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Thursday, February 16, 2017

High Heart Risks in Men Shovelling Snow

"We didn't go to their homes to find out whether they were shovelling or not."
"We looked at the relationship between snowfall and risk of MI [myocardial infarction/heart attack]."
"It's the first study that looks at actual risk in population."
"We don't know why that is [that men appear at greater risk than women]. It's possible that men shovel more than women. Or that women do it in a way that's less risky or causes less exertion. Snow shovelling is a demanding cardiovascular exercise requiring more than 75 percent of the maximum heart rate, particularly with heavy loads."
"In the big picture, very few people who shovel will actually have a heart attack. [Those with risk factors should shovel] slowly and with less exertion."
Nathalie Auger, Quebec Public Health Institute

It has always been common knowledge that winter, plus snow shovelling is hazardous, in particular for older men. Older men in poor physical shape, likelier. Since such winter-time shovelling takes place in front of a house, to clear a driveway, it's also likely that a family lives in the house. A family where, given the age of an older man at risk, no longer has sons living at home. So if there are only two people in the home, a man and a woman, it is more habitual for the woman to remain indoors and the man to go out to do the shovelling; a division of household tasks across traditional gender-role lines.

So a male is out in the winter cold far more frequently than a female, shovelling snow. Little wonder there are more men who suffer dangerously adverse heart effects than women. Lead researcher, epidemiologist Nathalie Auger, in an affiliation with University of Montreal Hospital Research Center, spoke recently of her group's study for the Quebec Public Health Institute, which was published by the Canadian Medical Association Journal. A study that examined data collected over a 33-year period, on the connection between snowfall, heart failure and death.

The study took under consideration factors that would certainly impact on morbidity when snow and shovelling were combined; obesity, diabetes, a smoking habit and high blood pressure. The study obviously looked at hand shovelling, perhaps overlooking the fact that snow blowers or snow throwers are now in fairly universal use by many home owners. And people getting on in age and who can afford a now-common mechanical device to aid in clearing away snow, generally tend to use them. Even with their use, it's true some minimum hand shovelling is also required.

The research team looked at days with no snowfall to the opposite; those with 20-centimetre snowfalls, during the winter months of November through April, from 1981 to 2014, in Quebec. They identified a firm link between the amount of snow fallen and resulting hospitalizations and deaths related to heart attacks. Almost 200,000 people were included in the study; 128,073 individuals admitted to hospital with an MI, and 68,155 deaths from MI, with the acknowledgement that some of those affected died before making it to a hospital.

Some experts theorize that combining a snowstorm with cold weather and hard work resulting in great physical strain to shovel wet, heavy snow, conceivably causes a sudden surge in blood pressure and heart rate. The study conclusion suggested that a snowfall of 20 cm increases the chance of being hospitalized by 16 per cent — dying from a heart attack by 34 per cent. One third of heart attacks occurred a day after a storm, while  10 per cent took place after snowfalls of five cm or more.

The association was even stronger after snowfalls lasting two to three days. 

In Ottawa last week a 49-year-old interventional neuroradiology expert who was a fitness buff was taking part in a ski marathon. This was a talented expert who performed skilled medical interventions, removing deadly blood clots and saving peoples' lives, a man whose professional talents were peerless and whose healthy lifestyle marked him as a model doctor who was intimate with the major problems that arise in cardiac arrest. His colleagues trusted and admired his professionalism and expertise, committed to his patients.

A nurse and a doctor on the scene directly followed by paramedics were unable to revive this athletic health professional at the ski event when he suddenly suffered cardiac arrest. He was dead at the scene. "I have seen patients with no family history [of heart disease], with a pristine lifestyle, who are endurance athletes at a very high level and all of a sudden they have a sudden, dramatic cardiac arrest", noted Ottawa cardiologist, Andrew Pipe, chief of rehabilitation and prevention at the University of Ottawa Heart Institute.

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