Cardiovascular responses to dynamic and static upper-body exercise in a cold environment in coronary artery disease patients

R.I.P. Valtonen, H.H.E. Hintsala, A. Kiviniemi, T. Kentta, C. Crandall, W. D. van Marken Lichtenbelt, J. Perkiomaki, A. Hautala, J.J.K. Jaakkola, T.M. Ikaheimo*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose Upper-body exercise performed in a cold environment may increase cardiovascular strain, which could be detrimental to patients with coronary artery disease (CAD). This study compared cardiovascular responses of CAD patients during graded upper-body dynamic and static exercise in cold and neutral environments. Methods 20 patients with stable CAD performed 30 min of progressive dynamic (light, moderate, and heavy rating of perceived exertion) and static (10, 15, 20, 25 and 30% of maximal voluntary contraction) upper body exercise in cold (- 15 degrees C) and neutral (+ 22 degrees C) environments. Heart rate (HR), blood pressure (BP) and electrocardiographic (ECG) responses were recorded and rate pressure product (RPP) calculated. Results Dynamic-graded upper-body exercise in the cold increased HR by 2.3-4.8% (p = 0.002-0.040), MAP by 3.9-5.9% (p = 0.038-0.454) and RPP by 18.1-24.4% (p = 0.002-0.020) when compared to the neutral environment. Static graded upper-body exercise in the cold resulted in higher MAP (6.3-9.1%; p = 0.000-0.014), lower HR (4.1-7.2%; p = 0.009-0.033), but unaltered RPP compared to a neutral environment. Heavy dynamic exercise resulted in ST depression that was not related to temperature. Otherwise, ECG was largely unaltered during exercise in either thermal condition. Conclusions Dynamic- and static-graded upper-body exercise in the cold involves higher cardiovascular strain compared with a neutral environment among patients with stable CAD. However, no marked changes in electric cardiac function were observed. The results support the use of upper-body exercise in the cold in patients with stable CAD.
Original languageEnglish
Pages (from-to)223-232
Number of pages10
JournalEuropean Journal of Applied Physiology
Issue number1
Early online date16 Oct 2021
Publication statusPublished - Jan 2022


  • Cold
  • Exercise
  • Upper body
  • Dynamic
  • Static
  • Coronary artery disease
  • SNOW
  • LEG
  • ARM


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