The joy of the winter holiday season is often marred for many as research shows that more people die from heart attacks during the last week of December than at any other time of the year. The American Heart Association (AHA) said being aware of this annual phenomenon and taking a few important, heart-healthy steps may save lives.

“The holidays are a busy, often stressful, time for many of us. Routines are disrupted; we may tend to eat and drink more and exercise and relax less. We’re getting too little sleep and experiencing too much stress. We also may not be listening to our bodies or paying attention to warning signs, thinking a trip to the doctor can wait until after the new year,” said AHA Chief Clinical Science Officer Mitchell S.V. Elkind, M.D., M.S., FAHA.

“While we don’t know exactly why there are more deadly heart attacks during this time of year, it’s important to be aware that all of these factors can be snowballing contributors to increasing the risk for a deadly cardiac event.”

Scientific research finds an uptick in cardiac events during the winter holiday season. A study published in Circulation, the scientific journal of the AHA, reported that more cardiac deaths occur on Dec. 25 than on any other day of the year; the second-largest number of cardiac deaths occurs on Dec. 26 and the third-largest number occurs on Jan. 1.

Winter weather has been noted as a trigger for increased heart attack risk due to restricted blood flow through constricted vessels caused by cold temperatures. However, another study published in Circulation found that even in the mild climate of Los Angeles County, about a third more heart attack deaths occur in December and January than in June through September.

These findings were supported by a study published in the Journal of the American Heart Association by researchers in New Zealand, where the December holidays fall during that area’s summer season.

“Research also shows that the biggest increases in these holiday heart attack deaths are among people who are not in a hospital. This highlights the importance of recognizing symptoms and seeking immediate medical care. Don’t ignore heart attack warning signs because you don’t want to spoil the holidays, the consequences could be much worse,” Elkind said. “It also calls attention to the need for increased awareness of knowing how to perform hands-only CPR. You could be out holiday shopping, enjoying an office party or spending time at a family gathering and witness someone having a heart attack and going into cardiac arrest.

“Starting CPR immediately and calling 9-1-1 could be the difference in life or death in those situations. Hands-only CPR is something nearly everyone can learn and do.”

Elkind notes that while it’s important to live heart-healthy all year long, there are a few tips you should gift yourself and your loved ones as we approach the holiday season:

— Know symptoms and take action: heart attack signs vary in men and women and it’s important to recognize them early and call 9-1-1 for help. The sooner medical treatment begins, the better the chances of survival and preventing heart damage.

— Celebrate in moderation: eating healthfully during the holidays doesn’t have to mean depriving yourself, there are still ways to eat smart. Look for small, healthy changes and swaps you can make so you continue to feel your best while eating and drinking in moderation, and don’t forget to watch your salt intake.

— Plan for goodwill toward yourself: make time to take care of yourself during the busy holiday. Reduce stress from family interactions, strained finances, hectic schedules and other stressors prevalent this time of year, including traveling.

— Keep moving: the AHA recommends at least 150 minutes of physical activity per week and this number usually drops during the hustle and bustle of the holidays. Get creative with ways to stay active, even if it’s going for a family walk or another fun activity you can do with your loved ones.

— Stick to your meds: busy holidays can cause you to skip medications, forgetting them when away from home or not getting refills in a timely manner.

The AHA has more on ways to live heart-healthy during the holidays and all year long at heart.org.