the air you breathe in.

Warm up with five to 10 minutes of walking before doing any activity. Intersperse the activity with rest periods. “If you experience shortness of breath, chest pressure or you start sweating, stop and rest,” says Dr. Rocco.

If you have high blood pressure, make sure you take your medication to keep your blood pressure and heart rate under control.

Smoking is bad, but smoking outside in cold weather is downright foolish. “It is the worse thing you can do, because it increases vasoconstriction,” Dr.Rocco says.

Don’t drink alcohol if you plan to be outside. Alcohol causes blood vessels to dilate, which promotes the loss of body heat. “You will feel warm, but you will be thwarting your body’s ability to stay warm,” says Dr. Rocco.

Get a flu shot. Flu increases the risk of hospitalization or death from cardiovascular disease. In studies, flu shots have been shown to reduce heart attacks and strokes by 55 percent in people who had recently suffered a cardiovascular event. The flu vaccine is associated with a 50 percent reduction in flu-season deaths among heart failure patients. “Even if the vaccine is not fully effective, it can lessen the likelihood you will have a heart attack or stroke,” says Dr. Rocco.


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