Emergency cases for heart attacks, high blood pressure, brain strokes spiked in Delhi NCR: Top Experts

By Shalini Bhardwaj
New Delhi [India], January 10 : Amid extreme cold, a number of people are battling heart attacks and brain strokes related problems during this year's winters, as per the experts.
It is worsening when people go out for walks during the early hours and those who are already cardiac patients, the top experts claimed.
Dr Nitish Naik, Cardiology professor at AIIMS Delhi said, "This is happening because of a30 well-known phenomenon where, in cold weather, the number of heart attacks increases. Right now, this annual phenomenon has spiked because of the rapid increase in the cold. So, people who are unaware may expose to the weather unnecessarily and may develop heart conditions. So, the cardiac patients, who have undergone bypass surgery, develop additional strain on the heart because of the severe cold weather."
"Cold weather thickens the blood, which leads to the blood vessels becoming a little narrower, further leading to a spike in blood pressure. All that adds to the strain on the heart is a very well-known phenomenon. People accustomed to doing morning walks also add to the severity of the condition. So in that condition, people can develop acute heart problems as well," he added.
The HoD of Cardiology of a hospital in Faridabad said that emergencies of heart problems and blood pressure-related complications increase in this extreme cold weather.
"Cold weather is known to increase admissions to emergency because of heart problems. These include more heart attacks, more admissions for heart failure, and more blood pressure-related complications. One difference between winter and summer is that cold weather raises blood pressure. Besides that, heart work increases with cold weather, and infections, especially respiratory infections, also increase, which precipitate heart attacks in vulnerable populations. Increasing pollution is also contributing to this increasing problem amongst people who have pre-existing heart diseases," said Dr Vivek Chaturvedi, HoD Cardiology, Amrita Hospital.
Addressing the severity of the condition, Nishith Chandra, Principal Director of Interventional Cardiology, Fortis Escorts said that low temperature leads to tightening of blood vessels which aggravates heart attack-related issues.
"The low temperature leads to tightening or constriction of blood vessels. This reduces blood supply to the heart, which can aggravate angina and block arteries, leading to heart attacks. This also leads to a spike in blood pressure and patients on BP medicines often need an increase in the dose or addition of a new medicine. The oxygen demand of the heart increases because the heart has to work harder to keep the body warm," Dr Chandra said.
"The early morning surge in blood pressure is an important reason for heart attacks being more common at this time. During winters, because of fewer daylight hours, people often have a tendency to finish outdoor work earlier in the day. The combination of cold temperature and hard work leads to higher blood pressure," he added.
He also said that shifting of activities to morning hours leads to a change in the circadian rhythm, leading to an increase in heart rate, BP and cortisol levels, which eventually results in heart attack and brain stroke.
Commenting on the preventive strategies he said, "Doing exercise regularly is one of the most important measures to keep the heart healthy. Exercising slowly and not suddenly should be the key. If going for a more strenuous exercise, do it for short periods like 10 to 15 minutes at a time. Let the body recuperate in between. Never overdo especially if one is not a regular exercise person."
"To regulate your exercise, a scientific way is to have an app on the mobile phone which counts the steps. Approximately 8,000 steps per day at least 5 times a week should be the goal," he added.
He advised not to smoke or have tea or coffee in between the spells of exercise as it may lead to increase in nicotine, which increases heart rate and BP.
"Do not eat a heavy meal just before or after exercise. Outdoor exercise should be done after wearing warm attire and not in freezing cold," he further said.
He also advised keeping oneself warm and wearing multiple layers of clothes in order to form protective insulation.
"Keeping yourself warm is again very useful. Multiple layers of clothes are important. Each layer traps air, forming a protective insulation. Our traditional phiran is a good way of protection with a few layers of warm clothes underneath. Also, wear a cap or a head scarf since heat can be lost through head. Ears are especially prone to frostbite. Keep hands and feet warm, too, as they tend to lose heat rapidly. Use gloves and warm socks," he advised.
Commenting on the increase in stroke patients, Dr Sanjay Pandey, HoD Neurology, said that most of these patients have intracranial haemorrhage which is caused due to spike in BP.
"As winter kicks in, we see a greater number of stroke patients, and what is very interesting to see is that most of these patients are having an intracranial haemorrhage like they have a hematoma in the brain. The reason behind that is that their blood pressure goes up because of the winter. There is more sympathetic activity, which leads to increased blood pressure, which causes a sudden rupture of the blood vessels inside the brain, and because of that, intracranial hematoma happens," said Dr Sanjay Pandey, Head, the Department of Neurology, Amrita Hospital, Faridabad.
Explaining the reason behind strokes during winters, Dr Pandey said that most patients with hypertension do not take medications which leads to sudden rise in BP and further rupture of the blood vessels, which eventually leads to clot formation in the brain.
"In the Indian context, what is most important is that many patients, even if they know that they have hypertension, don't take medications. They take alternative medicines or something else, or stop the medications on their own. During winter, what happens is that they have a sudden rise in blood pressure that causes rupture of the blood vessels or even the incidence of ischemic stroke increases. What happens is that the viscosity of the blood increases and the blood flow becomes a little sluggish in the coronary circulation, which supplies blood to the heart, and in the cerebral circulation, which supplies blood to the brain. And because of this sluggish circulation, there is a tendency to have clot formation in the brain." Dr Pandey said.