Cardiovascular Risk-Benefit Ratio of Alpine Skiing in Recreational Skiers

Worldwide, but especially in western countries, there is an epidemic of physical inactivity with its known detrimental health-related effects. Physical activity and regular physical exercise remain difficult to implement especially in sedentary elderly subjects, often because of a lack of appealing physical activities. Gaining the attraction of these target groups is a prerequisite in order to improve adherence. Alpine skiing is performed by millions of recreational subjects in the Alps alone and may be an attractive mode of physical activity for many local citizens and tourists alike. Besides the well-known positive effects of exercise on cardiovascular and other health-related outcomes, the risks also need to be considered. Indeed, myocardial infarction and sudden cardiac death during alpine skiing in recreational skiers are the leading causes of death in the Alps during the winter and exceed the number of fatalities due to avalanches or traumatic deaths. It is the aim of this article to provide an up-to-date evaluation of the potential cardiovascular risks of recreational alpine skiing as well as the known benefit s thereof. In the first section a general cardiovascular risk–benefit evalua tion of physical activity is provided. Thereafter the current knowledge of the cardiovascular benefits and risks of alpine skiing are summarized, followed by a discussion and conclusion.