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Woolly hats and heart attacks

Each winter there is a myriad of articles published warning us about the dangers of hypothermia, how to spot it and what to do about it. There are articles warning about cold injuries such as frostbite, warnings to the elderly about the dangers of not keeping at least one room warm. Warnings to get the boiler serviced in case carbon monoxide builds up if its faulty. We are warned that we may need extra vitamins, warned to drive carefully, warned to take care if using candles and warned not to leave the lights on the Christmas tree switched on overnight. Not once, anywhere in this plethora of warnings have I heard the one that warns you that you are more likely to suffer a heart attack if you don’t wear a warm hat in cold weather.

Every winter in the UK upwards of 20,000 extra deaths occur that are attributed in one way or another to the cold. These are referred to as ‘excess deaths from all causes’ on the official statistics. Now that wording makes it sound like the medics record which deaths are caused by the cold. In some cases they do, but in most they don’t the figure is derived by taking the figure for the deaths recorded during non-winter months and taking it away from the winter months total, the number left is the excess deaths from all causes figure.

Now, some things that happen in winter are fully understandable and clearly lead to more deaths than would occur in drier warmer weather. Road accidents, domestic boiler incidents, house fires, drowning from falling through ice, asthma, pneumonia, falls, influenza and so on all have a higher incidence level in winter than at any other time of year.

There are however other deaths that occur, that are directly attributable to cold weather that never even get a mention as weather related. We are all aware that heavy duty snow shovelling can cause a person to keel over with a heart attack, but this is not the main cause of heart attacks during cold weather. Heart attack and strokes, or to give them their proper names, cardiac arrest and cerebo-vascular accident are responsible for thousands of cold weather deaths each year. They are listed on the statistics as exactly what they are, but as a heart or brain does not have ‘packed up due to cold weather’ stamped on it at autopsy it’s hard to absolutely say the death was caused by the weather.

Even though they were.

These two conditions are entirely different but they do have one thing in common…blood. Both conditions are caused by a clotting of, or restriction of, the flow of blood through an organ, namely the heart and the brain, and this dear Friends, is where the woolly hat comes in. Trust me, all will become clear.

Although blood is a liquid, it is viscous, it has a stickiness to it that some fluids, such as water, don’t have. Like motor oil, blood becomes more viscous if its left in the open air, and it becomes more viscous when it is cooled, and less viscous when it’s warmed.
So, when it’s trundling around in your blood vessels, for the most part all is well, it’s warm and fluid and goes on it’s way doing its thing.

In some parts of your body blood vessels are far nearer the surface than you might think, look at the inside of your wrists, your jugular vein that you may see pulsing in your neck, the veins visible at your temples, and in the case of newborns under the thin skin of their scalp. Here the blood dissipates heat far more readily than it does from other parts of your body. When it cools, it becomes a little stickier, a little more viscous. Cool it further still, like on a really cold day, and it becomes even more viscous. Sticky blood cells stick together and form tiny clumps, which turn into bigger clumps quite quickly, certainly within a couple of hours.

So. Lets have an example. We’ll call him Joe. Joe has a desk job in the city, he travels by train as the congestion charge is exorbitant. He is fit, going to the gym three times a week and plays football on a Weekend. That and running around after his three kids is enough he feels. He gets up, showers has a healthy breakfast of whole wheat cereal and fruit, a glass of orange juice and sets off. He drives to the station, parks and makes his way to the platform. He is wearing a shirt, suit and tie and thick overcoat. He realises when he is standing on the open platform that he’s shivering, he has left his gloves and scarf in the car and doesn’t have time to fetch them. Still the train is hopefully running on time and will be here soon. The blood travelling around Joes’ body is cooling as it moves past his unprotected wrists and up to his unprotected neck, a shirt and tie is not that warm, and on to his unprotected head. As it moves back down into the protected areas of his body it warms and becomes more fluid again. He is shivering which increases his heart rate, making the blood move faster, so more blood is passing the exposed areas more often and passing through the warm areas at a faster rate. After a few minutes his blood is slightly more sticky than it was when he arrived on the platform. He continues to shiver. A couple of blood cells have agglutinated, clumped together in one of his veins. He doesn’t know this has happened, he feels nothing, but the process leading to Joes’ possible demise has begun. The longer he stands there in the cold the more cells will bump into the still microscopic clump and stick to it, increasing its size. At this point there are several scenarios:

  • The clot increases in size lodges in his brain, blocks the flow of blood and he has a stroke.
  • The clot increases in size lodges in his lungs and he has a pulmonary embolism.
  • The clot increases in size, lodges in his heart, blocks the flow of blood and he has a cardiac arrest.
  • The train comes, Joe warms up before the clot increases in size and lives to catch a train the next day although possibly getting a deep vein thrombosis in his leg at a later date.

Today is not Joes lucky day. The train is late. The thing with clots is the bigger they get the more blood cells bump into and stick to them. By the time Joe gets on the train fifteen minutes later the clot is no longer microscopic, but it is stuck in place for now. Joe feels a touch off colour but has put it down to the shivering and shaking he has been doing for 20 minutes.

He gets of the train and makes his way to his office, glad to be in the warm at last.
As he settles at his desk, he warms up, his blood gets less sticky and starts moving at its proper rate around his body. The clot in his vein gets less sticky also, a lump of it breaks off and gets carried along with the liquid blood the clot lodges in Joes heart. Joe doesn’t feel too good, he’s a bit pale, his chest is a little tight, the fingers on his left hand feel odd, his left arm is tingling. Internally more and more blood cells are backing up behind the clot, blocking the small gaps around its edges that was allowing enough blood through to keep his heart beating. As the blood supply slows Joes heart, starved of what it needs starts to fire off irregularly, the electrical system is failing. Joe feels a rapid tightening in his chest as the heart strains to maintain its output. It gives one last flutter before ceasing its activity. Joe Feels like his chest is going to explode, attempts to stand up and collapses. Now at this point he is not technically dead. Although not conscious of it his brain functions will continue until the oxygen in his body has been used up, but for all practical purposes Joe has died. He was 43 years old.

Well there you have it, the connection between woolly hats and heart attacks. Do you remember when your mother used to say ” put on your hat scarf and gloves or you’ll catch your death” ? She knew what she was talking about.

Thousands of people die each year of cold related strokes, heart attacks and pulmonary emboli. Even wrapped up, some people prone to sticky blood will still die, but a great many more would survive if they dressed in weather appropriate clothing. It’s not rocket science that the colder it gets the more we need to wrap up. Cover your head neck and wrists when out in extreme cold. The ankles also have vessels near the surface so socks are a must, and boots in snow or when trouser legs are likely to get soaked exposing the skin to excess cold. Wearing several layers means you can take something off if you get too hot and makes managing your temperature far easier.

Stay safe this winter

Take care


7 comments to Woolly hats and heart attacks

  • iaaems

    Cold engine oil all thick and gloopy, hot engine oil flows like water, then along comes 20/50 with all its viscosity enhancers and stuff keeping its flow rate more constant over a greater temperature range and therefore more effective at protecting the engine and keeping it going for longer.
    Do we therefore need a blood enhancer for the winter – something like antifreeze 20/50?
    No thanks – I’ll stick with me woolies, common sense and good reminder articles like this.
    I really can relate to your piece Lizzie – very many thanks!

  • bigpaul

    i have noticed when walking our dog, how many people are walking about “inappropriately” dressed, young chap passed me the other day, cold but not freezing, walking his staffie and he was only wearing a tee shirt and jeans,,,i thought ” its not that warm!”!, during the recent cold/frosty snap 4 males passed me walking their dogs, not one was wearing a hat! i was always told that we lose 60-75% of our body heat through the tops of our heads…probably more so if your older and bald! i have a collection of head gear from army caps to “deputy dawg” style to woolly hats and i am never seen out without a cap of some sort!!

  • prepper1

    Read this in conjunction with Lizzies article.

    While Lizzies article is thorough and I don’t want to take anything away from that, I was left feeling that if I went out in the cold in my t-shirt I’d likely die…

    This didn’t correlate for me as I often do this and other stupid stuff in the cold and wet and haven’t died… YET… notice I said YET….

    So being more than a little concerned for my health and wondered if I was potentially putting myself at risk by being a silly billy in the cold I found this article which I think goes into a little more detail, well it did for me anyway, so it may be of use to you also.

    Why Your Heart Attack Risk May Increase This Winter …

    Cold weather may increase your risk of a heart attack, according to new research from the UK. Each 1.8 degree Fahrenheit reduction in temperature on a single day was linked to about 200 additional heart attacks.

    The greatest risk came within two weeks of cold-weather exposure, and those aged 75-84, along with those with coronary heart disease, were most vulnerable to the temperature changes.

    LiveScience reported:

    “Cold temperatures are known to raise blood pressure and also increase levels of certain proteins that could increase the risk for blood clots. Certain activities more commonly performed during cold weather, such as snow shoveling, might also contribute to the risk, the researchers say.”

    Dr. Mercola’s Comments:

    Many people are aware of the heart attack risk that can occur while shoveling snow, and this occurs not only because of the physical exertion but also because of the cold temperatures.

    Winter is the most common season for heart attacks. Research shows there are up to 53 percent more heart attacks in winter than in summer, and twice as many heart attacks a day in January compared to July.

    This latest study from the UK even found that each 1.8 degree Fahrenheit drop in temperature on any given day was linked to about 200 additional heart attacks.

    Why Does Cold Weather Increase Heart Attack Risk?

    There are most likely several factors involved. For starters, cold temperatures can cause a rise in your blood pressure along with increasing levels of proteins that raise your risk of blood clots.

    When the weather is cold, your heart must also work harder to maintain body heat and your arteries tighten, which restricts blood flow and reduces the oxygen supply to your heart. When combined, all of these factors could trigger a heart attack, especially in the elderly or those with existing heart disease.

    There is also the issue of hypothermia, which occurs when your body temperature falls below normal. Heart failure is the leading cause of death in hypothermia cases, which is why it’s very important to dress appropriately for the weather if you plan to be outdoors in the cold.

    There is another factor, too, that may help explain why heart attacks occur more often during the winter, and this one has nothing to do with temperatures. Still, it may very well be more influential than all of these others combined … a lack of sunlight.

    Dark Winter Days May Pose a Risk for Your Heart

    Although many experts believe that colder temperatures cause heart attacks, if temperature is the sole factor then people who live at higher altitudes, where it is generally colder, should be more likely to die from heart attacks as well.

    However, according to Dr. John Cannell, founder of the Vitamin D Council, Greek researchers found that people living at higher altitudes are actually less likely to die from heart disease. He wrote:

    “Both the men and women living at 950 meters, where vitamin D-producing UVB light is much more intense, had significantly lower total and cardiac mortality than their lowland cousins. The lowland men were more than twice as likely to die from a heart attack in spite of having lower blood pressure and lower cholesterol.

    Three epidemiological facts about heart attacks cry out for a simple explanation, a single theory that explains all the facts. The three facts: heart attacks are less common closer to the equator, less common in the summer, and less common at higher altitudes.

    Three more facts: vitamin D-producing UVB light is higher closer to the equator, higher in the summer, and higher at higher altitudes.”

    Because sunlight is scarce for many during the cold winter months, it can be very difficult to maintain high enough vitamin D levels, especially if you are not using a safe tanning bed or taking a vitamin D3 supplement to make up for the lack of sunlight.

    In the United States, the late winter average vitamin D is only about 15-18 ng/ml, which is considered a very serious deficiency state. In fact, it’s estimated that over 95 percent of U.S. senior citizens may be deficient, along with 85 percent of the American public, and this poses a very serious risk to your heart.

    Your Heart Needs Vitamin D

    If your vitamin D levels are not optimized, you’re very likely putting your future heart health at risk.

    Vitamin D is the only known substrate for a potent, pleiotropic (meaning it produces multiple effects), repair and maintenance seco-steroid hormone that serves multiple gene-regulatory functions in your body.

    This is why vitamin D functions in so many different tissues, and affects such a large number of different diseases and health conditions, one of which is heart disease.

    There are a number of physiological mechanisms triggered by vitamin D production through sunlight exposure that act to fight heart disease, including:

    An increase in your body’s natural anti-inflammatory cytokines
    The suppression of vascular calcification
    The inhibition of vascular smooth muscle growth

    In fact, in a Clinical Endocrinology study, researchers found that people with the lowest average vitamin D levels had a 124 percent greater risk of dying from all causes and a 378 percent greater risk of dying from a heart problem.

    Researchers from Finland also showed that when compared with the participants with the highest vitamin D, those with the lowest levels had a 25 percent higher risk of dying from heart disease or stroke.

    Arterial stiffness, a major risk factor for heart disease and stroke, is also associated with vitamin D deficiency.

    So you can see that being vitamin D deficient leads to massively increased risks for your heart — and since maintaining vitamin D status requires extra attention during cold-weather months, it’s an important heart risk factor that should not be ignored.

    Fortunately, vitamin D deficiency is incredibly easy to fix, but the only accurate way to determine your optimal dose is to get your blood tested. Ideally, you’ll want to maintain a vitamin D level of at least 50ng/ml and perhaps as high as 80-90 ng/ml year-round.

    I encourage you to watch my free one-hour vitamin D lecture to find out how to get your levels optimized.

    More Tips for Lowering Your Heart Attack Risk

    Heart disease causes more than one in every four deaths in the United States, and each year over 631,000 people die from this condition, according to the U.S. Centers for Disease Control and Prevention (CDC).

    The good news is that heart disease is one of the easiest diseases to prevent and avoid, but you simply must be proactive in order to do this. Many people don’t realize that the most common symptom of heart disease is actually sudden death — not chest pain or shortness of breath. Most of the time there are NO warning signs, so that’s why knowing, and monitoring, your risk factors is critical.

    First, I recommend going through this checklist on How to Determine Your Cardiovascular Health, which includes both blood tests and simple do-at-home tests to help you determine if you’re at risk of developing heart disease. About 20 percent of heart attacks go undetected, so checking your susceptibility is a good idea.

    Next, you’ll want to evaluate your lifestyle to ensure you’re doing everything you can to lower your heart disease risk, which includes steps such as the following:

    One of the most important steps in lowering your heart disease risk is to take a high-quality, animal-based omega-3 supplement, such as krill oil.
    Make sure you’re eating the right foods for your body’s unique nutritional type.
    Exercise regularly. A comprehensive exercise program, including strength training, core exercises, stretching and Peak Fitness will help your heart stay in top form.
    Optimize your insulin levels. Elevated insulin levels can lead to insulin resistance, a major risk factor for heart disease. If your fasting insulin level is not lower than three, consider limiting or eliminating your intake of grains and sugars until you optimize your insulin level.

    Then, to keep your insulin levels where they should be, get plenty of exercise and follow my nutrition plan, which will automatically limit your intake of foods that raise insulin levels.

    Again, make sure your vitamin D levels are optimized. Most people are not aware that vitamin D can have a profoundly dramatic impact on normalizing blood pressure and lowering your risk for heart disease.

    Your best source of vitamin D is through your skin being exposed to the sun. In the wintertime, you can use a safe tanning bed or take an oral supplement. Just make sure you’re taking the right form of vitamin D in the appropriate amounts to reap the benefits, and remember to get your vitamin D levels tested regularly.

    High triglycerides are also an incredibly potent risk factor for heart disease. In combination, high triglycerides and low HDL levels are an even bigger risk; this ratio is even more important to your heart health than the standard good vs. bad cholesterol ratio!

    In fact, one study found that people with the highest ratio of triglycerides to HDL had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL. So while you strive to keep your HDL cholesterol levels up, you’ll want to decrease your triglycerides.


    You can increase your HDL levels by exercising and getting plenty of omega-3 fats like those from krill oil. And triglycerides are easily decreased by exercising and avoiding grains and sugars in your diet.

    These are steps you can take to protect your heart year-round, so come winter your heart will be more than ready for the challenge.

  • David075

    Great info makes me rethink my plan for bug out in winter .

  • Lightspeed

    Very timely and useful advice Lizzie.

    Hats and gloves are very much part of my winter appareil.

    The time you take in sharing your hands on medical experience with us is very much appreciated.

    Thank you.

  • Undertaker

    Thank you Lizzie, thoughi have to say it took me longer to read that article than some books, ( i really hate thinking about my own blood ) !!

  • Luana Stains

    deep vein thrombosis can be dangerous and life threatening if it is not treated properly.:

    Head to our website as well
    <img src=" “>

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