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10 Reasons Your Heart Attack Risk Is Highest in the Winter

Learn why your heart is more vulnerable in the cold, winter months, from the higher rates of infection to the stress of cold on the body.

It may seem like colder temperatures shouldn’t affect your heart health, but science suggests otherwise. There are seasonal ebbs and flows to heart trouble, and the risk of heart attacks, heart failure, and other cardiovascular problems can go up in winter. (These are the times heart attacks are more likely to occur.)

In a 2017 study of 113,000 people published in Environment International, Canadian researchers found for every 1°C (1.8°F) the average temperature drops, heart failure risk increases by 0.7 percent.

Heart failure is not the same as heart attack; it’s a chronic condition in which the heart muscle becomes weaker and has trouble pumping blood. Heart attacks happen more suddenly, when an artery becomes blocked and cuts off blood flow, often after a piece of plaque ruptures and forms a blood clot.

Read on to learn why your heart is more vulnerable in the winter months, including higher rates of infection, physical exertion, and  the stress of cold on the body.

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Your blood vessels constrict

When your body is working to keep you warm, it focuses most on protecting vital organs like the brain and lungs from extreme temperatures. One of its responses is to constrict blood vessels, making it harder for blood to reach your whole body. “It’s trying to preserve blood flow to your vital organs,” says Martha Gulati, MD, a cardiologist at the University of Arizona and editor-in-chief of CardioSmart, a patient education and empowerment initiative by the American College of Cardiology. That means your heart needs to beat harder and faster to supply your body with the oxygen it needs, she says. As your heart rate and blood pressure increase, you raise your risk of blood clots, stroke, and heart attack. Protect yourself by dressing warm—especially making sure your hands, feet, and head, which can lose a lot of body heat, are covered—so your heart doesn’t have to work so hard to regulate your temperature, says Dr. Gulati.

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Snow becomes a hassle

Any physical activity can leave your heart pounding, but if that activity includes shoveling snow, it raises your risk for heart issues. Your heart is working overtime to keep you warm while you shovel so the added strain of lifting heavy snow makes it pump even harder, says William Frishman, MD, MACP, an internist, cardiologist and director of medicine at Westchester Medical Center and chairman of the medicine department at New York Medical College in Valhalla, New York. Adding to the risk, you might ignore warning signs, chalking up feelings of strain to the unusual activity.

“They think their chest hurts because they’re shoveling—the muscle aches because they’re shoveling—and they keep going,” says Dr. Frishman. Keep your heart safe; pay a neighborhood kid to shovel your driveway. Kids’ hearts aren’t as susceptible to strenuous physical activity, so the extra work won’t put them at risk, says Dr. Frishman. If you do have to do your own shoveling, be sure to take breaks. Stop if you experience potential heart attack symptoms like chest pain, shortness of breath, or sweating. If the symptoms don’t go away call 911.

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You eat more unhealthy foods

Putting on a few pounds during the winter holiday season isn’t unusual, but it could put your heart at risk, says Dr. Gulati. Cookie swaps and holiday party spreads invite you to indulge in treats that are high in sugar, saturated fat, and sodium—and the latter two are linked with cardiovascular risk. “The biggest issue is salt because it retains fluids,” says Dr. Gulati. When you have underlying heart problems, all that water in your body makes it harder for your heart to pump. Dr. Gulati recommends drinking plenty of water before heading to a party, then filling up on healthy hors d’oeuvres such as veggies and hummus instead of sweets and alcohol. These are the 13 foods heart doctors try never to eat.

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You eat more

The quality of food isn’t the only thing that puts you at risk during winter; it’s the quantity too. The sheer amount of food people eat in winter could increase heart attack risk, says Dr. Frishman. Any time you eat a heavy meal, your digestive system requires more blood flow for digestion. When you go out in the cold after a heavy meal, your body has a hard time keeping up with the demands—and it all goes back to those constricted blood vessels in the cold. “There’s very little blood going to the heart, and yet the stomach says, ‘I need blood,’ ” says Dr. Frishman. Together, these factors could create a perfect storm for a heart attack, he says. In addition to keeping warm and eating healthy, he recommends getting regular exercise. But do it either before a meal or after you’ve had time to digest, so the physical activity doesn’t strain your heart even more.

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Flu risk is higher

Another reason to get the flu shot: It could protect your heart. A 2013 study in JAMA found that getting a flu vaccine cuts the risk of a cardiac event—including heart attack, stroke, and even death—by about a third over the next year. If don’t get the flu shot and come down with the flu, your system undergoes a lot of stress. Fighting the illness zaps your energy and puts demands on your body, and that’s not good if you already have a weak heart, says Dr. Gulati. “If you get the flu as an elderly person, the physiologic demands to the body and to the heart can be what ultimately kills you,” she says. Even if you do come down with the flu after getting vaccinated, you’ll probably get less sick than you would have without the shot, so your body won’t be so overworked. As always, be sure you ask your doctor about these 5 heart tests that could save your life.

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Your stress is skyrocketing

Winter can be a stressful time due to the holiday season, from prepping holiday food to shopping (and spending money) to dealing with relatives. A 2017 study in The Lancet has linked activity in the amygdala (the part of the brain associated with stress) with higher risk for cardiovascular events, which is why Dr. Gulati recommends doing your best to keep stress levels down during this hectic time of year. “We have to remember to take care of ourselves and focus on self-care as much as we care for other people,” she says. Make sure to make time for exercise, which has the double benefit of reducing stress levels and directly strengthening your heart. Check out these other 45 things cardiologists do to protect their own hearts.

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The holidays feel lonely

Loneliness really can break your heart. A 2015 study in the British Medical Jornal journal Heart found that poor social relationships increased heart attack risk by nearly 30 percent. If you’re spending winter alone, the holidays can be a time of sadness instead of cheer. “During the holiday season, people have memories of past Christmases,” says Dr. Frishman. Depression also has been linked with greater heart attack risk, possibly because the mental health condition makes it harder to keep up with heart-healthy habits. If you’re feeling isolated this winter, try volunteering during the holidays. You might find the good cheer comes right back to you when the “helper’s high” activates pleasure centers of the brain. Always double-check with a doctor, but this is how to tell the difference between a heart attack and cardiac arrest.

Young male opens curtains to bright sunny winter day and looks out of window through the sun during sunrisemariyaermolaeva/Shutterstock

You’re sleep is affected

A good night’s sleep is crucial for your well-being, and especially your heart health. Sleep heals and repairs the body, including your heart and blood vessels, and failing to get enough on a regular basis is linked to an increased risk of high blood pressure and heart disease. If your room temperature is too low during winter it may interfere with your sleep pattern. The National Sleep Foundation (NSF) recommends setting your thermostat to between 60 and 67 degrees Fahrenheit for optimal sleep. Just take care not to oversleep: a 2019 study in the Journal of the American College of Cardiology found getting too much, or even too little sleep boosts heart attack risk. The NSF recommends seven to nine hours of sleep for most adults between 18 and 64 years of age. Here are 7 signs you could be headed for a heart attack.

Christmas, Thanksgiving drinks. Autumn, winter cocktail grog, hot sangria, mulled wine - apple, rosemary, cinnamon, anise. On white marble table. With cones, rosemary. Copy space top view.Rimma Bondarenko/Shutterstock

You’re drinking too much alcohol

There are risks associated with imbibing too much alcohol when it comes to your heart health. First, alcohol can make you feel warmer than you really are, and that can be dangerous if you’re going out into the cold, say cardiologists at Northwestern Medicine. Be aware of your limits and stick to them, and take precautions if you are going out at night in the cold. Dress in multiple layers, beginning with a lightweight, insulating base layer. Body-heat loss relates to how much skin is exposed, so don’t forget a hat, scarf, and gloves. Staying hydrated also helps you retain body heat, so drink enough water throughout the day to make up for the dehydrating effects of alcohol. (Here are 17 tips for cutting back on alcohol.)

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You’ve missed prescription refills

Icy roads and snowstorms can present obstacles when it comes to getting to doctor’s appointments or picking up prescription refills. “If you haven’t had your medications, and blood pressure is not adequately controlled, it can increase heart attack risk,” Randall Zusman, MD, a cardiologist at Massachusetts General Hospital, told Harvard Health LetterFor the winter months, make sure to bulk up on your medication supply or refill your prescriptions ahead of time before a predicted storm hits. Next, check out these 12 silent signs of heart trouble you should never ignore.

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