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For international nurses entering the United States, transitioning to a new healthcare environment can be exciting yet challenging. One aspect that may take you by surprise is the demanding winter season, which often sees a surge in health risks and conditions that require immediate attention in the emergency room. 

As a registered nurse, being prepared for the influx of patients with winter-related illnesses is essential. In this article, we’ll focus on the risks of hypertension, heart attack, and stroke and why they can easily occur during the winter season. 

How Does Cold Weather Raise the Risk of Heart-Related Conditions? 

When it gets colder, our bodies try to keep warm by holding onto heat in the center of our bodies. This can be harder for people with heart problems. 

Cold temperatures can lead to various effects on our hearts and blood vessels, including: 

  • Faster heart rate 
  • Higher blood pressure 
  • More strain on the heart 
  • Thickening of the blood, which might lead to blood clots, increases the risk of heart attacks and strokes 

Aside from the common dangers of winter, like frostbite and unsafe driving conditions, there are also risks to the heart that we should be aware of. 

The blood vessels in our body become smaller, and the arteries that supply blood to the heart can also narrow. This can make our blood pressure go up, increasing the chances of having a heart attack or stroke. 

This stress is a physiological reaction. In a 2023 study from The Physiological Society, researchers found that the increase in blood pressure was mainly because blood has to push harder through the body’s blood vessels.¹

Researchers also suggested that this change occurs mainly because the blood vessels near our skin get smaller, reducing blood flow and cooling the skin, especially around the face. When the blood vessels constrict, our heart has to work harder to push blood through these narrower pathways, and this extra effort can put more stress on the heart. 

3 Common Illnesses During Winter and What You Can Do 

The winter season is a hectic and often stressful period for some people. Regular habits change, so people might eat more, be less active, and have fewer moments of relaxation. They might not get enough sleep, feel more stressed, and overlook their health, postponing visits to the doctor until after the winter season. 

It’s important to recognize these factors can collectively escalate the risk of heart-related conditions. Let’s delve into the common illnesses during the winter season and how you can provide urgent care and support for your patients. 

1. Hypertension 

People with hypertension are prone to experiencing an increase in blood pressure during the winter months.²

On average, blood pressure readings increase by about 1.7mm Hg in the winter compared to summer months, and efforts to manage blood pressure drop by 5%. This elevation can lead to kidney and heart problems. 

A patient’s blood pressure can be well controlled when they visit in the summer, but when they come back six months later during the winter, it can be elevated. 

Why Blood Pressure Tends to Spike in Cold Climates 

Blood pressure tends to rise in cold climates due to the body’s physiological response to low temperatures. The “fight or flight” system activates, leading to the release of catecholamines, narrowing blood vessels, and increasing blood pressure.  

Moreover, patients’ daily habits can exacerbate this effect, with reduced exercise and unhealthy eating contributing to elevated blood pressure. Winter’s gloomy and dark conditions can lead to seasonal sadness, further impacting lifestyle choices and physical activity. 

Managing Winter Hypertension 

It’s crucial to advise your patients with hypertension to monitor their blood pressure at home regularly. Engaging in regular exercise, maintaining a balanced diet, and seeking emotional support can help mitigate the impact of cold weather on blood pressure.  

Encouraging patients to stay active, eat nutritious foods, and reach out for support can also play a significant role in preventing winter-related health issues. 

2. Heart Attack 

A heart attack occurs when something, such as a blood clot, clogs the blood vessels and suddenly stops the blood from getting to the heart. It’s a medical emergency because it can lead to sudden death. Chilly temperatures can make your heart work extra hard and raise the chances of heart attacks, especially if you already have heart problems. 

Cold temperatures make blood vessels narrow, elevating blood pressure and worsening angina, a condition causing chest pain due to heart disease. Additionally, the heart works harder to maintain body warmth in the cold, which can harm the heart muscle if the body temperature drops below 95 degrees. 

Related Reading: A Crash Course on Cardiac Nursing: 5 Best Tips for New Cardiac Nurses 

Other Risk Factors 

The chance of a heart attack increases when a patient is exposed to cold weather and engages in sudden physical activity. That’s why it’s essential to encourage your patients to be cautious when participating in exercise or outdoor activities in freezing or snowy conditions. 

In winter, people often transition from sedentary routines to more physically demanding activities, like shoveling snow. This sudden exertion can strain the heart, causing chest pain and worsening angina due to inadequate blood flow. In severe cases, especially for those with blocked arteries, this heightened stress may even trigger a heart attack. 

Other risk factors that increase the risk of heart attacks and heart disease include the following: 

  • High blood pressure 
  • Increased blood cholesterol 
  • Smoking 
  • Age 
  • Family history of heart issues 
  • Diabetes 
  • Excess weight or obesity 
  • Lack of regular exercise 
  • Excessive alcohol consumption 
  • Consuming a diet rich in saturated fats, trans fats, and cholesterol 

However, certain risk factors may exert a more pronounced impact on how the cold weather interacts with heart conditions than others. For instance, smoking habits and alcohol intake appeared to be the most influential risk factors for initiating a heart attack in colder temperatures.³ This is primarily due to their direct influence on vasoconstriction, which, in turn, raises blood pressure. 

Reducing Heart Attack Risks 

Patients can reduce the risk of winter heart attacks by following these tips: 

  • Manage Health: Keep high blood pressure, cholesterol, and other risk factors under control. 
  • Exercise Wisely: Incorporate regular, moderate exercise and adapt activities for colder weather. 
  • Embrace a Healthy Lifestyle: Avoid smoking, limit alcohol, maintain a healthy weight, and consume a balanced diet. 

3. Stroke 

As the temperature drops, the occurrence of strokes, which is the fifth leading cause of death in the country, tends to rise. Cold weather, similar to heart attacks and high blood pressure, can constrict and narrow blood vessels, elevating stroke risk. 

In fact, a 2019 study in Sao Paulo, Brazil, with 56,000 stroke-related cases, found a correlation between lower temperatures and higher stroke-related deaths, especially in those aged 65 and above.⁴ Additionally, cold temperatures can result in blood thickening, making it stickier and increasing the chances of clot formation. 

Can You Easily Recognize Stroke Symptoms? 

As a nurse, you can apply the “BE FAST” acronym to promptly identify stroke symptoms, whether they occur in one of your patients or someone in your vicinity, and then take appropriate action. 

  • Balance: Unexpected loss of balance and/or coordination 
  • Eyes: Sudden blurriness, double vision, or sudden vision problems 
  • Face: Drooping of one side of the face 
  • Arms: Weakness or numbness on one side of the body or one arm drifting down when raised 
  • Speech: Difficulty speaking clearly, slurred speech, or trouble repeating simple phrase 
  • Time: If you notice these signs in someone, don’t wait – call 911 immediately or seek immediate medical help at your healthcare facility

Providing Care in Cold Climates 

Stationed at the forefront of patient care, as a nurse, you bear significant responsibility for assisting patients as the colder months approach. The demand for health care services usually increases during the winter, with a heightened risk of conditions such as hypertension, heart attacks, and strokes, among other contributing factors. 

Being prepared to recognize and respond to these conditions is crucial to ensuring your patients’ well-being. Stay vigilant, provide compassionate care, and make a difference in the lives of those who depend on your expertise so you can be in a position to provide advanced practice and the best care to your patients. 

Related Reading: Empathy is Not Just a Feeling: 6 Tips for Practicing Empathy for Global Nurses   


Despite adapting to a new healthcare system and weather conditions, professional nursing remains a rewarding and fulfilling career choice. And PRS Global is here to help you connect with employers seeking their next global nurse.  

We’re committed to maintaining transparency throughout your application process, providing you with the assurance that you are in good hands. Contact us today to learn more! 


1 Mugele, Hendrik, et al. “Control of Blood Pressure in the Cold: Differentiation of Skin and Skeletal Muscle Vascular Resistance.” Experimental Physiology, vol. 108, no. 1, 1 Jan. 2023, pp. 38–49,, Accessed 16 Apr. 2023. 

2 “Cold Weather May Pose Challenges to Treating High Blood Pressure.” American Heart Association, Accessed 7 Nov. 2023. 

3 Sartini, Claudio, et al. “Effect of Cold Spells and Their Modifiers on Cardiovascular Disease Events: Evidence from Two Prospective Studies.” International Journal of Cardiology, vol. 218, Sept. 2016, pp. 275–283, Accessed 15 July 2020. 

4 Ikefuti, Priscilla V., et al. “Mean Air Temperature as a Risk Factor for Stroke Mortality in São Paulo, Brazil.” International Journal of Biometeorology, vol. 62, no. 8, 25 May 2018, pp. 1535–1542,