If you live in a cold climate in the winter, be sure to bundle up, stay warm and minimize your time outdoors to decrease your risk of a heart attack.

Cold temperatures make your heart work harder to keep your body warm causing your blood vessels to constrict, consequently reducing blood flow to your heart. This can lead to increased blood pressure in addition to demanding more from your heart.

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Besides cold temperatures, high winds, snow and rain can steal body heat and force your heart to work harder. Wind is especially dangerous, because it removes the layer of heated air from around your body.

Research from a large study published last month (October 2018) in the JAMA Cardiology journal showed that below-freezing temperatures and winter conditions can increase the risk of a heart attack. Data merged from the Swedish Meteorlogical and Hydrological Institute showed that the number of heart attacks increased on days when the temperature dropped below freezing. In addition to below freezing temperatures, low atmospheric pressure, wind velocity, and shortened daylight were all found to increase the risk of a heart attack. (1)

The connection between cold weather and heart events was noted in 1926 in the Boston Medical Surgery Journal for the New England area. (2)

It must be noted that other health factors during cold weather can elevate the risk of a heart attack as well, namely respiratory tract infections and influenza.

Snow-shoveling is a strenuous activity that, when coupled with cold temperatures, increases the demand on your heart—especially if you haven’t been exercising regularly. Breathing in cold air while you shovel increases the workload further. For people who have heart disease, there can be an increased risk of a heart attack.

If you have heart disease, a heart condition or are elderly, when temperatures are extremely cold, try to minimize your time outside or if possible avoid going out altogether. And consider hiring someone to shovel your driveway.

Or if you have the resources to go, you may consider doing what millions of “snowbirds” do and head south for the winter.