According to a new study published Wednesday in the British Medical Journal, the holiday season may not actually be the most wonderful time of the year. While millions of people across the world gather together with family and friends on Christmas Eve to kick off holiday celebrations after a month full of activities, decorating, shopping, planning, and more — a dark reality looms.

The new study found that heart attack risk peaks around 10 p.m. on Christmas Eve when the chances of having a heart attack increased by a shocking 37 percent.

According to Lund University cardiologist David Erlinge:

“The peak is very pronounced exactly on Christmas Eve and the following two days, so, I think it is something specific for the way we celebrate these holidays.”

Researchers sifted through the data associated with 283,000 heart attacks recorded in Sweden over a span of 16 years, from 1998 to 2013. “It’s a big study, not a sample,” Erlinge added. “Every heart attack for 16 years in the whole country is in it. It’s reality.”

Christmas is traditionally celebrated on Christmas Eve in Sweden, suggesting that the risk of heart attack may actually be more pronounced at 10 p.m. on Christmas Day in countries where Christmas is celebrated the day of, like the United States and Britain.

While the observational study does not draw conclusions about the cause of the Christmas Eve spike, findings suggest that stress, travel, emotions, and a tendency to over-indulge during the holiday season may have deadly results. The risk is especially pronounced for those with diabetes or a history of heart disease.

“We do not know for sure but emotional distress with acute experience of anger, anxiety, sadness, grief, and stress increases the risk of a heart attack. Excessive food intake, alcohol, long distance traveling may also increase the risk,” Erlinge said.

In addition to the Christmas Eve spike, researchers noted additional patterns when it comes to heart attack occurrence. The study found a slightly higher risk on Mondays as well as before 8 a.m. Smaller spikes were found to occur on New Year’s Day, summer holidays, around major sporting events, and during Islamic holidays.

“People could avoid unnecessary stress, take care of elderly relatives with risk of heart problems and avoid excessive eating and drinking,” Erlinge added.

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