Home » UofL Physicians: Cold weather puts a strain on health

UofL Physicians: Cold weather puts a strain on health

LOUISVILLE, Ky. (Jan. 27, 2014) – Cold weather might just seem like an inconvenience, but there can be real effects on health. And with bitterly cold temperatures expected here until at least the middle of this week, it’s a good time to talk about what they can do to the body.

“People sometimes forget just how cold it can get,” said Dr. M. Eli Pendleton, a family medicine doctor with UofL Physicians. “And therefore, they may not be properly prepared.”

Cold weather causes stress to the system, especially the heart, he said.

“In extremely cold temperatures, the body works hard to stay warm, expending energy and stressing itself more than you might realize,” Pendleton said.

Effects on the heart

Dr. Atul Chugh, a cardiologist and director of preventive cardiology and hypertension with UofL Physicians, says people experience a number of biomedical changes during the colder months, and studies show there is an increase in cardiovascular problems such as heart attack and stroke.

“Extreme cold makes a huge difference in the body,” Chugh said. “We know there is an increase in cardiovascular problems during the winter months, and we have a few theories as to why.”

One is that cold weather ramps up the body’s sympathetic nervous system, which increases the pressure of blood through the blood vessels and puts stress on the heart as the body tries to keep warm and conserve heat.

“Your heart is basically working harder in the cold weather than in warm weather, even at rest,” he said.

Another is that people who may ordinarily lead a sedentary lifestyle suddenly become physically active, picking up a snow shovel and clearing walkways and stairs, which “causes a sudden increase in the work that the heart has to do and the oxygen it demands, raising the risk of heart attacks and strokes – especially in patients with existing risk factors,” Chugh said.

A third is that the body undergoes hormonal changes during colder weather, increasing its metabolic rate to stay warm, and stress hormones such as epinephrine and angiotensin II may increase.

People also tend to change their eating habits during colder weather, eating more and consuming more fatty and salty foods, which can increase blood pressure and cholesterol buildup in the blood vessels.

The body also loses some of its ability to process vitamin D during the winter, when the sun is less present.

“We definitely know that vitamin D is important for the regulation of blood pressure. In addition, we are discovering that sufficient vitamin D levels are important for cardiovascular health,” Chugh said.

When it’s cold, people also tend to stay inside more, where they are exposed to more particulates in the air as there is less ventilation when homes and businesses are shuttered, he said. They may also be exposed to air pollution outdoors as society demands more energy to keep the heat going and the lights on.

“All of this accumulates in the body,” Chugh said. “And we are seeing links between ambient pollution and cardiovascular disease.”

Effects on the lungs

Dr. Rodney Folz, a pulmonologist with UofL Physicians, said winter can be hard on people with common conditions such as asthma or COPD (chronic obstructive pulmonary disease, also known as emphysema and chronic bronchitis), as they can be sensitive to the changes in temperature and humidity. He sees more complications in winter months.

“When they go from humid, warm air indoors to cold, dry air outdoors it can lead to what we call ‘hyperactive airways,’” Folz said. “This means the airways can constrict, making it hard to breath.”

For those who have this type of condition, using a rescue inhaler about 20 minutes before going outside can help, he said.

Folz also recommends placing a scarf over the nose and mouth to mitigate the cold air and give it a chance to warm up before it reaches the lungs.

Other health effects

Some of the other cold-weather-related health problems that Dr. Pendleton sees are circulatory issues, especially for those with already impaired circulation such as diabetics or smokers. This can increase the risk of frostbite of the fingers and toes, especially if the wind chill sends temperatures below zero degrees.

Skin conditions such as eczema also worsen during cold weather, and exposed skin increases the risk.

“Wear gloves and a scarf, and respect the cold,” Pendleton said. “Bundle yourself up like your mother would when you were a kid.”

When it comes to slips and falls, remember to wear warm footwear that’s as skid-proof as possible, Pendleton said.

“The best thing you can do is to go slow, be careful and avoid ice. Also, take a cane of a buddy if you’re more prone to falls,” he said.

Effects in older adults

Older adults in particular can have health problems from the cold, said Dr. Christian Furman, a geriatrician with UofL Physicians.

“Older adults don’t have a lot of reserve, so when they’re stressed, their heart and lungs can’t take it,” Furman said. “And it’s hard on the body to go from sitting or walking around the house to trying to shovel snow. That’s when we see incidents such as heart attacks.”

She said older adults often show up in the hospital short of breath, or from falls or slips on the ice.

But many know their limitations, and they just don’t venture out in wintry weather, she said.

“That’s the best thing they can do, if they can avoid it. Unfortunately, not everyone can.”


The key to avoiding health problems with the cold is to be prepared, Pendleton said. He recommends:

  • Wearing extra layers of clothing, including hats and gloves
  • Keeping blankets and extra warm clothes in your car
  • Keeping an adequate supply of medicine at home, and making sure you have enough before cold weather sets in. Pharmacies can get overwhelmed by requests for refills during winter storms and cold spells, which can cause a delay in getting your prescription.
  • Staying at home unless you really need to get out in the cold
  • Keeping a “winter preparedness” box in your home with items such as extra water and food so you won’t have to leave the house
  • Stocking up on salt for traction on walkways and stairs, and getting it before cold weather sets in to avoid shortages
  • Getting your furnace serviced before cold weather starts
  • Taking precautions against frozen pipes so you’ll have running water when you need it

Cold weather resources

For more on the health effects of cold weather, Pendleton recommends these sites:

  • U.S. Centers to Disease Control and Prevention, “Extreme cold: A prevention guide to promote your personal health and safety”


  • U.S. Centers for Disease Control and Prevention, “Cold Stress”


  • World Health Organization, “Adverse health effects of exposure to cold”