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Cold Weather Has a Chilling Influence on Heart Attack and Stroke

Not just cold, but winter lifestyle changes raise cardiac event risk.

This winter season has produced some of most widespread frigid weather in US history and, per a 2013 article in the North American Journal of Medical Sciences there is a clear seasonal increase of adverse cardiovascular and stroke events during the cold winter season. The epidemiological data cited in the article indicates that low temperatures and barometric pressure changes can induce changes in coagulation factors, hormones, and reduced Vitamin D levels. These in turn can lead to hypertension, angina, acute myocardial infarction, stroke, and other adverse cardiac events. Among the other factors recognized were the seasonal changes in lifestyle factors, including reduced regular physical activity and a less healthy diet, which can impact cholesterol levels. 

A man shoveling snow on a sunny day; Unsplash photo

One often noted physical stressor is shoveling snow. Harvard Health reported that shoveling raises heart rate and blood pressure more quickly and dramatically than many other forms of exercise. Further, many sedentary people shovel snow. Also, the deeper the snow to shovel, the more men who are admitted to a hospital  or ultimately died from a heart attack. There was no link observed between snowfall and heart attacks in women.

When advising patients to remain active during cold weather, clinicians may first want to assess a patient’s condition. One assessment framework included in the evidence-based Lifestyle Medicine Core Competencies Program involves the following 5-steps:

  • Assess
  • Advise
  • Agree to goals, collaboratively set
  • Assist in identifying and overcoming barriers
  • Arrange plan/follow-up,including "physical activity prescriptions"

If specifically advising patients about shoveling snow, Harvard Health recommends:

  • Warming up muscles before starting
  • Shoveling many light loads instead of fewer heavy ones
  • Taking frequent breaks
  • Drinking plenty of water
  • Advising patients to head indoors immediately if their chest starts hurting, s/he feels lightheaded or short of breath, their heart starts racing, or some other physical change makes them nervous
  • If they suspect they are having a heart attack, call 911 or the local emergency number
  • If out of shape or worried about their heart, they should hire someone to do the work
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