Cold weather is the most common health risk you encounter in the winter, but people often view the danger in the extreme, as hypothermia or frostbite. However, the drop in temperature can impact your health, specifically your heart, in ways you may not expect.

“Heart attacks are more common in winter,” Patricia Vassallo, MD, a cardiologist at Northwestern Medicine, explains. “There are several theories why heart attacks increase in winter.”

• The cold causes blood vessels to contract. This can raise your blood pressure and increase your risk of heart attack and stroke.
• Angina, or chest pain due to coronary heart disease, can also worsen in winter when coronary arteries constrict in the cold.
• In the cold, your heart works extra hard to maintain a healthy body temperature. Winter wind can make this more difficult because it causes your body to lose heat more quickly. If your body temperature drops below 95 degrees, hypothermia can damage your heart muscle.

• People often find themselves doing more strenuous physical activity than they are used to, such as shoveling or walking through heavy snow.

• Practicing self-care around the holidays can help you manage your stress and minimize your risk.

Whether you’re impacted by all or just one of these factors, temperature, physical activity and emotional stress can contribute to a higher risk of a heart attack during the winter. However, you can take precautions by following a few tips from Dr. Vassallo:

• Dress for the weather. Wear layers, especially hats, gloves and heavy socks.

• Come inside often. Give yourself breaks to warm up if you’re spending time outside in the cold.
• Avoid excess alcohol. Alcohol can make you feel warmer than you really are which and can be particularly dangerous when you’re outside in the cold.
• Do not shovel for long periods. Ask your doctor if it’s safe for you to shovel at all.
• Wash your hands frequently. Respiratory infections can increase the risk of heart attack.
• Get help. If you have new symptoms of a heart condition, don’t wait to get help, even if it’s a holiday.

• Acute (severe) chest pain is the most common warning sign of heart attacks.
• Other heart attack symptoms include:
• Nausea or vomiting
• Dizziness
• Shortness of breath
• Pain, numbness or tingling in your jaw, back, neck or shoulders
• Cold sweat
• Sensation of heartburn
• Sudden fatigue

These tips are always in season:

• Stick to a heart-healthy diet.
• Be sure to exercise regularly.
• Know your blood pressure, cholesterol and blood sugar numbers, and work with your physician to keep them in normal range.
• Take steps to manage stress.
• Listen to your body and if you feel different, see your physician.