Can Christmas Bring on a Heart Attack?

New research looks at heart attacks on Christmas and New Year

Posted Dec 24, 2018

Nobody denies that the holidays are stressful. Even when festive, the anticipation, bustle, and sudden change in lifestyle over Christmas and New Year can take an emotional toll. Moreover, many people suffer from the Holiday Blues.

It makes sense that the increased stress experienced during these festive periods could play an acute role in heart attack risk. And in a Christmas 2018 population-based study published in the BMJ, authors led by Moman A Mohammad from Lund University found just that.

In this retrospective observational study involving a Swedish population, the investigators examined 283,014 cases of myocardial infarction between 1998 and 2013. They mined hospital admission records for onset of symptoms on Christmas, New Year, Easter, Midsummer (Sweden's second biggest holiday), and big sporting events.

Roman Samborskyi/123rf
Source: Roman Samborskyi/123rf

They found that the risk of heart attack on Christmas Eve was 37% higher, and peaked at about 10 at night. Based on previous research, the investigators suggested that anger, anxiety, sadness, grief, and stress could play a role in these cardiac events.

Importantly, people aged 75 and older were at highest risk for heart attack—especially those with diabetes and heart disease.

With regard to New Year, there was a 20% heightened risk of heart attack on New Year’s Day. The authors possibly attributed this spike to excess drinking, excess food consumption, exposure to cold nighttime temperatures (from being outside), or sleep deprivation.

Stress may not be the only explanation for this holiday presentations, and there could be other confounding variables at play. For instance, relatives may come visit during the holidays only to discover their older kin in poor general health and needing medical attention. Or, older people may delay seeking help for fear of disrupting the festivities. Nevertheless, the team found no temporal evidence supporting these hypotheses.

“Understanding what factors, activities, and emotions precede these myocardial infarctions and how they differ from myocardial infarctions experienced on other days could help develop a strategy to manage and reduce the number of these events,” wrote the authors.

Finally, the researchers found that there was no link between heart attacks and Easter. There was also no link between heart attacks and sporting events. But there was a link between heart attacks and Midsummer.

For non-Swedish readers, Midsummer Eve precedes the summer solstice. On this night, Swedes dance around a maypole, sing, eat, and drink to excess, according to the authors. This holiday is tied to the Feast Day of Saint John the Baptist.

References

Mohammad M.A, et al, Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. BMJ 2018;363:k4811.