Why Hypertension, Heart Attack, Stroke Risks are Higher in the Winter

By Beth Ann Mayer

  • Research and experts indicate that cold weather puts stress on the heart.
  • It can increase the risk of high blood pressure and even heart attacks.
  • Individuals at higher risk for cardiovascular disease in warm weather are more likely to have high blood pressure or heart failure when the temperatures dip.
  • It’s possible to reduce the risk of cold-related heart issues.

You may have heard that your mood can take a dip in the winter. Seasonal Affective Disorder (SAD), a major depressive disorder (MDD) that occurs around the same time each year, affects 0.5 to 2.4 of people in the U.S.

During these times, someone may feel like they have a broken heart.

But what about physical heart health?

“Cold weather can increase the risk of heart attack, worsening heart failure, or increased blood pressure,” says Dr. Bethany Doran, MPH, a board certified cardiologist and founder of Enabled Healthcare.

Several studies, including a small 2023 studyTrusted Source of 34 healthy participants, have found that cold stress can trigger an increase in a person’s blood pressure as well as raise a number of additional heart health risks.

Why does the cold increase heart health risks?

“Cold weather can put additional stress on the body and especially the heart,” says Dr. John A. Osborne, PhD, an American Heart AssociationTrusted Source volunteer.

The stress response is physiological. In the small 2023 studyTrusted Source, researchers noted that the increase in blood pressure was mostly due to a change in total peripheral resistance (force used for blood circulation by the body’s vascular system).

Researchers suggested this change was mainly because of cutaneous vasoconstriction, which reduces the skin’s blood flow and temperature, with face cooling.

“In response to cold exposure, your blood vessels constrict to prevent heat loss, and this puts added stress on the heart,” says Dr. Holly Andersen, a cardiologist at NewYork-Presbyterian and Weill Cornell Medicine.

Though physical activity can lower the risk of high blood pressure and other cardiovascular issues, a sudden spike in it can also take a toll on your heart.

“Patients are also more likely to engage in activity that is more strenuous than they are used to [in the winter],” says Doran. “For example, someone who is usually sedentary [may] begin to shovel snow. Individuals who strain their heart more than usual with heavy activity can have worsening angina and heart failure symptoms.”

As a result of all of this stress, your blood pressure may rise.

“This…[puts] additional stress on the heart and can cause chest pain and angina, or chest pain due to inadequate blood flow to the heart for the work it needs to do,” Osborne says. “In the most extreme circumstances, this can even cause a heart attack, especially in patients with blocked arteries.”

People with pre-existing cardiovascular conditions are at a greater risk for increased blood pressure or other heart issues in the cold.

“These risks are amplified in those individuals who already have some degree of blockage in the arteries that supply the heart,” Osborne says. “When the heart’s workload goes up, the heart muscle may not receive enough blood flow, and chest pain, or angina, may result. If this process continues, it may even cause damage to the heart muscle.”

The risk of stroke is also a concern.

2018 study suggested that the risk of ischemic stroke, which happens when a blood clot reduces or blocks blood flow to the brain, was higher in patients with atrial fibrillation (irregular heartbeats) was highest in the winter.

2016 study indicated a link between lower average temperatures and stroke hospitalizations.

A large 2019 study of 56,000 stroke deaths in Sao Paolo, Brazil, suggested that the risk of stroke death rose as temperatures fell.

How to reduce your heart health risks in cold weather

Having high blood pressure or being at a higher risk for a heart attack doesn’t mean you have to hibernate inside all winter. Fear of heart attack, stroke, or high blood pressure from the cold (even if you don’t have a pre-existing heart condition) shouldn’t keep you indoors either.

“Most people can venture outside as long as appropriate precautions and planning are taken,” Osborne says.

Andersen suggests taking a few of the following simple precautions.

Warm up

You want to ease into physical activity, including snow shoveling or excise, instead of going into it cold — no pun intended — especially when the temperature is low.

“Warm up with stretching and light activity,” Andersen says.

Bundle up

“Layering clothes underneath a windproof and waterproof outer shell helps maintain body heat,” Andersen says. “Wear a hat, as a lot of heat can get lost from your head.”

She also suggests wearing a scarf that covers your mouth and nose.

Take a break

Rome wasn’t built in a day. It’s OK if you’re not dug out in an hour.

“You should take frequent breaks while shoveling to give your muscles, especially your heart muscle, a chance to relax,” Andersen says.

Buddy up

If a friend, particularly one under 50 without underlying heart disease, owes you a favor, a post-snow clean-up may be the time to phone it in.

“You may also consider [shoveling] with a friend to make the workload lighter and ensure that you are not alone in the event of an emergency,” Andersen says.

How to exercise safely in the cold

The American Heart AssociationTrusted Source recommends getting at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity each week.

It’s entirely possible to keep up with those guidelines during the cold months, even if you don’t want to go outside.

“Exercise your heart gently if possible,” Doran says. “Yoga [or] swimming indoors at a local gym, if road conditions are ok, [will help].”

If the road conditions aren’t safe for driving — or you simply don’t want to shell out for a gym membership for a few months — get moving in the comfort of your own home.

But you can also get exercise for the same price as running around the block (free).

“There are many videos that will give you a great workout,” Andersen says. “You can simply play some music and dance to keep active. Exercises like jumping, squats, walking up and down stairs, and lunges can help promote heart health indoors when it is too cold to be active outside.”

But avoid suddenly going from Netflix marathoner to burpee machine in 24 hours, even if you’re snowed in or avoiding an Arctic blast.

“If you don’t exercise regularly, start slow and take baby steps,” Osborne says.

Over-exertion, even inside, can up the risk of a heart issue.

“If you are over the age of 50, overweight…or have suffered a heart attack, you should consult a doctor before shoveling snow or starting any exercise routine,” Andersen says.

Source: Healthline