diff --git a/Include/listobject.h b/Include/listobject.h
--- a/Include/listobject.h
+++ b/Include/listobject.h
@@ -72,6 +72,7 @@
 #define PyList_GET_ITEM(op, i) (((PyListObject *)(op))->ob_item[i])
 #define PyList_SET_ITEM(op, i, v) (((PyListObject *)(op))->ob_item[i] = (v))
 #define PyList_GET_SIZE(op)    Py_SIZE(op)
+#define _PyList_ITEMS(op)      (((PyListObject *)(op))->ob_item)
 #endif
 
 #ifdef __cplusplus
diff --git a/Modules/_heapqmodule.c b/Modules/_heapqmodule.c
--- a/Modules/_heapqmodule.c
+++ b/Modules/_heapqmodule.c
@@ -11,7 +11,7 @@
 static int
 siftdown(PyListObject *heap, Py_ssize_t startpos, Py_ssize_t pos)
 {
-    PyObject *newitem, *parent;
+    PyObject *newitem, *parent, **arr;
     Py_ssize_t parentpos, size;
     int cmp;
 
@@ -24,10 +24,11 @@
 
     /* Follow the path to the root, moving parents down until finding
        a place newitem fits. */
-    newitem = PyList_GET_ITEM(heap, pos);
+    arr = _PyList_ITEMS(heap);
+    newitem = arr[pos];
     while (pos > startpos) {
         parentpos = (pos - 1) >> 1;
-        parent = PyList_GET_ITEM(heap, parentpos);
+        parent = arr[parentpos];
         cmp = PyObject_RichCompareBool(newitem, parent, Py_LT);
         if (cmp == -1)
             return -1;
@@ -38,10 +39,10 @@
         }
         if (cmp == 0)
             break;
-        parent = PyList_GET_ITEM(heap, parentpos);
-        newitem = PyList_GET_ITEM(heap, pos);
-        PyList_SET_ITEM(heap, parentpos, newitem);
-        PyList_SET_ITEM(heap, pos, parent);
+        arr = _PyList_ITEMS(heap);
+        newitem = arr[pos];
+        arr[pos] = arr[parentpos];
+        arr[parentpos] = newitem;
         pos = parentpos;
     }
     return 0;
@@ -51,7 +52,7 @@
 siftup(PyListObject *heap, Py_ssize_t pos)
 {
     Py_ssize_t startpos, endpos, childpos, limit;
-    PyObject *tmp1, *tmp2;
+    PyObject *tmp, **arr;
     int cmp;
 
     assert(PyList_Check(heap));
@@ -63,15 +64,15 @@
     }
 
     /* Bubble up the smaller child until hitting a leaf. */
+    arr = _PyList_ITEMS(heap);
     limit = endpos / 2;          /* smallest pos that has no child */
     while (pos < limit) {
         /* Set childpos to index of smaller child.   */
         childpos = 2*pos + 1;    /* leftmost child position  */
         if (childpos + 1 < endpos) {
-            cmp = PyObject_RichCompareBool(
-                PyList_GET_ITEM(heap, childpos),
-                PyList_GET_ITEM(heap, childpos + 1),
-                Py_LT);
+            cmp = PyObject_RichCompareBool(arr[childpos],
+                                           arr[childpos + 1],
+                                           Py_LT);
             if (cmp == -1)
                 return -1;
             if (cmp == 0)
@@ -83,10 +84,10 @@
             }
         }
         /* Move the smaller child up. */
-        tmp1 = PyList_GET_ITEM(heap, childpos);
-        tmp2 = PyList_GET_ITEM(heap, pos);
-        PyList_SET_ITEM(heap, childpos, tmp2);
-        PyList_SET_ITEM(heap, pos, tmp1);
+        arr = _PyList_ITEMS(heap);
+        tmp = arr[childpos];
+        arr[childpos] = arr[pos];
+        arr[pos] = tmp;
         pos = childpos;
     }
     /* Bubble it up to its final resting place (by sifting its parents down). */
@@ -362,7 +363,7 @@
 static int
 siftdown_max(PyListObject *heap, Py_ssize_t startpos, Py_ssize_t pos)
 {
-    PyObject *newitem, *parent;
+    PyObject *newitem, *parent, **arr;
     Py_ssize_t parentpos, size;
     int cmp;
 
@@ -375,10 +376,11 @@
 
     /* Follow the path to the root, moving parents down until finding
        a place newitem fits. */
-    newitem = PyList_GET_ITEM(heap, pos);
+    arr = _PyList_ITEMS(heap);
+    newitem = arr[pos];
     while (pos > startpos) {
         parentpos = (pos - 1) >> 1;
-        parent = PyList_GET_ITEM(heap, parentpos);
+        parent = arr[parentpos];
         cmp = PyObject_RichCompareBool(parent, newitem, Py_LT);
         if (cmp == -1)
             return -1;
@@ -389,10 +391,10 @@
         }
         if (cmp == 0)
             break;
-        parent = PyList_GET_ITEM(heap, parentpos);
-        newitem = PyList_GET_ITEM(heap, pos);
-        PyList_SET_ITEM(heap, parentpos, newitem);
-        PyList_SET_ITEM(heap, pos, parent);
+        arr = _PyList_ITEMS(heap);
+        newitem = arr[pos];
+        arr[pos] = arr[parentpos];
+        arr[parentpos] = newitem;
         pos = parentpos;
     }
     return 0;
@@ -402,7 +404,7 @@
 siftup_max(PyListObject *heap, Py_ssize_t pos)
 {
     Py_ssize_t startpos, endpos, childpos, limit;
-    PyObject *tmp1, *tmp2;
+    PyObject *tmp, **arr;
     int cmp;
 
     assert(PyList_Check(heap));
@@ -414,15 +416,15 @@
     }
 
     /* Bubble up the smaller child until hitting a leaf. */
+    arr = _PyList_ITEMS(heap);
     limit = endpos / 2;          /* smallest pos that has no child */
     while (pos < limit) {
         /* Set childpos to index of smaller child.   */
         childpos = 2*pos + 1;    /* leftmost child position  */
         if (childpos + 1 < endpos) {
-            cmp = PyObject_RichCompareBool(
-                PyList_GET_ITEM(heap, childpos + 1),
-                PyList_GET_ITEM(heap, childpos),
-                Py_LT);
+            cmp = PyObject_RichCompareBool(arr[childpos + 1],
+                                           arr[childpos],
+                                           Py_LT);
             if (cmp == -1)
                 return -1;
             if (cmp == 0)
@@ -434,10 +436,10 @@
             }
         }
         /* Move the smaller child up. */
-        tmp1 = PyList_GET_ITEM(heap, childpos);
-        tmp2 = PyList_GET_ITEM(heap, pos);
-        PyList_SET_ITEM(heap, childpos, tmp2);
-        PyList_SET_ITEM(heap, pos, tmp1);
+        arr = _PyList_ITEMS(heap);
+        tmp = arr[childpos];
+        arr[childpos] = arr[pos];
+        arr[pos] = tmp;
         pos = childpos;
     }
     /* Bubble it up to its final resting place (by sifting its parents down). */