It seems like it was just Halloween. Then suddenly, you’re feeling glittering snowflakes on your face, getting invites to holiday parties and hearing the joyful cries of children swooshing down sledding hills. All signs point to winter. But did you know that winter can also bring a higher risk of heart trouble?

Studies have shown that Americans can be up to 30% more likely to have a heart attack in the coldest winter months, compared to warmer months throughout the year. Even people with good overall health are at risk.

Read on to learn why winter is often called heart attack season and what you can do to reduce your risks.

How cold weather affects the heart and circulatory system

The cold weather affects your heart in a few different ways. Your circulatory system undergoes physical changes in response to the cold. Plus, you might be less active in the winter, choosing to stay inside to relax and keep warm. So you may not be exercising your body and heart as much.

Here’s what can happen to your heart during cold winter months:

Narrowed blood vessels

Usually when you exercise or are physically active, your blood vessels open to give your body the extra oxygen it needs for the work it’s doing. But in the cold, blood vessels shrink, making it harder for blood to get to your heart.

This is especially concerning if you already have plaque buildup in your blood vessels. If the cold shrinks vessels that are already partially blocked by plaque buildup, it’s more likely that blood won’t be able to get to your heart and the rest of your body. This can lead to a heart attack.

There’s also research that suggests that going between the warm inside and freezing outside can make that plaque buildup bigger and less stable – which can result in an even greater risk of heart attacks.

Increased blood pressure

Blood pressure is the amount of pressure within your arteries. Because cold narrows the blood vessels, it means that your heart must work harder to get blood where it needs to go. This means that cold weather can contribute to increased blood pressure.

If your blood pressure is typically normal, a temporary increase in blood pressure is probably not a big deal. But if you always have high blood pressure numbers, it can lead to sudden blocked arteries, increasing the risk of heart attack and stroke.

Increased pulse rate

Have you noticed that your heart beats faster in cold weather? The cold can affect your heart rate because when the temperature drops, your heart must work harder to keep your body warm – this causes your heart rate to increase. While a fast heart rate isn’t a sign of heart attack or heart disease, it can be a signal that your heart is working too hard and you need a break.

Winter lifestyle choices that increase your risk of heart disease

It’s probably no surprise that most people would rather snuggle under a blanket on the couch instead of going on a long winter walk when it’s 5 degrees below zero. But we’re also more likely to eat fatty comfort food and drink more alcohol – oh, those holiday cocktails. And if moderation goes out the window, these choices aren’t exactly great for a heart-healthy diet.

The combination of these behaviors can lead to unhealthy changes in weight, cholesterol and blood pressure – and increase your risk for heart disease and heart attacks.

Cold weather and winter activities: When they’re a recipe for heart attack risk

Since the cardiovascular system doesn’t work as well in cold temperatures, does that mean you should only exercise inside during the winter?

No. It just means that you should pay attention to your body when you’re skiing, snowshoeing, sledding, skating or doing other activities that put additional strain on your heart. This is especially true when it comes to snow shoveling, an activity that’s linked to many winter heart attacks.

How shoveling snow can increase heart attack risk

Why is snow shoveling dangerous for your heart? Well, it’s enough of a workout that people should practically train for it. But in most cases, the people who are tossing shovels of snow aren’t on their way to the next Olympics.

Instead, snow shoveling is the responsibility of everyday people who aren’t used to lifting and throwing hundreds of pounds around. This alone makes shoveling a big challenge for most hearts. But because of the cold weather, the reduced blood flow makes it even more difficult for your heart to pump the blood throughout your body. And if your heart can’t get enough oxygen and nutrient-rich blood, your risk of heart attack goes up.

So, you’ll want to be careful when you’re off to shovel snow, especially if you have heart disease or any of the top risk factors for heart attacks – high cholesterol, high blood pressure and smoking. These risk factors are more common than you think. According to the Centers for Disease Control and Prevention, about half of Americans have one or more of the top risk factors for heart attack.

How to reduce the risk of heart attacks in the winter

Of course, we know your sidewalk isn’t going to shovel itself. And, you want to get the most out of your season pass at Lutsen Mountains ski resort, right? So here are some tips on how to stay active and healthy during the cold weather to prevent heart attacks:

• Dress in layers – If you go outdoors, dress for the weather and the activity you’re doing. Dressing in layers allows you to remove layers as you increase your level of activity. You want to stay warm, but you also don’t want to overheat. If you feel like you’re sweating, it’s a good idea to remove a layer and take a break to cool down.
• Modify your shoveling routine – Consider investing in a snow blower, especially if you have a long driveway. But if you need to shovel, get out before the snow has a chance to pile up. Then do it slowly, in short sessions.
• Give yourself a pass – If possible, hire a neighborhood kid. Offloading the responsibility is a particularly good idea if you’ve already had a heart attack, have heart disease or aren’t especially active throughout the year.
• Take water breaks – Take frequent breaks when you are exercising and stay hydrated. Dehydration makes it harder for the body to stay warm, which also makes it easier for blood to clot.
• Ease into outdoor exercising – Even if you’re in shape, start slowly when exercising in winter weather so your body can adjust to operating in the cold. Try some light exercise once you’re outside such as stretches or running in place. If you don’t want to bundle up for an outdoor walk, stroll around the mall or join a gym.
• Take special care if you have a known heart condition – The truth is that cold weather and heart conditions aren’t a good combination. If you’ve already had a heart attack or have heart disease, you may want to take it easy. Working with a doctor can help you gain confidence when it comes to exercise for heart health and help you prepare for winter.
• Limit caffeine and alcohol – These drinks increase blood pressure. So, pay attention to how much you drink before heading outdoors.
• Quit smoking or vaping – Tobacco products can increase blood pressure and cause plaque buildup. Quitting is one of the best things you can do for your heart.
• Eat a heart-healthy diet – Continue to watch what you eat and drink, focusing on foods for good cholesterol levels and foods for lower blood pressure.
• Keep up on routine preventive care – From flu shots to annual checkups, staying up to date on preventive care helps keep you healthier and can help catch potential issues earlier, when they’re easier to treat. Plus, those appointments are a great opportunity to ask questions like, should you take baby aspirin for your heart?

And one last thing: Know the signs of heart trouble

So, what are the signs that your heart is having trouble keeping up and you need to slow down – and possibly get help?

Whether you just finished shoveling snow or are lounging and reading a book, the most common warning sign of heart attack and cardiovascular problems is chest pain. Chest pain is often described as central chest tightness, heaviness, burning or heartburn, which may extend to the jaw, neck, arms, back of the chest or upper central stomach area. Shortness of breath, excessive sweating, dizziness or lightheadedness, and nausea are other common symptoms.

If you are outside in the cold shoveling or participating in any other physical activity, stop and take a break immediately if you are experiencing any of the above symptoms. However, it’s best to take a break even sooner, once you notice your heart beating faster than usual.

What to do If you think you’re having a heart attack:

• Call 911 right away
• Chew one adult-strength (or 2-4 low-dose) aspirin – this will help keep your blood from clotting
• Stay on the phone with the emergency operator while waiting for the ambulance. Do not try to drive yourself to the hospital