While you may be used to battling frigid temperatures and the inevitable snowstorms that arrive every winter, are you aware of the dangers these pose to your heart?

“When the temperature outside drops, our blood vessels narrow to prevent our bodies from losing heat. This is a natural response that can also put people with heart conditions and those involved in strenuous exercise at greater risk of having a heart attack,” says Dr. Holly Andersen of the Perelman Heart Institute at NewYork–Presbyterian Hospital/Weill Cornell Medical Center.

Shoveling snow is one of the most strenuous and dangerous winter exercise activities. It can raise blood pressure, and coupled with the effects of colder temperatures, shoveling can increase heart attack risk drastically. Take these precautions:

•  Warm up. Warm up with stretching and light activity before shoveling, exercising or beginning more strenuous physical activities.

•  Bundle up. When going out to shovel, always wear a scarf over your mouth and nose to warm the air before you breathe in, and dress in layers. Layering clothes underneath a windproof and waterproof outer shell helps maintain body heat.

•  Push the shovel. It is less strenuous to push the snow rather than lifting it, and this reduces the risk of overexerting yourself.

•  Take breaks. You should take frequent breaks while shoveling to give your muscles, especially your heart muscle, a chance to relax. You may also consider sharing the work with a friend to make the workload lighter and ensure that you are not alone in the event of an emergency.

•  Consult a doctor. If you are over the age of 50, overweight, out of shape or have suffered a heart attack, you should consult a doctor before shoveling snow or starting any exercise routine.