Winter Warnings: Protect Your Heart During the Chill

Winter is almost here and with the health hazards associated with it. These are seen more often in the vulnerable populations like in extremes of age, people with co-morbidities like diabetes, high blood pressure and in those with previous heart ailments like previous heart attacks, weak hearts (heart failure patients) and with chronic lung problems like asthma and chronic bronchitis.

Cold weather is usually defined as an average temperature around 10 degrees Celsius or lower. It leads to several changes in our biological system. These include, shrinking of arteries in general including those of heart. There are some circadian changes resulting from shorter hours of day light and longer nights, this leads to higher cortisol levels which can result in higher blood pressure, increased pumping action of heart to increase the circulation of blood necessary to keep the body warm . Of the several important risks factors which account for most of the heart attacks many are adversely affected. These risk factors are: Smoking which in smokers invariably, increases in colder months, high bad cholesterol levels generally deteriorate because of more sedentary habits and increased intake of cholesterol rich foods, BP levels increasing in general, diabetics getting sugar levels out of control, gain in weight and tendency for obesity, depression and anxiety because of gloomy overcast weather and often getting stuck indoors. Reduced exercise and less intake of fruits and vegetables.

Newer Concepts:

Inflammation of the arteries supplying the heart muscle has been found to be an important trigger for the clot formation in the heart arteries leading to the catastrophe called myocardial infarction. It has been found that the inflammatory markers like the levels of hs CRP, sVCAM-1, and sICAM-1 significantly increase during the colder months especially in the elderly promoting a higher risk of the heart arteries to get clogged. Viral illnesses like influenza its variants and pneumonias seen often during the colder months are inflammation producing diseases and can add to the problems.

Smoke and pollution with microparticles leading to a poor air quality index in the plains of North India which includes the Jammu city and its surroundings leads to these particles getting through the lungs without getting trapped and entering the blood stream. These eventually get attached to the blood vessels and making them inflamed thus prompting a clot formation and adding to the risk of getting a heart attack.

Tips to Avoid Heart Attack:

It is desirable to get a general physical examination and a routine blood bio-chemistry done at the onset of winter in all adults. Blood pressure, blood sugar, blood cholesterol and triglycerides estimated. If abnormal seeking a consultation with a physician is advised.

Regular modest exercise done regularly is one of the best ways to keep the heart healthy. For un accustomed persons it should be started gradually and increased steadily. Vigorous exercises should be avoided. There have been examples of people getting heart attacks during such spurts. For persons with risk factors like diabetes, high BP and high cholesterol levels getting an exercise test with ECG monitoring is the best way to start. Keeping a count of the pulse rate is a scientific way of monitoring the heart activity. A number of apps are available for this. In general, for an average person between 40 and 60 years a rate of 120/ minute is considered a good level. Patients with underlying heart problems should always consult their physician to guide them regarding the duration and speed etc.

Blood pressure at rest should be less than 140/90, Fasting blood sugar less than 120 mgs, Total cholesterol less than 150 mgs, weight under check and no tobacco smoking both active and passive.

Eating 3 to 4 servings of fresh fruits, green vegetables and salads are highly recommended. Winter has special cuisines like Harissa, traditional dried vegetable curries (Hokha Syun), dried fish (Hoggada) duck meat, Shabdeg (simmered stew of turnips, mutton or kidney beans or Rajmah . These are a part of our age-old traditions. Have them but sparingly and balancing them with regular exercise and also consuming plenty of fresh fruits and vegetables which are easily available throughout the winter unlike in the past.

Winter season predisposes to heart related disorders. These problems can be avoided to a large extent by healthy heart checks and timely preventive measures. Regular moderated exercise and intake of plenty of fruits and vegetables are very cost-effective solutions. Patients with high BP, diabetes and underlying heart diseases should maintain their targets. Tobacco use should be avoided at all costs.

Author is a Cardiologist and Founder Director Gauri Kaul Foundation