2019: Beware what the festive period could have brought!Dr Kunal Patel 03 Jan 2019
On Christmas Eve, I posted a link to a recent study that looked at cardiac health and risk. It particularly investigated how sports events, national holidays and Christmas could affect risk. We know many, including myself, do like to indulge a bit more than usual when the days get darker and people look toward Christmas and New Year. However, as it is now 2019 and as our bellies are larger, it is now time to reflect on some of this data that was produced.
The study was conducted by a Swedish team, hence Midsommar or the Midsummer celebrations were included. What was fascinating was that Christmas Eve, of all the days was the day of highest risk, with the Christmas and midsummer holidays overall, being associated with a higher risk of myocardial infarction (incidence rate ratio 1.15, 95% confidence interval 1.12 to 1.19, P<0.001, and 1.12, 1.07 to 1.18, P<0.001, respectively).
No surprise both involve drinking, celebrating and the occasional dance and we would casually think, this must be the reason. Yet, sports events and Easter had no significant link to heart attacks. Great news for all us sports fans out there, especially those I see devouring huge pies and pints of beer before, during and after football games. However, what could be the cause for Christmas, Midsummer and New year? The authors propose the acute experiences of anger, anxiety, sadness, grief, and stress around these periods increases the risk of myocardial infarction and thus possibly explains the higher risk, yet, this, of course, warrants further investigation. Interestingly, there is a 20% increase in risk on New Year’s Eve alone, and again the authors suggest this could be due to food and alcohol excesses, the cold temperatures or even sleep deprivation. Men were only at higher risk during midsummer, where it is suspected they drink more alcohol.
Nevertheless, these links and possible factors need to be investigated and are only suggestions at this time. However, what it does mean is that primary care services and cardiology outpatient services should observe those at risk more closely, particularly during but importantly before these periods during the year. The study emphasizes this by showing the association of higher risk at Christmas being more pronounced in people older than 75, those with known diabetes, and those with a history of coronary artery disease. Additionally, further education both at the public and health worker level around cardiac risk and non-communicable disease must be maintained and improved upon.
What it means for me is that I can still enjoy my visits to watch Arsenal but should probably be a bit more careful around New Year and Christmas, even if my risk factor profile is low!