Mental health and financial challenges swell around Christmas, but does the stress and merriment of the season take a toll on one’s physical body? Unfortunately, the answer is yes, according to one of the first studies that looked at heart-attack registry data on a large scale. The research authors published in BMJ in December 2018 explored whether time factors, such as national holidays, major sports events, the hour of the day, or the day of the week, could trigger a heart attack.

What Did the Study Find?

The researchers analyzed data for 283,014 heart attacks reported to the Swedish coronary care unit registry from 1998 to 2013. They found that Christmas and Midsummer (in June) were associated with a higher risk of heart attack, 15 and 12%, respectively, compared to the control period.

In particular, Christmas Eve had a 37% increased risk of heart attack, peaking at 10 PM. Researchers suggest the reason is that Swedes do most of their celebrating on the 24th, so that’s when emotions will reach their peak. In addition, the data showed that people over 75 years old and/or with diabetes and existing heart disease had the highest risk.

Another stressful time of day, Mondays at 8 AM, posed a higher risk than New Year’s Day. On the other hand, New Year’s Eve, Easter, and sporting events did not appear to increase heart attack risk.

What Does the Study Mean for Providers?

The authors recognize that the study is observational, and therefore they can draw no conclusions about cause and effect. However, they note that emotions like anger, anxiety, sadness, grief, and stress have increased the risk of a heart attack. In addition, changes in lifestyle, such as more eating and drinking and less exercise, common around Christmas, can also contribute. One of the biggest takeaways from the research is that providers should raise awareness of the risks of Christmas and New Year’s to older folks and those with preexisting conditions.

The Centers for Disease Control and Prevention also offer these tips to stay healthy over the holidays:

• Wash your hands often. To prevent flu, soap and water are more effective than hand sanitizer. And don’t forget to cover your cough.

• Dress warmly in several layers, and stay dry. This is especially important for infants and older people.

• Manage stress and try to get enough sleep, and ask for help when you need it.

• Travel safely, especially if you’re driving—no drinking and driving, and follow-up car seat and seatbelt protocols.

• Get vaccinated. Providers should ensure that patients are up to date with vaccinations during visits around the holiday season.

• Prevent child injuries by keeping an eye on your kids and dangerous foods and items out of reach. Parents should know how to provide early treatment for a choking child.

• Prep food safely and be aware of contamination. Wash hands and surfaces often, and cook food to the proper temperature.

• Stay active and shoot for 150 minutes per week of moderate-intensity aerobic activity.