Dr Harinder Singh Bedi
Eating sarson ka saag and makki ki roti with a dollop of butter, gajjak, rewari and groundnuts , sitting around the fire , cuddling up in a warm blanket and – guess what — having a heart attack all have something in common : You’re more likely to experience them in the winter !!! .
The risks of having a heart attack during the winter months are twice as high as in the summertime – and the winter attack is also more likely to be fatal . There is a combination of factors that increase heart attack risk in winter:
Cold weather blues – Spasm of arteries: When a person gets exposed to cold weather, the body’s automatic response is to narrow the blood vessels. This can trigger a heart attack in diseased arteries. The problem is higher in India as we do not live in artificially regulated temperatures as in the West.
Increased blood pressure: due to the narrowing leading to a strain on the heart. This has the effect of a double whammy – not only does the heart have to work harder but its blood supply is reduced.
Thicker blood: In cold weather, blood platelets appear to be more active and stickier and therefore more likely to clot.
Holiday feasting: People tend to eat and drink more, and gain more weight during the holiday season and winter months – all of which are hard on the ticker.
Unaccustomed exercise: Every 1st Jan. millions of people join gyms as part of their New Year’s resolution to get in shape — and many may overexert themselves too soon. Start an exercise regimen under the supervision of your trained coach
Increased stress hormones: During the winter months, there is a change in the ratio of daylight hours to dark hours, which causes an increase of stress hormones eg cortisol.
Snow shoveling: Believe it or not, studies from Shimla show that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling. One of my patients – a PT teacher at a boarding school in Shimla – suffered a heart attack as he was showing his NCC students how to work in the snow.
Less daylight: Less of sunlight in winters not only adds to depression but also lowers levels of vitamin D (which comes from sunlight falling on skin) – this by itself has been linked to heart attacks .
Delay in seeking treatment: The risk is higher at the holidays because people commonly delay seeking treatment for symptoms during this time of year. In fact I vividly remember a polite elderly patient in Sydney who apologized profusely for having ‘disturbed’ me in the holiday season with a heart attack that he had been nursing for the last 2 days !!! This is compounded by the still present unfounded fear of getting Covid in a hospital.
So does this mean you have to fear the winter and huddle indoors all the time ?
Not at all !! .
The take home message is not to be afraid of the winter but to know that winter is a period of increased risk and to look for ways to minimize that risk. So during the winter, try to keep your heart healthy by keeping the following pointers in mind:
* Stick to your normal exercise plan
* Avoid very early morning walks – wait for sunrise
* Wear proper attire – a thermal inner , muffler, cap, warm socks and a jacket with hood are good investments to enjoy a healthy walk. Wear clothes in layers – at least 3 . 40% of body heat can be lost via an exposed head in winters – wear a monkey cap or a cap and ear muffs .For Sikh gentlemen a turban offers good protection to the head and ears from the cold.
* Start slow – the cardiovascular system can adapt to slow and progressive changes, but it has a much more difficult time adapting to sudden changes.
* Have a proper trained gym instructor chart a graded exercise programme for you . Don’t aim for a SRK 6 pack in a short time .
* If its really really cold and you just do not feel like going out – Hop on the treadmill, find inner peace on the yoga mat or hit the dance floor with some friends.
* Eat a prudent diet low in saturated fats and calories. Nuts and dry fruits can be taken in moderation if one is not overweight. Avoid fatty fried and non vegetarian food .
* Avoid tobacco, coffee, tea or alcohol just to ‘warm you up’ – the additional nicotine and caffeine put a stress on the heart. Alcohol or ‘Holiday spirits’ cause vasodilatation and so produces a feeling of warmth – but the body loses heat. They also increase blood pressure and rhythm irregularity.
* Skip the frantic shopping last minute trip to the mall for gifts to give for New Year. Plan well in time – gifting online is a good option.
* Stop and smell the roses . Don’t get stressed out about preparations – make time to enjoy celebrations with family and friends.
* Avoid gambling on New Year – it can be stressful – both financially and on the heart ! Punjab has the one of the largest number (unofficial – of course !) of people gambling at New Year.
* Know and manage your blood pressure
* Don’t ignore symptoms if you are feeling unwell-doctors on duty will not mind !! – they’re away from home anyway !!!
* Rest if you are sick
* ‘Let The Sunshine In’ – sit in the sun – this improves your levels of Vit D
* Take your medication as recommended
* Get a flu shot (vaccine) to lower your risk of getting flu
* Do not postpone doctors’ visits
If you follow all these simple tips – you can enjoy winter without hurting your heart. And when spring arrives, you’ll be fit as a fiddle.
(The writer is Director, Cardio-Vascular Endovascular & Thoracic Sciences, Ivy Hospital, Punjab)
Dr Harinder Singh Bedi