The Holiday Heart Attack Phenomenon and How to Avoid It

As a cardiologist, one of the phenomena that concerns me the most around the holiday season is the rise in cardiovascular-based mortality, commonly referred to as the “Christmas Holiday Effect.” This trend has been observed in the United States and worldwide, including Norway, Sweden, Canada, and Denmark. Despite the festive spirit that surrounds this time of year, research consistently shows that cardiovascular deaths spike between late December and early January. 

The numbers are striking. A 2016 study published in the Journal of the American Heart Association found that cardiac events increased by 4.2% between December 25 and January 7. One of the earliest hypotheses was that the colder weather experienced in the northern hemisphere during this period might be a major contributor. However, researchers found the same effect in New Zealand—a country experiencing summer during this time. This indicates that other factors beyond climate are at play. 

Why does the holiday heart attack phenomenon happen? 

The cause of the Christmas Holiday Effect is a mystery, but there are several contributing factors that I often see in my practice: 

1. Increased stress levels: The holidays bring heightened stress for many people. Financial pressures, travel plans, and family dynamics often lead to emotional strain, which can elevate blood pressure and heart rate—key risk factors for heart attacks and other cardiovascular events.
2. Changes in diet and alcohol intake: Holiday celebrations typically revolve around rich, indulgent meals, often high in salt, carbs, and unhealthy fats. This shift in diet, combined with increased alcohol consumption, puts additional strain on the cardiovascular system. Research conducted in Denmark in 2018 even showed a significant spike in cholesterol levels after Christmas festivities.
3. Disruption in routine: Many of my patients find their usual exercise routines disrupted during the holidays. The result is often less physical activity due to travel, social events, or colder weather. This often leads to weight gain and a rise in cardiovascular risk factors like high cholesterol and hypertension.
4. Delays in seeking medical attention: Another troubling aspect is the delay in seeking care. People are less likely to visit the hospital or call their doctor during the holidays because they don’t want to disrupt family plans or assume their symptoms are stress-related and temporary. This delay can be fatal when dealing with heart conditions, where early intervention is critical.

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How to protect your heart during the holidays 

While these trends are concerning, there are steps you can take to protect yourself and your loved ones during this festive season. Here are a few recommendations: 

• Watch your diet: While it’s tempting to indulge in every holiday treat, try to moderate your intake of salty, fatty, and sugary foods. Keep portions reasonable, and if you know you’re attending several parties or family gatherings, aim to balance rich meals with lighter, heart-healthy options. 
• Limit alcohol consumption: Excessive alcohol intake can lead to dehydration, increased blood pressure, and irregular heart rhythms, all of which strain your cardiovascular system. Stick to moderation. This typically means no more than one drink per day for women and two for men. 
• Stay physically active: It’s easy to let exercise slide during the holidays but staying active is essential for heart health. Even if your usual gym routine is interrupted, incorporate brisk walks, stretching, or light workouts into your daily schedule. 
• Manage stress: Finding ways to reduce stress can go a long way in protecting your heart. Whether through mindfulness practices, deep breathing, or simply carving out quiet time for yourself, prioritizing mental health is critical. 
• Don’t ignore symptoms: If you experience chest pain, shortness of breath, or unexplained fatigue, don’t delay seeking medical attention. It’s better to be cautious and have your symptoms checked than to ignore a potentially serious condition. 

The Christmas Holiday Effect is a stark reminder that the holiday season, despite its joy and celebration, can pose severe risks to our health. As a cardiologist, I advise approaching this time of year with mindfulness—enjoy the festivities but take care of your heart. Pay attention to your diet, stay active, manage stress, seek timely medical care, and ensure you’re around to enjoy many more holidays. 

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Dr. Carl M. Fier is board-certified in interventional cardiology and cardiovascular disease. He is in practice at Elliot Cardiovascular.  

Elliot Cardiovascular is a trusted team of board-certified cardiologists, interventional cardiologists, and electrophysiologists – working with our highly skilled team of nurse practitioners, nurses, technicians, and staff – who have deep experience caring for the greater Manchester community for many years. As part of Elliot Health System, a non-profit healthcare system rooted in our community since 1890, cardiovascular patients are connected to a broad array of high-quality healthcare services for seamless, integrated care that is proven right here in Manchester, New Hampshire.