The holiday season’s been called heartwarming, with the many opportunities to gather with family and friends.

But it’s not necessarily heart-friendly.

“The holidays are a risk factor for death,” the journal Circulation reported clear back in December 2004. That study found that heart-related deaths peak in December and January, with particular spikes at Christmas and New Year’s. It noted as well that those days see spikes for noncardiac death, too.

According to The Wall Street Journal, “Heart-related medical problems increase during the winter probably in part because respiratory viruses and cold weather cause some constriction of the blood vessels, which may put more pressure on the heart. Respiratory viruses, including COVID-19 and flu, can affect breathing and oxygen levels and lead to inflammation. And the holidays add extra disruptions to routines, diet and sleep that can heighten the risks.”

But it’s not just about cold weather and related circulating ills.

The article said cardiologists also believe that during the holidays, people are less likely to go to the doctor and more apt to skip medications accidentally. Experts also told the Journal that stress — think “travel, family gatherings, less sleep and busy schedules” — can create heart issues.

And then there’s food and alcohol. A study this year in the journal Nature Cardiovascular Research says alcohol “has emerged as an important risk factor for atrial fibrillation,” which is marked by a sometimes deadly arrhythmia. Additionally, holiday meals are often replete with fat, salt and other indulgences that aren’t necessarily good for the heart. Too much salt can trigger excessive fluid buildup that makes it hard for that vital pumping muscle to do its job.

But there’s more, often related to winter activities like the exertion involved in shoveling that fresh heap of snow. The HealthPartners Blog said that “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.”

The article cites narrowed blood vessels, higher blood pressure, a faster pulse and a tendency of some to become couch potatoes when it gets cold outside. And it, too, says shoveling snow can be heart-risky. “Snow shoveling is the responsibility of everyday people who aren’t used to lifting and throwing hundreds of pounds around,” it says. “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.”

The Centers for Disease Control and Prevention says everyone should know the symptoms of a heart attack. If you have symptoms, call 911 immediately.

Warning signs include:

  • Chest pain or discomfort.
  • Feeling weak or faint.
  • Pain or discomfort in the jaw, neck or back or in one or both arms or shoulders.
  • Shortness of breath.
  • Less common signs can include “unusual or unexplained tiredness and nausea or vomiting.”

Symptoms of heart disease for women are more likely to include pain in the jaw, neck, back and shoulder than chest pain. And nausea or vomiting can be a telling sign, as well.