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Any list of real risks of heart attack, high cholesterol does not rank very high. In fact, completely unrelated factors are more likely to trigger this life-changing, sometimes life-ending event.

High Cholesterol Is Not Highest on the List

Recently the news services have buzzed with the story of the man in America who recently consumed his 25,000-th Big Mac. Many commentators expressed amazement that he had normal cholesterol and no heart disease, perhaps unaware that the human body itself makes nearly 90% of the cholesterol in circulation in the bloodstream.
Any list of real risks of heart attack, high cholesterol does not rank very high. In fact, completely unrelated factors are more likely to trigger this life-changing, sometimes life-ending event. Here are the top 10 heart attack risks.

Monday mornings

In Europe, a study published in the American Journal of Emergency Medicine tells us, heart attacks are least common on Sunday and most common on Monday mornings. However, a study at the Massachusetts General Hospital, affiliated with the Harvard University School of Medicine, found that those who are admitted to the ER for heart attacks on the weekend are more than twice as likely to die, because the regular staff is less likely to be available.

Snow days

A study at the University of Virginia at Charlottesville found that ER admissions for heart attacks were highest on snowy winter days, especially if the atmospheric pressure was also low. In fact, 25% of all admissions for the entire year were associated with shoveling snow. Since residents of Virginia deal with snow less often than residents of locations further north, they may experience greater stress finding shovels, starting snow blowers, or lifting wet, heavy snow.

Thanksgiving, Christmas, and holiday dinners

In the USA, Thanksgiving dinner is a time most people eat two, three, four or more times their regular amount of food. Most American hospitals see a temporary upswing in admissions for heart attacks the next day. Similar trends are found for Christmas in Europe and Eid in Muslim countries. When people overeat, heart attacks are more likely.

Extra fat and sugar digested from a large holiday meal literally shrink veins and arteries. The flood of free radicals caused the the auto-oxidation of sugar temporarily interferes with the release of the chemical nitric oxide, which keeps blood vessels open. Eating a big meal does not necessarily cause a heart attack, but if some other process causes formation of a blood clot, smaller blood vessels are more likely to be completely blocked.

Holiday drinking

In much of the Western world, holidays are occasions for additional consumption of alcohol. "Holiday heart syndrome" results from the extra alcohol, and interferes with the normal rhythms of the atria, the upper chambers of the heart. Atrial fibrillation can cause the formation of blood clots that can cause heart attacks or go to the brain and cause strokes.

Eating at festivals focusing on salty foods

An unusually large number of Minnesotans have heart attacks after church suppers featuring lutefisk, a dish made by soaking fish in lye. The resulting delicacy is so high in sodium that it cannot be served on porcelain plates, because it will dissolve them. The load of sodium from the lutefisk causes immediately higher blood pressure that increases risk of heart attack until the sodium is excreted in urine, usually 2 or 3 days later.

Five More Causes of Heart Attacks that Might Surprise You

Here are five more triggers for heart attacks that might surprise you.

Inappropriate use of anti-inflammatory supplements

Fish oil is widely recommended for reducing inflammation to reduce the risk of heart attack. A minority of people, however, are actually more likely to have heart attacks if they take fish oil or other anti-inflammatory omega-3 essential fatty acids. These are people who suffer congestive heart failure.

Anti-inflammatory omega-3 essential acids reduce the inflammation that causes cells in the heart muscle to misfire. The remaining cells beat in steady rhythm, reducing the risk of atrial fibrillation, heart attack, and stroke.

People who have congestive heart failure, on the other hand, don't have enough healthy heart cells to pump blood throughout the body. Turning off "misfiring" cells in the heart muscle can reduce circulation to the point that blood clots can form. The people most likely to suffer undiagnosed congestive heart failure are those who take the type 2 diabetes drugs Actos or Avandia.

Descent from high altitude

People who have cardiovascular disease and healthy people alike have slower heart rates at higher altitudes. If your maximum heart rate is 180 at sea level, chances are it will be about 130 at 4200 meters (13,000 feet), whether you have heart disease or not.

When people who have heart disease descend from higher altitudes, however, their maximum pulse rates increase. Persons with a predisposition to heart attack may actually be at greater risk at the bottom of a ski slope than at the top, or at the end of a helicopter tour rather than while still in flight.


Diarrhea depletes the body of fluids. When the volume of blood is significantly diminished, the heart has to work harder to pump the remaining blood to provide oxygen to every part of the body. The stress of dehydration brought on by diarrhea can lead to heart attack in the elderly and in people who have diagnosed or undiagnosed cardiovascular disease.

Air pollution

Some kinds of air pollution have surprisingly little effect on heart health. Ozone, sulfur dioxide, and particulate matter are not directly linked to elevated risk of heart attack. Carbon monoxide and nitrogen dioxide, however, are. Even if there are no obvious symptoms of toxicity after exposure to these gases, the risk of heart attack is elevated for several days after exposure. Typically heart attack occurs 1 day after exposure to the toxic gas.


Not everyone who snores is at elevated risk of having a heart attack. When snoring and snorting are caused by the nighttime condition of oxygen deprivation known as sleep apnea, however, are at considerably greater risk of cardiovascular problems.
How could snorting and snorting through the night cause potentially deadly health effects? The answer is that any kind of interruption in breathing causes fluctuations in bloodstream oxygenation. If you were to measure the PulsOx (oxygen saturation) of someone who breathes normally while sleep, you would probably observe over 95 per cent saturation.

If you were to measure PulsOx of someone who has even a mild case of sleep apnea, you likely would see the oxygen saturation fall to 94, 93, or even less than90 percent after just a few seconds of lost breath. In people who have mild apnea, a few dozen events of breathlessness every night may cause oxygen saturation levels between 90 and 95 percent all night.

In people who have severe sleep apnea, more than 40 events of breathlessness every 60 minutes, oxygen saturation may fall as low as 70 percent. This forces the heart to work very hard to circulate oxygen to the brain and vital organs. The heart can work so hard that a kind of "charlie horse" leads to heart attack, or atrial fibrillation may cause a stroke.

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  • Tanner JM,Chang TI,Harada ND,Santiago SM,Weinreb JE,Friedlander AH. Prevalence of Comorbid Obstructive Sleep Apnea and Metabolic Syndrome: Syndrome Z and Maxillofacial Surgery Implications. J Oral Maxillofac Surg.2011 May 19. [Epub ahead of print]
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