Whatever their cause, symptoms of cardiovascular events like heart attack and stroke should never be taken lightly—especially during the winter months.

According to Cynthia Thaik, MD, a holistic cardiologist and member of the American College of Cardiology and the American Heart Association, research has shown that cardiovascular deaths spike by about 18 percent as the days shorten and the weather cools.

Why Cardiovascular Events Are More Prevalent in Winter

Cold weather, being indoors more often, stress, lack of vitamin D and changes in the daylight-to-nighttime ratio during the winter months all play a role in increasing a person’s overall risk of cardiac problems, says Dr. Thaik. There’s also something about the holidays themselves that seems to be hard on the heart. Christmas and New Year’s Eve top the list of most dangerous days for cardiovascular events and death.

Surprisingly, a recent study shows that geographic location doesn’t seem to play a significant role in a person’s risk. Researchers from the University of New Mexico discovered that people who lived in places at lower latitudes like Texas, Georgia, Arizona and Los Angeles experienced the same jump in heart-death risk as those residing in cooler northern states, such as Massachusetts and Pennsylvania. Whether you live in icy Wisconsin or sunny Florida, the winter months can still take a toll on your ticker.

6 Ways to Avoid Winter Heart Problems

Fortunately, there are steps that can be taken to minimize winter’s impact on the cardiovascular system. Use these tips to protect your heart this holiday season:

  1. Bundle up. Despite the findings of the University of New Mexico study, Dr. Thaik says it’s still important to keep warm during the winter months because temperature does affect the cardiovascular system. Cold weather can cause blood vessels to constrict, blood pressure to elevate and blood to become more prone to clotting, explains Neal Kleiman, MD, a cardiologist at the Methodist DeBakey Heart and Vascular Center in Houston, Texas.
  2. Moderation is key. Bitter weather and savory comfort foods make for an unhealthy combination—especially during the holiday season. While it’s okay to indulge a bit during celebrations, Dr. Thaik urges people to stick to their good habits during the wintertime. This means sticking to a regular exercise routine, eating a diet rich in fruits, vegetables and whole grains, and keeping alcohol and dessert consumption in check.
  3. Don’t forgo medications. Just as maintaining a healthy diet and exercise plan is important in the winter, so is sticking to any existing medication regimen you may have. Kleiman urges people not to “slack off on their medications” and other health maintenance habits.
  4. Get happy. Seasonal affective disorder (SAD) is a type of depression that strikes during the winter months. Shorter, cooler days spent inside can cause a person to become lethargic, hungry and uninterested. As with any type of depression, people suffering from SAD may be less likely to practice healthy behaviors, such as engaging in regular physical activity and eating a well-balanced diet. Dr. Thaik says it’s important to avoid getting into this depressive cycle. Make sure you take time to do things that lift your mood, such as going for a walk or spending time with your family (if doing so doesn’t stress you out).
  5. Don’t be an early bird. According to Dr. Thaik, one of the subtle side effects of fewer daylight hours in the winter is that people tend to try and start their days earlier. But, because blood pressure naturally spikes in the morning, these early risers could be putting themselves at greater risk for a heart attack. Dr. Thaik suggests keeping early morning activities to a minimum during the winter months. If you simply must wake earlier in the day, do so cautiously. “The heart likes to take time to warm up,” she says, “so take things gradually in the morning.”
  6. Get a flu shot. “Your immune system weakens in the winter,” explains Dr. Thaik. “Getting the flu leads to increased inflammation in the body and can possibly cause secondary complications like pneumonia, all of which have a negative impact on your cardiovascular risk.” Recent research has shown that getting a flu shot could reduce a person’s risk for a major cardiac event (i.e. stroke, heart attack, heart failure, or cardiac death) by as much as 50 percent.