By AMERICAN HEART ASSOCIATION NEWS
Amidst all the heart-warming seasonal stories this time of year, a grim fact also exists — several studies have reported an uptick in deaths around Christmas and New Year’s compared to other times throughout the year.
Sometimes referred to as “holiday heart attacks,” the phenomena has been explained through several studies over the years. What researchers have found is that deaths from cardiac and non-cardiac causes often peak during the holiday period.
This was observed with the release of a 1999 study, published in the American Heart Association’s journal Circulation. Researcher Robert Kloner, M.D., Ph.D., of the University of Southern California examined 222,265 death records from Los Angeles County and found that cardiac deaths in December and January were 33 percent higher than in summer months, with a dramatic increase in deaths starting at Thanksgiving and continuing through the New Year’s holiday.
An analysis in 2004 of 53 million death records over 26 years from across the United States pinpointed more specifically that more cardiac deaths occurred on December 25 than any other day throughout the year, followed by December 26 and January 1.
“For cardiac and noncardiac diseases, a spike in daily mortality occurs during the Christmas/New Year’s holiday period. This spike persists after adjusting for trends and seasons and is particularly large for individuals who are dead on arrival at a hospital, die in the emergency department, or die as outpatients,” wrote the authors of the study, which was published in Circulation. “The excess in holiday mortality is growing proportionately larger over time, both for cardiac and noncardiac mortality.”
In 2010, a study published in Social Science & Medicine noted that the “two weeks starting with Christmas are associated with an excess of 42,325 natural deaths over a 25 year period. This nontrivial loss of life is an important public health concern and warrants further research.”
While researchers don’t know exactly why deaths are more common around the holidays, some possible reasons include changes in diet and alcohol consumption; stress from family interactions, strained finances, travel and entertaining; respiratory problems from burning wood; and lack of attention to the signs and symptoms of a heart attack.
That list sounds very plausible to Julie Rickman, who had a heart attack during the Christmas season in 2010.
“I felt like we were running around, going everywhere, and I just couldn’t catch my breath,” she said. “I remember two days before Christmas, we thought I was allergic to my live Christmas tree, and we took it down and got an artificial tree.”
The day after Christmas, Rickman got winded while folding laundry. She thought it was exhaustion but decided to go to the emergency room anyway.
Now 47, the Overland Park, Kansas, resident realizes that trip saved her life. She had two blockages in her heart and doctors discovered that at some point in December she had suffered a heart attack.
“I have no idea when the heart attack happened. I was one of those women who attributed feeling badly to the holidays and thinking I was exhausted,” she said.
“The progression of heart disease doesn’t happen overnight, so an uptick in cardiac death during the holidays is actually more the acute manifestations of the disease,” said Jorge Plutzky, M.D., director of preventive cardiology and cardiovascular medicine at Brigham and Women’s Hospital in Boston.
There are many different factors that could play a role, he said. For instance, cold weather can constrict arteries and increase demand on the heart. Additional holiday stress could result in a delayed doctor visit or a patient could break from healthy eating.
“Dietary indiscretion can contribute to a chain of events leading to more stress on the heart,” Plutzky said. “A cardiac event might be triggered because the heart is working harder.”
People who have had a heart attack are at increased risk of another one and need to be careful even though routines change during the holidays, Plutzky said.
“Make sure the holidays don’t get in the way of taking your medicines and continuing to be attentive to a healthy diet,” he said. “But even when the holidays are passed, these things continue to be issues all year long because heart disease remains a leading threat to America’s health.”