AHA: Snow Shoveling Increases Risk of Heart Attack, Sudden Cardiac Arrest

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An American Heart Association scientific statement cautions individuals with known or suspected cardiovascular disease or risk factors against shoveling snow.

The exertion of shoveling snow could increase the risk of heart attack or sudden cardiac arrest, according to findings from the American Heart Association.1 In a scientific statement, the organization notes that the risk can be for individuals with or without heart disease.1,2

Man clearing snow by shovel after snowfall. Outdoors. | Image Credit: svetlana_cherruty - stock.adobe.com

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"Shoveling a little snow off your sidewalk may not seem like hard work. However, the strain of heavy snow shoveling may be as or even more demanding on the heart than taking a treadmill stress test, according to research we’ve conducted,” Barry Franklin, PhD, FAHA, director of preventive cardiology and cardiac rehabilitation at Corewell Health East at the William Beaumont University Hospital, said in the statement. “For example, after only 2 minutes of snow shoveling, study participants’ heart rates exceeded 85% of maximal heart rate, which is a level more commonly expected during intense aerobic exercise testing. The impact is hardest on those [individuals] who are least fit.”1

Tips for Shoveling, According to the American Heart Association

  1. If someone knows or suspects they have a heart disease or risk factor,, they should have someone else remove the snow for them.
  2. If having someone else remove the snow is not possible, start gradually and set a slower pace.
  3. Wear layered clothing to stay warm, ensuring that the mouth and nose are covered, especially in the increased wind.
  4. Consider pushing or sweeping the snow instead of shoveling, as it requires less exertion.
  5. If possible, use an automated snow blower instead of shoveling, but proceed with caution.

According to the press release, Franklin said there are 5 ways that snow shoveling affects the heart. First, he stated that the action involves mostly isometric or static exertion, which contracts muscles without any movement in the surrounding joints. Additionally, snow shoveling is more taxing and demanding for the heart due to it involving mostly arm work. Franklin also added that when lifting heavy snow, individuals tend to subconsciously hold their breath, leading to an increase in heart rate and blood pressure. Further, due to the legs not moving as much as the arms, blood pools in the lower extremities, which limits the blood from being oxygenated in the heart. Lastly, when breathing cold air, blood vessels constrict more causing a rise in blood pressure and constricting the coronary arteries.1

The risk when shoveling is greatest for those who have cardiovascular risks, including a sedentary lifestyle or obesity, current or former smokers, diabetes, high cholesterol or high blood pressure, and who previously had a heart attack or stroke, according to Franklin.1

“[Individuals] with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” Franklin said in the press release. “We often see events in [those] who are usually sedentary, they work at a computer all day or get little or no exercise. Then once or twice a year they go out and try to shovel the driveway after a heavy snowfall and that unexpected exertion can unfortunately lead to tragedy.”1

Franklin added that if someone knows or suspects that they have a heart disease or risk factor, they should have someone remove the snow for them. However, if that is not possible, Franklin said to start gradually and to set a slower pace. He added to wear layered clothing and cover the mouth and nose. He also suggested to push or sweep the snow because it requires less exertion. If possible, using an automated snow blower is preferred to shoveling, but individuals should still proceed with caution.1

Further, Franklin said that individuals should be extra careful when it is windy as that decreases the temperature and increases the effects of the cold in the body.1

References

  1. Snow shoveling, cold temperatures combine for perfect storm of heart health hazards. Press release. American Heart Association. January 11, 2024. Accessed January 15, 2024. https://newsroom.heart.org/news/snow-shoveling-cold-temperatures-combine-for-perfect-storm-of-heart-health-hazards
  2. Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, et al. Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association. Circulation. 2020;141(13):e705-e736. doi:10.1161/CIR.0000000000000749
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