Ask the Expert: Heart attacks

Question: Does cold weather increase the risk for a heart attack?​

Kelley Anderson, M.D.: Heart attacks and sudden death do occur more often in the winter, often in people who do not normally exercise but go out in the cold to shovel snow.

This results from a combination of factors tied to plaque, or defects, in the walls of our arteries. ​

Plaques usually start in childhood as fat in the walls of the arteries.

Eventually this fat becomes inflamed and develops a fibrous cap of scar tissue, making it more prone to rupture.

When this happens, it causes blood clots that block the flow of blood to the heart and result in what we call a heart attack.

Exposure to cold combined with exercise contributes to this process in several ways.

The cold stimulates the sympathetic (involuntary) nervous system, which increases heart rate and blood pressure.

This increases the workload on the heart, and raises blood flow velocity and pressure in the arteries.

At the same time, exercise forces the heart to supply blood flow to the muscles being used.

Exercise also further stimulates the sympathetic nervous system.

Other seasonal factors can include inflammation from common winter infections such as colds or influenza, depression and more sedentary lifestyles.

We have even seen heart attacks caused by emotional responses while watching sporting events!

To reduce your risk of a heart attack:

• Dress warmly
  
• Don’t overdo it on snow shoveling, especially if you do not exercise regularly
  
• Commit to regular exercise at home or a community facility.
  
• Stop smoking and drink alcohol in moderation, never more than two drinks per day for men or one drink for women.
  
• Don’t use illegal drugs.
  
• Eat properly, avoiding salty snacks, saturated fats and calories.
  
• Make sure your blood pressure is well monitored.
  
• Reach out to someone if you’re feeling depressed.
  
• Keep it in perspective if your favorite sports team lets you down!
  

​Marshfield Clinic provides heart care​ in a number of our centers. Your primary care doctor can refer you to the appropriate specialty and location.​​ ​