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Cardiovascular diseases, cold exposure and exercise.

Tiina M Ikäheimo1,2

  • 1Center For Environmental and Respiratory Health Research, University of Oulu, FI-90014 University of Oulu, Oulu, Finland.

Temperature (Austin, Tex.)
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PubMed
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Cold exposure and exercise increase cardiovascular strain, particularly for individuals with heart conditions like coronary artery disease (CAD) and heart failure. Medications can help manage symptoms and improve performance in cold environments.

Keywords:
cardiac workloadcardiovascular diseasescoronary artery diseaseexerciseheart failurehypertensionlow temperaturemyocardial oxygen supply

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Area of Science:

  • Cardiovascular Physiology
  • Environmental Medicine
  • Exercise Science

Background:

  • Cold exposure significantly impacts cardiovascular responses.
  • Exercise in cold environments exacerbates cardiovascular strain, especially in individuals with pre-existing cardiovascular diseases.
  • The specific effects of cold exposure on individuals with cardiovascular diseases, particularly during exercise, are not fully understood.

Purpose of the Study:

  • To investigate the cardiovascular responses to acute and prolonged cold exposure, with and without exercise, in individuals with cardiovascular diseases.
  • To explore how underlying cardiovascular conditions modify the body's response to cold stress.
  • To assess the efficacy of certain medications in mitigating adverse cardiovascular effects during cold exposure and exercise.

Main Methods:

  • Controlled studies involving whole-body or local cold exposure.
  • Utilizing cold pressor tests to assess sympathetic stimulation.
  • Evaluating cardiovascular workload, cutaneous vasoconstriction, and myocardial oxygen supply.
  • Assessing exercise performance in thermoneutral versus cold conditions.
  • Examining the effects of antianginal and blood pressure-lowering medications.

Main Results:

  • Cold exposure can augment cardiac workload and cause cutaneous vasoconstriction, particularly in individuals with mild hypertension.
  • In coronary artery disease (CAD) patients, cold exposure reduces myocardial oxygen supply, potentially leading to ischemia, and exercise in cold further increases cardiac workload and risk of ischemia.
  • Heart failure patients exhibit deteriorated exercise performance in cold conditions.
  • Blood pressure-lowering medications improve exercise performance in cold for both CAD and heart failure patients, while antianginal medications primarily lower blood pressure without altering cold-related cardiovascular responses in hypertension.

Conclusions:

  • Both acute and seasonal cold exposure, especially when combined with exercise, can increase morbidity and mortality in individuals with cardiovascular diseases.
  • Further controlled studies are needed to elucidate the pathophysiological mechanisms underlying these adverse cold-related health effects.
  • Medications play a role in managing cardiovascular responses and improving exercise tolerance in cold environments for specific patient groups.