Heart prescription for the cold onslaught

Much like the prescription Santa hats on Christmas eve and hateful hangovers the next morning, all health columns leading up to the new year are inevitably on innovative permutation-combinations of how to live a sober, fitter and better life. At the risk of being contrarian, I won’t go into all that.

Instead, I’ll just help those over 40 years survive Monday morning and the very many cold winter mornings that follow it.

Heart attacks and strokes are five to six times more likely to occur in the morning, with wintry Mondays being the days when your heart and brain are most at risk.  The most common cause is the sudden surge in blood pressure as you jump out of bed to meet the day and its many deadlines. This sudden spike in pressure —  called the “a.m. surge” — taxes the heart, at times causing it to pack up. Apart from blood pressure, work-related stress also raises stress hormones cortisol, which makes the arteries constrict and restrict blood flow.

Newer studies now reveal a biological cause. A study in the journal Nature has identified a link between circadian rhythms — your hormone-governed sleep-wake cycle —  and early morning heart attacks. It reports that daylight-related shifts in the body’s circadian clock makes the level of a protein called KLF15 fluctuate, which causes rapid, irregular heartbeats called arrhythmia that impair the heart’s ability to pump blood, causing sudden death.

Morning heart attacks and the resulting complications are also more serious. Heart attacks occurring between 6 am and noon were associated with the most damage, according to a study reported by the journal Heart, earlier this year. Attacks that occurred in the morning hours resulted in 20% more dead heart tissues.

But while managing your stress would certainly be helpful, as would lowering all your risk factors for heart disease — quitting smoking, losing weight, getting active, and, if needed, taking prescription medicines to lower high blood pressure and cholesterol, to name a few — you also need to watch out for the cold.

For much like Mondays and mornings, winter is high time for heart attacks and stroke. In cold weather, the heart needs more oxygen because it has to work harder to maintain body temperature. Cold weather makes arteries tighten, restricting blood flow and reducing oxygen supply to the heart. It also makes blood thicker and sticky, making the platelets more likely to stick to the inside walls of the blood-vessels, blocking blood flow.

Viral attacks in winter, too, add to heart woes. Flu causes inflammation, make fatty-deposits inside the arteries unstable and these may dislodge to block arteries.

Outdoor activities such as early morning walks and runs further add to the morning spike in blood pressure, increasing heart rate, blood pressure, and cortisol levels. So start your day slow and give your heart and blood vessels some time to adapt. Go for sunshine walks and runs and even then, make sure you don’t overdo it. While walking or exercising, push yourself just enough — till you’re slightly out of breath but are not so breathless that you cannot complete a sentence.

And when you take a break, don’t smoke or have tea, coffee or alcohol to warm up because nicotine, caffeine and alcohol further burden the heart. While nicotine makes the blood viscous and more prone to clotting, caffeine acts as a diuretic, while alcohol gives an initial feeling of warmth by making the blood vessels in the ski to expand but ultimately make the body lose heat rapidly, leaving you colder.

And stay alert to the signs. Few people have the classic symptoms of chest pain. For most, especially women, the symptoms could just be a general feeling of uneasiness, a pulled back or neck muscle or a pain in the arm. Stroke, too, could just feel like a mild dizzy spell. So, listen to your body and get all signs of uneasiness whetted for early signs of a potentially fatal disease.


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