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Dr. Campbell: Cold weather and heart health

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RALEIGH, N.C. -

We're in the middle of winter right now and although we haven't seen much snow, we've certainly experienced cold temperatures. That brings a whole different set of problems than snow.

When temperatures drop, the heart has to work harder to help maintain your body's core temperature. In fact, according to the American Heart Association, heart failure is the cause of most deaths from hypothermia- a dangerous condition in which the body's temperature falls below normal.  

Cold weather increases heart attack risks—particularly in those with underlying heart disease who begin to exert themselves in the cold –activities such as shoveling snow, etc.

When we are exposed to extreme cold we are at risk for hypothermia as well as other cardiovascular issues. When the temperature drops, the heart must work harder to maintain a core body temperature. If you have underlying heart disease, the cold may be the additional stressor that ultimately causes you to have a heart attack.

Hypothermia means the body temperature has fallen below 95 degrees Fahrenheit. This occurs when your body can't produce enough energy to keep the internal body temperature warm enough. It can kill you. Heart failure causes most deaths in hypothermia. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.

When you are in the extreme cold, your body must work harder to maintain a safe core temperature. Your blood vessels constrict and your blood pressure increases. When you begin to exert yourself in the cold, your heart rate increases in order to keep up with the oxygen demands of your body . 

Some studies have shown that clotting factor levels and platelet activities (they become more sticky) are increased during exposure to extreme cold—this all can contribute to the formation of a clot in the heart arteries that ultimately causes a heart attack.  

As for hypothermia, it can come on quickly. Symptoms include exhaustion or drowsiness, shivering, confusion, memory loss, fumbling hands and slurred speech.

Here are some tips for staying safe when out in the bitter cold:

Dress in layers. Use a base layer and build from there. Warm up before exerting yourself. Stretch, take your time getting going. Take frequent breaks. Make sure that others are aware of what you are doing and know where your are so that they can check on you frequently.

You should also avoid alcohol as alcohol can mask the signs of a heart attack and can give you a false sense of warmth even when you are at risk for hypothermia. Alcohol also causes blood vessels in the skin to dilate which can result in more heat loss.

Also, don't eat a big meal or drink caffeine prior to going out for activity in the cold—big meals divert blood flow to the gut from the heart and caffeine is a stimulant that can increase blood pressure and put more stress on the heart.

So, what is the bottom line?

Use common sense, dress warmly and  don't go outside in the cold unless you have to. 

If you do have to work, make sure that you take frequent breaks and work with a buddy. If you have underlying heart disease—do not overdo it in the show and cold. The very young, the very old and those with heart disease must be very careful to limit exposure during very cold temperatures.

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