Why do more heart attacks happen in the morning? Cardiologist explains the risks

A heart attack, also known as myocardial infarction, occurs when blood flow to a portion of the heart suddenly gets blocked, typically by a clot in a coronary artery. Without oxygen-rich blood, the heart muscle in that area starts to die. Going by statistics, it is one of the leading causes of death in the world. Around 32 percent of all global deaths in 2019 were connected to cardiovascular diseases, according to the World Health Organization. Eighty five percent of these deaths were due to heart attack and stroke. Myocardial infarction can occur in the day or night. However, it happens more often in the early hours, if studies are to be believed.

Why do heart attacks happen in the morning?

There may be a higher risk of getting a heart attack in the morning. A study, published in the American Journal Of Hypertension, showed that between 6 am and noon, there is a 40 percent higher risk of heart attack.

Here’s why morning heart attacks may be more common:

1. Release of certain hormones

When you wake up, blood pressure and stress hormones tend to spike. “During the Rapid Eye Movement (REM) sleep, which is early morning, the autonomic nervous system releases hormones like adrenaline, noradrenaline and cortisol. These hormones boost heart activity and constrict blood vessels, straining the heart and reducing its oxygen supply,” explains cardiologist Dr Abhijit Borse.

2. Blood may get stickier

“The levels of PAI-1 or Plasminogen Activator Inhibitor-1, a protein that prevents blood clots from breaking down, are usually high right after getting up,” says the expert. In other words, blood tends to be stickier in the morning, which raises clot risk.

3. Dehydration

Dehydration from overnight also thickens the blood, which can lead to a heart attack in the morning. A study, published in the European Journal of Nutrition, showed that even mild dehydration in healthy, young people may increase the risk of cardiovascular disease.

4. Waking abruptly to an alarm

Using an alarm clock can help to get up on time, but if you already have high blood pressure, you might want to skip that. Waking abruptly to an alarm can lead to a sudden increase in blood pressure as well as heart rate. This can potentially raise the risk of heart attacks. A study, published in Heart & Lung, found that people who used alarm clocks had a morning blood pressure that was 74 percent higher compared to individuals who got up naturally.

“Also, rushing out of bed or exercising too quickly on an empty stomach can overwhelm a vulnerable heart,” says Dr Borse.

What are the signs of a heart attack in the morning?

The warning signs of a morning heart attack are the same as at any other time:

• Chest pain or pressure is the most common symptom
• The pain can spread to the left arm, jaw, shoulder, neck or upper back
• You may also feel short of breath, nauseated, lightheaded or start sweating

“Some people, especially women and older adults, notice more subtle signs first. They may experience unusual fatigue, jaw or back pain, indigestion-like discomfort or anxiety,” says the expert.

How to prevent a morning heart attack?

Here’s what to do to prevent having a heart attack in the morning:

1. Get enough sleep on a regular schedule

You must have heard it a number of times, but sleeping for 7 to 8 hours each night is important for your heart. “Chronic sleep deprivation raises stress hormones and inflammation, a known trigger for heart attacks,” says Dr Borse. Also, if you are well rested, you will wake up naturally instead of being forced to get up by an alarm.

2. Hydrate first thing in the morning

Drink a full glass of water soon after waking up. Overnight dehydration makes blood thicker, so rehydrating helps your circulation start smoothly. “But avoid gulping strong coffee or energy drinks on an empty stomach, as caffeine can spike blood pressure and heart rate,” says the expert.

3. Ease into the day

Morning exercise may be important for you, but don’t rush into any strenuous activity. Sit up slowly, stretch gently and let your heart rate rise gradually. Skip intense morning exercises until you have warmed up for 30 to 60 minutes after waking up. Also, ensure you have eaten something light like a pre-workout snack.

4. Manage stress and blood pressure

Calming rituals such as deep breathing, meditation or a quiet morning walk can be good ways to manage stress. “Reducing chronic stress lowers the surge of adrenal hormones upon waking,” says the expert. Also, keep hypertension under control with diet, exercise and medications, because in the morning, blood pressure tends to peak.

5. Eat healthy

Whether it is for your heart or your overall health, a balanced diet rich in vegetables, whole grains, fruits and lean protein is a must. Cut down on saturated fat, salt and simple sugars. “Avoid heavy late-night meals, which can disrupt sleep and lead to morning spikes in blood sugar or blood pressure,” says the expert.

6. Quit smoking and limit alcohol

“Tobacco is often associated with heart disease, as it may cause artery damage and increase clotting,” says Dr Borse. Even excess alcohol consumption can affect your heart. It can raise blood pressure and disrupt your sleep, which may lead to a morning heart attack. Quitting smoking and drinking less alcohol are among the most effective ways to reduce heart attack risk.

7. Check blood pressure, cholesterol and blood sugar

If you have diabetes, heart disease or high cholesterol, monitor your blood pressure, cholesterol levels and blood sugar regularly. Follow your doctor’s plan, including morning doses of prescribed medications. This can help in early detection of blockages or rhythm problems.

High blood pressure, a surge of stress hormones and a greater clotting tendency in the morning may be why a heart attack tends to happen in the early hours. If you experience it, call emergency services immediately then sit or lie down and try to keep calm.