The snow is falling. The winter winds are raging, you are over 50 years of age and you have to shovel the driveway. You may be aware that heart attacks are increased in winter, almost twice the rate as at other seasons. Why and how can you protect yourself?
The reason for the increase in heart attacks involves the cold weather primarily, although snow shoveling helps. Cold weather causes the arteries to constrict, increasing the work of the heart by raising the blood pressure. When the arteries have arteriosclerotic plaque, this decreases blood flow even more. Also, cold causes the heart rate to increase, making the work of the heart even greater. Finally, lifting snow with your shovel is an isometric exercise adding to the work of the heart by an increase in blood pressure.
If you want to shovel snow early in the morning, beware! This is the time of day when heart attacks are greatest, because of the surge of adrenaline that occurs around the time of awakening. With the decreased daylight hours there is also a tendency for depressed mood which can also affect the function of the heart.
You are still over 50 and need to shovel snow despite the cold. How do you protect yourself? There are short-term and long-term methods. The short-term methods include bundling up, protecting your ears and head. Now that you see the large snow mounds, don’t try to shovel down to the ground level all at once. Push a little off the top and fling it away without lifting the shovel and continue to do so shoveling layers of snow in one area. Pause every few minutes and take a few deep breaths. If your heart seems to be going fast, wait until it slows down.
Even when you are taking a walk in cold weather, stopping every few minutes could be protective. There is no reason to walk four miles an hour in cold and snowy weather unless you feel that stress testing outside a medical facility tests your mettle. If you feel that you want to test the EMS facilities in your area, shovel or walk and smoke at the same time!
What about long-term protection? Decrease your cardiovascular risk factors that lead to heart attacks and strokes! STOP SMOKING. Try to moderate your food intake and alcohol drinking during the holiday season (and other times!). A full stomach increases the work of the heart. It also increases your weight. Alcohol increases heart rate and blood pressure for a short time. Check your cholesterol level. Make sure that your blood pressure is under control. A decrease in these risk factors will provide better long-term protection against heart attacks and strokes. Getting into an exercise program gradually will also bolster your heart function.
There is also some indication that increasing your vitamin D intake during the winter may provide some protection at a time when the vitamin D levels in your body are lowest because of the decreased sunlight.
As you may know, February is Heart Month, not because it is winter but because Valentine’s Day falls at this time, and what do we think of during this holiday? Certainly not broken hearts!
Philip R. Liebson MD, FACC, FAHA, practices general cardiology and preventive cardiology at Rush University Medical Center, including hypertension and lipid management.is a professor of medicine and preventive medicine. He holds the Mc-Mullan-Eybel Chair of Excellence in Clinical Cardiology.