A fresh snowfall may make your neighborhood look like a winter wonderland, but don’t let the white stuff fool you. The task of shoveling all that snow can pose a major risk to your health. Now that we’re in the thick of snow season in the United States, the American Heart Association (AHA) is sounding the alarm that the exertion from shoveling may lead to an increased risk of a heart attack or cardiac arrest.
“The cardiac dangers of snow are woefully underestimated, and people should think twice if they’re middle aged or older about going out and shoveling heavy wet snow,” says Barry Franklin, PhD, the director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, and a spokesperson for the AHA.
Year after year, snow shoveling has been linked to a spike in cardiovascular events soon after major snowstorms, according to a 2020 AHA scientific statement.
A major study looking at snow-removal-related medical emergencies treated in the United States between 1990 and 2006 identified about 11,500 shoveling injuries over the 17-year span — cardiovascular events accounted for half of the hospitalizations and 100 percent of the deaths.
Certain People Have a Higher Risk
Shoveling snow may not seem like a big deal for many people, because everyone seems to do it, including non-athletes. The activity can even provide good exercise if done cautiously. Franklin, however, calls shoveling a “double-edged sword” because too much can overtax the heart.
Research led by Franklin found that healthy men in their early thirties who shoveled wet snow for several minutes raised their heart rates and blood pressure to levels equal to or greater than maximal treadmill testing. After just two minutes of snow shoveling, participant heart rates exceeded 85 percent of the maximal heart rate, which is a level more commonly expected during intense aerobic exercise tests.
Plus, shoveling ordinarily goes beyond two minutes and can involve moving hundreds of pounds of snow.
This type of intense physical strain can especially be a threat to those who are typically sedentary and don’t exercise regularly.
According to Franklin, individuals who are more likely to have a cardiac event due to shoveling are 45 or older and have known heart disease. People at higher risk include those who have had a heart attack, angioplasty (a minimally invasive procedure to widen narrowed or blocked arteries), or bypass surgery, and those who have experienced some chest discomfort when exerting themselves. Other factors that raise the risk are high blood pressure, high cholesterol, diabetes, obesity, and cigarette smoking.
Many people have heart disease and don’t know it. A study published in 2022 in the journal Circulation looked at 93 people, averaging 66 years, who had been diagnosed with a heart attack. Imaging revealed that almost 70 percent of them had signs of coronary artery disease (a buildup of plaque in the arteries), but in 3 out of 5, the condition had not been previously detected.
Although the risks of shoveling can affect both sexes, men in particular may want to be extra cautious. A study conducted in Canada a few years ago found that the chance of heart attack after a snowfall increased among men but not among women. In the research, heavy snowfall of seven to eight inches versus no snowfall was associated with a 16 percent greater chance that men were admitted to the hospital for a heart attack and a 34 percent higher risk of men dying of a heart attack.
How Shoveling Strains the Body
The act of shoveling snow requires a unique set of motions that can especially challenge the heart. Primarily, it involves arm work, which is more demanding on the heart than leg work.
“Upper body exertion from lifting snow is extremely vigorous,” says Sharonne N. Hayes, MD, a cardiologist with the Mayo Clinic in Rochester, Minnesota. “We have less muscle mass in the upper body [compared with our legs], so when we use our upper body to do vigorous exercise, it places a bigger demand on our heart. If there are already blockages [in the arteries], shoveling can cause the heart muscle to not get enough oxygen.”
Because you’re not moving your legs much when shoveling, blood can pool in the lower extremities and not get back to the heart, which relies on the oxygenated blood. The AHA also notes that while straining to lift heavy loads, you often unconsciously hold your breath, which causes big increases in heart rate and blood pressure.
On top of these factors, cold air constricts the coronary arteries, raising your blood pressure even higher.
Dr. Hayes adds that a mental aspect to shoveling may compel individuals to push themselves beyond their limits.
“People want to finish the driveway or the walk, so even when they start to feel super tired or even get a little chest pain, they don’t listen to their bodies and just keep going,” she says. “Some of these heart events may be attributed to stubborn people who just want to get their work done.”
Ways to Protect Yourself and Your Heart While Shoveling
Franklin, who lost two close friends who died of cardiac events brought on by snow shoveling, offers these tips to avoid major heart trouble.
- If you must shovel the snow, start gradually and pace yourself. Don’t try to clear the driveway all in one shot.
- Know the common signs of heart problems. If you experience chest pain or pressure, lightheadedness or heart palpitations or irregular heart rhythms, stop the activity immediately. Call 911 if symptoms don’t subside shortly after you stop shoveling or snow blowing.
- Have someone keep an eye on you. If you do collapse from a cardiac event, a person monitoring you can quickly call for emergency help and start hands-only CPR if you are unresponsive with no pulse.
- Always cover your mouth and nose so you’re not inhaling cold air, and wear layered clothing, as well as a hat and gloves, to stay warm.
- Ideally, push or sweep the snow rather than lifting and throwing it—that action involves less exertion.
- Be extra careful when the wind is blowing. The wind makes the temperature feel even colder and will increase the effects of the cold on your body. Franklin says that if it’s 10 degrees outside with a 30 mile-per-hour wind, the windchill can be equivalent to minus 33 degrees.
- Use an automated snow blower if possible. While you should still proceed with caution and be mindful of how your body is feeling, research shows that a snow blower raises the heart rate to around 120 beats per minute, compared with shoveling’s rate of around 170. “If you’re wrangling a heavy snow blower though, it can still cause some risk,” cautions Hayes.
- Stay active in general. Try walking or doing some type of aerobic exercise 30 minutes several days a week. Your heart will thank you.
- If you have known or suspected heart disease or risk factors for heart disease, get someone else to remove the snow for you. “I recommend that all high-risk older persons put a label on their shovel that says, ‘Warning: Use of this instrument for snow removal may be hazardous to your health,’” says Hayes.