The risk of having a heart attack is highest around 10pm. on Christmas Eve, probably due to the highest emotional stress, according to a new study in the Christmas issue of the BMJ.
Researchers in Sweden analyzed the exact timing of 283,014 heart attacks reported to the Swedish Register of Coronary Care Units over a 16-year period from 1998 to 2013. In addition to the weeks leading up to the holidays, Christmas Eve increased by 15 percent, adding to the risk of heart attacks. A similar increase – 12 percent – was recorded for Midsummer, a major holiday in Sweden.
The authors explain feelings of anger, anxiety, sadness. Earlier studies found that grief and stress increase the risk of heart attack. The current study found that those over 75 years of age and people with diabetes and coronary artery disease were the most susceptible to short-term triggers in the past.
"Holiday stress, both emotional and financial, can lead to norepinephrine and epinephrine spikes that can negatively impact the cardiovascular system," said Drs. Kaitlyn Ibrahim, a cardiology specialist in cardiology interview with ABC News.
In addition, people will often overexert themselves at this time of year – shoveling snow, dancing at family gatherings – and indulging in foods and drinks that they would not normally consume, such as excessive alcohol, caffeine, and high-fat foods, Ibrahim explained.
Apart from heart attacks, Ibrahim said the holidays could also be associated with a so-called "holiday heart syndrome", a condition that causes both adults and adults with heart disease in emergency departments across the country for abnormal heart rhythms after overeating excessive consumption of alcohol.
"We have no routine and pattern during the holidays, and it's especially important to stick to a healthy diet and reduce alcohol intake, especially if you have heart disease," Ibrahim said.
In Dr. med. Barbara Robles, psychiatrist at UT Health San Antonio's Long School of Medicine, said healthy eating habits mean that self-care is more important than ever during the holiday season.
"Take a walk or get some fresh air and know your limits. Remove yourself from situations and conversations that you know are likely to cause anger, anxiety, or stress, "Robles said in an interview with ABC News.
For people with known heart disease, Robles also recommends not discussing any major topics during the holidays when the emotions are already high.
"Remember to offer consolation to those who are at high risk for stress and emotional distress. Think of those who lost a loved one during the holidays. Give them a big hug, a tapping on the shoulder, a few warm words and a listening ear, "said Robles.
Edith Bracho-Sanchez is a Board-Certified Pediatrician, Stanford Global Health and Journalism Fellow and a member of the medical department at ABC News.