There are many things that are distinctly Filipino, and a deep love for the Christmas season is undoubtedly at the top of the list. But between back-to-back Christmas parties, family reunions, long trips to our hometowns, and week-long festivities, the “most wonderful time of the year” can also become one of the most stressful—especially for your heart.
According to the Philippine Statistics Authority (PSA), cerebrovascular disease (CVD)—which includes stroke—ranked as the third leading cause of death in the Philippines from January to May 2023 and in the same period in 2024.
And the holiday season, with all its hustle and bustle, might be playing a role in this grim statistic. Several health professionals who handle stroke cases note that their census often spikes after Christmas and New Year, but the timeframe varies.
For instance, an adult neurology resident in a public hospital who wanted to remain anonymous, looked at their 2023 census. Speaking to GMA News Online, the resident said they found “a steady increase in the number of stroke patients admitted from late October to late December, heralding the holiday/reunion season. By January, this number plateaus.”
Ancilla Diamante, an Occupational Therapy staff in The Medical City Physical Medicine and Rehabilitation department for 4 years and a co-host of Rehab to Talk, the department’s podcast that discusses topics on rehabilitation, shared a similar experience.
“As an OT in a hospital-based setting, we often see a spike in referrals of patients with acute stroke around late December until February. They get referred to our department immediately through our Early Rehabilitation in the ICU (ERICU) program, which aims to set the recovery process into motion as early as possible,” she said.
These patients are then referred to their department to address concerns like difficulty swallowing and retraining for activities of daily living (ADLs), like going to the bathroom.
Worse, individuals who suffer from stroke or heart attack during the holidays are more likely to die compared to other times of the year. This pattern holds across various countries.
For example, a 2019 Australian study found that patients admitted for hemorrhagic stroke on holidays or weekends faced a 59% to 119% higher risk of death compared to those admitted on weekdays. Similarly, a 2021 Norwegian study identified the three days after Christmas as the “deadliest time of the year” for cardiovascular-related deaths, with significant shifts in heart-related mortality patterns.
In Taiwan, patients hospitalized during extended holiday periods were also more likely to die during their stay, or within seven and 30 days afterward compared to those admitted on regular days.
“The phenomenon of increased fatalities during weekends and holidays is known as the ‘holiday or weekend effect,’” explained Dr. Philippe Hubert Co, a specialist in physical medicine and rehabilitation at Health Hub Pro Clinic Banawe QC, Inc., in an interview with GMA News Online.
Healthcare facilities themselves might play a part in this trend. Dr. Hubert shared that fewer healthcare facilities and resources available during the holiday season, reduced staffing with fewer nurses or doctors per hospital bed, limited access to diagnostic procedures, and the admission of more critically ill patients on weekends may play a role behind this “weekend effect.”
However, some studies suggest that the standard of care remains consistent year-round. In the Taiwanese study mentioned earlier, the “holiday season effect” persisted even after accounting for stroke severity, age, and pre-existing conditions.
Why are holidays stressful for the heart?
So, what makes the holidays so stressful for the heart?
“Stroke is related to several risk factors, such as increased stress levels, increased consumption of alcohol, increased smoking, and spikes in blood pressure, cholesterol, and blood sugar—these lifestyle choices we tend to during weekends and holidays,” explained Dr. Hubert.
Diamante also noted the major events that take place before the onset of a stroke or cerebral vascular accident (CVA), like dinners and family reunions.
“Many of the patients I handled held big (major) responsibilities for these events, such as being the party planners, point persons, and drivers. Others recall having reversed body clocks or sleeping significantly less prior to the onset of symptoms,” she said.
Meanwhile, the neurology resident said that the holidays can be a stressful time for people.
“The holiday season often brings increased stress from hectic schedules and emotional gatherings, which can trigger an acute vascular event,” explained the neurology resident.
Festivities also often involve rich, high-fat, high-salt foods like lechon and desserts paired with alcohol, including binge drinking.
The neurology resident added that people with controlled conditions like hypertension or diabetes can find it harder to stick to their diet, lifestyle, or medications during the holidays: “This can lead to sudden spikes in blood pressure or blood sugar, increasing the chance of a stroke.”
For many, the holiday season is a free pass for socialization—which often involves drinking.
Holiday binge drinking is common enough that there’s a condition called holiday heart syndrome, where excessive alcohol intake leads to a fast, irregular heartbeat known as atrial fibrillation (Afib). This condition can increase the risk of serious cardiovascular issues, including stroke and heart failure.
Even for those skipping the parties, the holidays can still mean unhealthy habits like staying up late, skipping exercise, or binging Netflix with junk food—all of which place stress on the body.
Unfortunately, most heart attack deaths occur outside the hospital, showing the importance of recognizing the early signs of stroke and heart attack. These emergencies can strike anywhere—whether you’re holiday shopping, at an office Christmas party, or enjoying a family gathering at home.
Feeling okay doesn’t always mean you are. As Kapuso broadcast journalist Arnold Clavio, who suffered a hemorrhagic stroke in June 2024, shared, “ARAL: Feeling OK does not mean [you’re] OK. Feeling good does not mean we’re good. Listen to your body. Traydor ang hypertension! Always check your BP.”
[The lesson: Feeling okay does not mean you’re okay. Feeling good does not mean we’re good. Listen to your body. Hypertension is a traitor. Always check your BP.]
It’s also crucial to know the warning signs of a stroke, which can be easily remembered with the acrostic BE FAST:
- B: Balance loss or dizziness
- E: Eye problems, like double vision
- F: Facial drooping, such as a crooked smile
- A: Arm weakness or numbness
- S: Speech difficulties
- T: Time—act fast and get to the nearest hospital immediately
Tips to keep your heart healthy this holiday season
To avoid an unexpected trip to the ER, here are some practical tips:
- Stay active: Regular exercise can significantly lower your risk of stroke and heart disease. “Make it a habit to exercise, and don’t stay sedentary: 20-30 minutes of physical activity per day (simple walking, stretching, jogging) and staying consistent with that routine will help strengthen your resistance and decrease your risk of stroke,” recommended the resident neurologist.
- Eat mindfully: Holiday feasts are often loaded with rich, unhealthy dishes. Balance your plate by including vegetables and fruits to help protect your heart and reduce stroke risk. “Eat everything in moderation. It’s hard to totally avoid eating and indulging during the holidays, and going ‘cold turkey’ on those types of food may just lead to binging later on. Hindi bawal; basta hindi rin sobra-sobra,” the neurology resident added.
- Minimize air pollution exposure: Air pollution ranks among the top 10 stroke risk factors. Choose routes with less traffic congestion whenever possible. If you can’t avoid Metro Manila’s infamous holiday traffic, consider wearing a mask to protect yourself.
While you get to take a rest this Christmas break, remember that your health—particularly your heart—doesn’t get to rest. So, please, take care of your heart this holiday season, literally.
— CDC, GMA Integrated News
