Most People Die Of Heart Attacks During Winter; Here's Why

Acute exposure to elevated temperatures has been shown, while repeated cold exposure led to hypertension and impaired endothelial vasodilator function.

Cardiovascular diseases (CVDs) stand as the primary global cause of death, claiming around 17.3 million lives in 2022, constituting 30% of total global deaths. Notably, there is a seasonal fluctuation in the morbidity and mortality rates of CVDs in both the northern and southern hemispheres, with a heightened occurrence during the winter months, particularly around Christmas and New Year. Cardiologist Abhijit Khadtare at Ruby Hall Clinic, Pune, explains this variation is linked to various risk factors, including temperature, physical activity, air pollution, infections, and dietary habits. Firstly, cold weather exposure activates the sympathetic nervous system, causing an elevation in heart rate, blood pressure, and blood vessel constriction, placing strain on the hearts of individuals with pre-existing cardiovascular conditions.

Seasonal Affective Disorder (SAD)

1. Furthermore, the winter season's shorter daylight hours and reduced sunlight contribute to Seasonal Affective Disorder (SAD), associated with increased inflammation and depression, both of which are risk factors for heart disease. Air pollution tends to be higher in winter, aggravating lung conditions and negatively impacting cardiovascular health.
2. The North American Journal of Medical Sciences has extensively documented seasonal variations in sudden cardiac death (SCD), with numerous epidemiological studies revealing maximum and minimum incidences during winter and summer. Some studies even note a distinct peak in SCD occurrences during summer. The precise cause of this seasonal fluctuation remains unknown.

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3. Still, it is hypothesized that increased platelet aggregability, reduced fibrinolytic activity, and other blood components involved in thrombogenesis may significantly trigger SCD during winter. This hypothesis gains support from similar seasonal patterns observed in myocardial infarction, transient myocardial ischemia, and arrhythmias. The winter surge in these related disorders suggests identifiable triggers.
4. The mechanisms linking cardiovascular diseases to temperature variations are not fully understood. Still, cold temperatures are known to activate the sympathetic nervous system and increase catecholamine secretion, potentially leading to elevated blood pressure through increased heart rate and peripheral vascular resistance.

Summary

For individuals with compromised coronary circulation, this additional demand may result in myocardial ischemia, leading to conditions such as angina pectoris or myocardial infarction. Studies have also revealed statistically significant positive correlations between air pressure, humidity, and the incidence of pulmonary embolism. In Scotland, a study found associations between wind speed, temperature, and the seasonal peak of deep vein thrombosis, with a delayed effect of approximately 9-10 days. Experimental research indicates that temperature alterations may influence vascular function by affecting endothelial nitric oxide synthase and nitric oxide bioavailability. Acute exposure to elevated temperatures has been shown, while repeated cold exposure led to hypertension and impaired endothelial vasodilator function.