Prevent Heart attacks in winter! Beware of early morning heart attacks – A.M. surge!

GUEST COLUMN: Dr. N Prabhudev

Bengaluru, Nov. 27:
Winter has started in India. People are feeling cool and relaxed. But along with this, the winter season also invites many diseases. Winters in India are an enchanting season with a myriad of snow-capped mountain peaks, cool and sunny plains, scenic beaches, warm deserts and lively festivals. India is set for an extreme winter in 2024 due to the onset of the La Niña phenomenon, which causes cooler ocean temperatures in the Pacific, impacting global climate. The India Meteorological Department (IMD) predicts a severe drop in temperatures and increased rainfall!
Among seasonal illnesses that strike in winter, flu and bronchitis and pneumonia have another sinister companion – Early mornings of winters are the prime time for heart attacks in those with comorbidities like Diabetes, high BP and High cholesterol.
• Winter cold kills more than twice as many as summer heat does.
• The risk of getting a heart attack is higher in winter or colder months, compared to summer or warmer months. Heart attacks rates can rise by up to 53% in winter compared to summer! This is more so especially the case in the elderly.
Heart attacks are caused by inflammation, oxidative stress and immune dysfunction in the lining of our blood vessels that causes plaques to rupture, platelets to clot and disrupt the blood supply to the heart. There is an incidental risk of strokes, heart failure, cardiovascular issues, arrhythmias and disorders in the colder months particularly around Christmas and New Year. Cardiovascular diseases – CVDs stand as the primary global cause of death, claiming around 17.3 million lives annually constituting 30% of total global deaths.
Why are heart attacks more common during winter? Identifiable triggers.
• Heart attacks increase by 11 percent every time the temperature drops by 2.9 degree Celsius over a period of 24 hours. Yes, there’s a surge in heart attacks during winter – Heart attacks increase during winters by about more than 30%.
• Sympathetic nervous system activation is increased during winters resulting in narrowing of the blood vessels – vasoconstriction and elevation of blood pressure, increasing the risk of heart attacks and strokes. Elders, in particular, are susceptible because of a vulnerable temperature control mechanism.
• Changes in blood rheology including increased platelet activation, increased fibrinogen, and increased viscosity due to dehydration have a hazardous effect on blood pressure- a combination of these factors may trigger an acute cardiac event.
• Those with previous heart attacks are highly vulnerable for repeat heart attacks in winters.
• Air pollution tends to be higher in winter, aggravating lung conditions and negatively impacting cardiovascular health. Pollutants like PM2.5 and PM 10 have the same narrowing effect.
People suffering from Angina- chest pain on effort, need to be extra vigilant. The cold limits blood flow and reduces supply of oxygen to the heart, which leads to heart attack. Further Seasonal Affective Disorder – SAD, can increase levels of stress hormones, thereby, increasing the risk of heart attack and stroke.
Due to cold, people are more alcoholic and smoking in winter. Due to this, the nerves shrink and the heart muscles become weak. This condition also increases the risk of heart attack. Especially if the person is already suffering from effort angina. Cold weather constricts blood vessels to conserve body heat. This makes it harder for the blood to flow and increases blood pressure.
Vitamin D deficiency, can increase the risk of hypertension. You sweat less in colder temperatures, you retain salt. This increases blood volume and consequently blood pressure.
If your BP is higher than 140/80 mmHg, and you have risk factor like diabetes – then the risk of heart attack goes up by two-fold. If you have multiple risk factors like obesity or cholesterol, then the combined risk goes up by up eight-fold.
How can you reduce your risk and stay safe?
• Any difficulty in breathing, heaviness in the chest, sweatiness, shoulder pain, jaw pain, dizziness or nausea should be taken seriously. Do not delay getting help.
• Keep body temperature stable and optimal.
• Keep the body warm. Wear winter friendly clothes!
Regular physical activity and exercise boost your immunity. Home workouts, heart-friendly aerobic moves, yoga and meditation work wonders. Reduce the risk of comorbidities- sugar control, BP control and No smoking are very crucial in reducing the risk. Also limit the consumption of alcohol and ‘No’ tobacco. Preventive medical check-ups go a long way in reducing the risks of acute heart events!
Know the symptoms of heart attack! Do not ignore them!
Chest pain- severe and Left sided, radiating to the L shoulder and to last one and a half finger, radiating to Jaw, to the neck,
Profuse sweating, cold sweats, breathlessness, Weakness and fatigue, dizziness or fainting, nausea and vomiting, Sense of bloating and constipation!
Don’t panic. Make the patient comfortable. Rush someone to get a tablet of Nitro-glyceriine or sorbitrate and keep it below the tongue! Give a tablet of Aspirin!
Give a tab of calmpose! Make arrangements to shift the patient to the Hospital!
Remember what is tasty to the tongue is harmful to the Heart! Hydrate yourself! Drink enough Water- unbelievably simple, prevents kidney failure and improves metabolism. ! Smoking, being inactive, obesity, poor nutrition, and too much alcohol- alone and together, set the stage for heart disease.Cholesterol initiates artery blockages. All too often, the end result of these is a heart attack or a stroke and a heart failure.
Information and knowledge is only valuable if it is acted upon and implemented. We must change our habits if we wish to change the course of our own health.