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Ikäheimo TM. Cardiovascular diseases, cold exposure and exercise. Temperature (Austin). 2018;5(2):123-146doi: 10.1080/23328940.2017.1414014.
Ikäheimo, T. M. (2018). Cardiovascular diseases, cold exposure and exercise. Temperature (Austin, Tex.), 5(2), 123-146. https://doi.org/10.1080/23328940.2017.1414014
Ikäheimo, Tiina M. "Cardiovascular diseases, cold exposure and exercise." Temperature (Austin, Tex.) vol. 5,2 (2018): 123-146. doi: https://doi.org/10.1080/23328940.2017.1414014
Ikäheimo TM. Cardiovascular diseases, cold exposure and exercise. Temperature (Austin). 2018 Feb 01;5(2):123-146. doi: 10.1080/23328940.2017.1414014. eCollection 2018. PMID: 30377633; PMCID: PMC6204981.
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Temperature (Austin). 2018 Feb 01;5(2):123-146. doi: 10.1080/23328940.2017.1414014. eCollection 2018.

Cardiovascular diseases, cold exposure and exercise.

Temperature (Austin, Tex.)

Tiina M Ikäheimo

Affiliations

  1. Center For Environmental and Respiratory Health Research, University of Oulu, FI-90014 University of Oulu, Oulu, Finland.
  2. Medical Research Center, University of Oulu and Oulu University Hospital, FI-90029 OYS, Oulu, Finland.

PMID: 30377633 PMCID: PMC6204981 DOI: 10.1080/23328940.2017.1414014

Abstract

Both acute and prolonged cold exposure affect cardiovascular responses, which may be modified by an underlying cardiovascular disease. In addition, exercise in a cold environment increases cardiovascular strain further, but its effects among persons with cardiovascular diseases are not well known. Controlled studies employing whole-body or local cold exposure demonstrate comparable or augmented increase in cardiac workload, but aggravated cutaneous vasoconstriction in persons with mild hypertension. A strong sympathetic stimulation of a cold pressor test, increases cardiac workload in persons with coronary artery disease (CAD), but does not markedly differ from those with less severe disease or healthy. However, cold exposure reduces myocardial oxygen supply in CAD, which may lead to ischemia. Exercise in cold often augments cardiac workload in persons with CAD more than when performed in thermoneutral conditions. At the same time, reduced myocardial perfusion may lead to earlier ischemia, angina and impaired performance. Also having a heart failure deteriorates submaximal and maximal performance in the cold. Antianginal medication is beneficial in the cold in lowering blood pressure, but does not affect the magnitude of cold-related cardiovascular responses in hypertension. Similarly, the use of blood pressure lowering medication improves exercise performance in cold both among persons with CAD and heart failure. Both the acute and seasonal effects of cold and added with exercise may contribute to the higher morbidity and mortality of those with cardiovascular diseases. Yet, more controlled studies for understanding the pathophysiological mechanisms behind the adverse cold-related health effects are warranted.

Keywords: cardiac workload; cardiovascular diseases; coronary artery disease; exercise; heart failure; hypertension; low temperature; myocardial oxygen supply

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