Physically Unprepared Skiers Face Heart Risk

High Altitudes and Low Temperatures Add to Risk of a Heart Attack on the Slopes

Medically Reviewed by Elizabeth Klodas, MD, FACC on September 01, 2010
From the WebMD Archives

Sept. 1, 2010 (Stockholm, Sweden) -- As you start your early planning for this winter's ski vacation, you should be thinking about more than getting the best possible plane ticket and hotel rates -- think about your heart, too.

Many people fail to rev up their exercise regimen before they leave -- and the sudden burst of activity on the slopes puts them at risk for sudden cardiac death, researchers say.

"Our study of tourists in the Austrian Alps shows that inadequate preparation for the physical exertion required, combined with the effect of high altitude and cold temperatures, led to an increase in heart attacks, particularly during the first two days of vacation," says study researcher Gert Klug, MD, of the Medical University of Innsbruck in Austria.

Previous research showed that sudden cardiac death, of which heart attacks were the leading cause, accounted for 40% of deaths on the slopes. The new study aimed to figure out why the figure was so high, Klug tells WebMD.

Heart Attacks Can Happen at Start of Vacation

The researchers analyzed data on 110 people who had suffered a heart attack during their winter sports vacation in the Alps between 2006 and 2010. All filled out detailed questionnaires that asked about their heart disease risk factors, activities before their trip, and circumstances under which they suffered their first symptoms.

Among the findings, presented here at the European Society of Cardiology Congress:

  • 56% of heart attacks occurred within the first two days of hitting the slopes; 39% struck on the day of arrival.
  • About one in five people had suffered previous heart symptoms, and seven in 10 had at least two heart disease risk factors such as high cholesterol, high blood pressure, or smoking.
  • Half suffered their heart attack during or within one hour of activity.
  • The average time from hitting the slopes to suffering the first symptoms was nearly two hours.
  • More than 50% had not been doing the recommended levels of exercise before they left. You should engage in at least two hours of physical activity a week in the weeks leading up to a vacation in which you’re going to be more physically active than usual, Klug says.

The Role of Altitude and Cold

Previous research also suggests that cold temperatures may trigger a heart attack, Klug says.

Altitude may also play a role, he tells WebMD. The heart attacks occurred at an average altitude of 4,429 feet, while the patients lived at an average of only 557 feet above sea level.

"Although winter sports are quite safe, there is a risk of heart attack, which can lead to sudden cardiac death. Our advice is proper preparation, with a stepwise increase in exercise prior to and during your holiday," he says.

American Heart Association spokesman Ray Gibbons, MD, professor of medicine at the Mayo Clinic in Rochester, Minn., tells WebMD that inadequate physical preparation, high altitudes, and cold temperatures create a "perfect storm" for heart attacks.

"We don't want to discourage people from exercising as its benefits in improving heart health are well established. Just prepare," he says.

Gibbons' advice:

  • Increase physical activity gradually.
  • If you're going to a high-altitude resort, wait a day before hitting the slopes or engaging in other strenuous activity.
  • If it's a very high altitude resort, ask your doctor about strategies for acclimatization.
  • Dress warmly, in layers.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

WebMD Health News



European Society of Cardiology Congress 2010, Stockholm, Sweden, Aug. 21-Sept. 1, 2010.

Gert Klug, MD, Medical University of Innsbruck, Austria.

Ray Gibbons, MD, professor of medicine, Mayo Clinic, Rochester, Minn.

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