Avoid the hazards of a holiday heart
Christmas, New Year’s…the holidays.
‘Tis the season for office parties and family gatherings, for bountiful feasts and sugary treats, for imbibing and reveling.
‘Tis a season of joy. It’s also a season of excess. Chances are you’ll eat too much, maybe drink too much, stress too much and, in the process, tax your heart to some degree. Combine these excesses with the cold of winter, and you could be setting yourself for cardiac concerns, from irregular heart rhythms to a heart attack.
“Probably every holiday season, starting at Thanksgiving and getting closer to Christmas and New Year’s, I probably have three or four patients come in with cardiac problems,” says Dr. John Pensock, an interventional cardiologist at the University of Pittsburgh Medical Center. “There clearly is increased incidence around the holiday season of acute coronary syndromes [such as chest pain and heart attack] or even sudden cardiac death.”
When you’re busy worrying about how you’re going to finish your Christmas shopping, decorate your home and Christmas tree, prepare meals, and welcome in 2015, stop and think about your heart health and what you can do to keep your “ticker” ticking well into the new year.
Holiday heart
The adverse effect of holiday binging on the heart is so common that medical experts have coined a term for it: holiday heart syndrome. It most commonly refers to irregular heart rhythms (arrhythmias) that can occur as a result of alcohol abuse during the holidays. And holiday heart syndrome can occur even in seemingly healthy people, particularly younger or middle-aged people, Pensock says.
Binge drinking can trigger atrial fibrillation (Afib), the most common arrhythmia, affecting more than 2 million Americans. In Afib, irregular electrical impulses cause the heart’s two upper chambers, the atria, to beat rapidly and erratically instead of contract and relax in a normal synchronized manner. As a result, blood isn’t fully pumped out of the heart, but instead pools in the atria, where it can clot. These clots may break free from the atria, travel to the brain and cause strokes. Afib is a leading stroke risk factor.
“It is a very common problem,” Pensock adds. “There has clearly been an association with imbibing more alcohol during the holidays and the provocation of atrial fibrillation.”
Research has found that just three standard drinks are enough to trigger Afib in some people. (A standard drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof hard liquor.) The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that men consume no more than two standard drinks a day, while women and anyone over age 65 should limit their alcohol intake to no more than one standard drink daily (seven per week). The NIAAA calls for no more than three drinks on a single day.
In a study published July 22 in the Journal of the American College of Cardiology, researchers found that compared to abstaining from alcohol, consuming one or two drinks a day increased the relative risk of Afib by 8 and 17 percent, respectively. Drinking three, four, or five drinks daily raised the relative risk by 26, 36, and 47 percent, respectively, the study found.
Some research has found that for every extra drink, the incidence of Afib increases by as much as 10 percent, Pensock says.
“By and large, most people would be able to drink without having any issue,” he says. “A lot of times, those episodes are running concurrent with other ongoing risk factors. If a patient is overweight or maybe has an underling history of hypertension, their heart may be a little more vulnerable. And then you throw the alcohol on top of it and it’s enough to provoke that episode of Afib.”
Some patients with alcohol-induced Afib may convert back to normal heart rhythm on their own, but others remain in persistent Afib and require an electric shock to the heart or medications to restore a normal heart rhythm.
Don’t derail your diet
Just as you can drink excessively during the holidays, you can just as easily overindulge on food. Everywhere you turn you encounter cookies, candy and other holiday staples that you just can’t resist.
Not only can these delicacies add inches to your waistline, but they also can take a toll on your heart if you “pig out.” Eating copious amounts of food in a sitting can trigger a nervous system response that causes Afib. Overindulging in sweets can cause your blood sugar to skyrocket if you have diabetes. Plus, eating too much high-sodium food, such as your Christmas ham, can cause spikes in your blood pressure, particularly if you already have hypertension.
Whether you’re enjoying some family time around the Christmas tree or you’re glued to a recliner while watching football on New Year’s Day, think before you reach for another cookie, another helping of ham, or that extra slice of pie.
“You can have and sample some foods, and you’re not going to fall off the wagon and have some catastrophic problem because you eat something you normally wouldn’t have eaten,” Pensock says. “But keep things in moderation. During the holiday season, hold firm to the guiding principles that we try to have in place all through the year as closely as you can.”
Stress and your heart
The holidays are a time for joy, a time for celebration. But they can also be a trying time.
All the pressures of finding the right gift, cooking Christmas dinner, traveling to see loved ones or preparing your home for company can take their toll, and for some, the holidays bring unwelcomed visitors: anxiety and depression.
“Chronic stress is heightened during the holidays because people have expectations of what it should be and what they have and don’t have, so they feel stressed to take care of all that,” says Jeanne Brinker, integrative medicine consultant with Highlands Hospital, in Connellsville. “Whether it’s taking care of the meals or buying the gifts or the financial aspects, whatever it is, I just see people’s stress levels increasing just because of all the things in everyday life.”
The effects of anxiety and depression extend beyond the brain and may affect more than your mood. Research suggests a link between these disorders and heart health. Chronic stress and anxiety may prompt some people to seek relief from alcohol, tobacco or binge eating, all of which can contribute to high blood pressure and affect the health of your heart and arteries. Chronic stress also triggers your body’s release of the hormone adrenaline, which increases your heart rate and blood pressure.
Similarly, depression has been identified as a risk factor for cardiovascular disease. People with depression may be less likely to manage cardiac risk factors, like high blood pressure, cholesterol and diabetes. They also may be more likely to smoke, drink alcohol or engage in other unhealthy habits, and less likely to exercise.
“Studies are finding more and more about the mind-body connection,” Brinker explains. How you perceive things greatly affects your body.”
Take steps to manage stress, and seek help if you experience signs of depression, such as feeling down, depressed or hopeless, or gaining little interest or pleasure in doing things.
Getting regular exercise on most days of the week can be a great stress reliever, and it also helps promote cardiovascular health. Also, Brinker recommends practicing mindfulness, a form of meditation that forces you to live in the present moment while tuning out negative thoughts and worries (see Action Points for a sample mindfulness exercise and other tips for managing stress and depression).
“The biggest challenge is to get people to let go of things, because we like to hang on to all of our problems and ruminate over them until we make it worse than what it is,” she says.
Your heart in winter
Concerns about your heart health continue beyond the holidays and throughout the winter. Studies have found higher rates of heart attack during wintertime, as the cold weather can strain your heart, especially when you’re walking through or shoveling heavy snow.
When your body senses cold weather, it preserves heat by constricting your arteries (and thus raising blood pressure) and increasing the heart’s workload, Pensock explains. Quick bursts of activity in the cold, such as shoveling snow after you’ve been sitting for hours, can significantly tax the heart and increase the risk of a heart attack, especially if you already have heart disease or cardiac risk factors.
“You have the worst of both situations: You’re increase blood pressure and increasing the heart’s workload, which is not the typical way we manage people with cardiovascular disease,” Pensock says. “You want to lower heart rate and lower blood pressure to make it easier for the heart to work. The cold weather certainly does the complete opposite of that.”
If you have to shovel snow, don’t overexert yourself. Take frequent breaks, and pay attention to how your body feels when you take those breaks. If you feel any chest pain, pain that radiates from the chest to the arms, back or jaw, or shortness of breath, stop what you’re doing.
Lift smaller amounts of snow or, if possible, simply push the snow out of the way to reduce the physical stress placed on your heart. Also dress in layers to keep warm, and strip down only when indoors, to avoid lowering your body temperature too rapidly (see Action Points for other tips).
Action points
• If you imbibe, limit your alcohol consumption to no more than two drinks per day for men and no more than one a day for women or anyone over age 65.
? If you’re succumbing to holiday stress, keep a journal to identify the stressors in your life, and confide in a friend or loved one who can offer an objective opinion about your concerns.
? If you feel anxious, go for a walk or take part in a relaxing hobby or exercise, such as tai chi.
? Stop or limit your intake of products containing caffeine (coffee, tea, chocolate) and nicotine, all of which can worsen anxiety.
• Don’t eat a heavy meal or drink alcohol before or after shoveling snow.
• If possible, use a snow blower instead of a shovel to clear your driveway and sidewalks of snow.
• If you have a medical condition or you don’t regularly exercise, consult your physician before exercising in cold weather. Or, purchase home exercise equipment or join a gym to stay active over the winter.
Breathe to beat stress
Try this simple diaphragmatic breathing technique to help ease stress:
• Find a comfortable position, either sitting or lying down.
• Try to clear your head.
• Close your eyes, take a breath, and focus your awareness on your breathing.
• Inhale for four seconds, starting at your belly and working up through your chest to your collar bone. Pause for a moment, and then exhale for eight seconds. If you feel dizzy, shorten your inhaling and exhaling, but make sure you exhale for twice as long as you inhale.
• Acknowledge any thoughts that enter your mind or any sensations in your body; gently let them go and return your focus to your breathing.
• Continue this process for as long as it takes for you to calm down and feel better.
Holiday eating strategies
Consider these tips to help you avoid overeating or eating too much of the wrong foods during the holidays:
• Eat more slowly. Slowly chew your food, and put down your fork after each bite.
• Drink a glass of water or two or eat a low-calorie snack before you have dinner, to help you fill up faster.
• Fill up first with fruits and vegetables. You’ll be less likely to stuff yourself with less healthful, higher-calorie foods.
• Follow the plating method. Fill half your plate with non-starchy vegetables (e.g. broccoli, cauliflower, leafy greens) and a quarter of the plate with a high-fiber starch, such as wild rice, whole-grain pasta or starchy vegetables (corn, peas or potatoes). Fill the rest of your plate with a lean protein (fish, skinless chicken or turkey).
• Use smaller plates and bowls for meals and snacks. Less space equals less food.
• Keep snacks and desserts in the cupboard, not within easy reach on the kitchen counter.
• Find a hobby that occupies the time you’d normally spend snacking.
• Break familiar patterns. For example, if you tend to eat snacks while sitting in a favorite chair, switch seats.
• Tighten your belt a notch to remind yourself not to overeat.
• Compensate for the extra calories you’ll take in at holiday parties. Cut back on your portions in the days before a big holiday meal or social function.