Previous studies demonstrated an increased risk of cardiac events, for example, sudden cardiac deaths (SCDs), during vigorous exercise. However, such events seem to be provoked particularly in people who are normally sedentary. Only a few investigations deal with SCDs during downhill skiing or have drawn comparisons with other types of mountain sports.
Therefore, we analyzed the fatalities during mountain sports in Austria from 1985 through 1993. The number of persons involved in mountain sports was compiled on the basis of a representative Austrian-wide survey taken in 1984 and in the 1989 microcensus. SCDs are defined as unexpected, nontraumatic events that lead to death within 1 h after the onset of symptoms.
In nine years (1985 to 1993), 157 SCDs occurred during downhill skiing and 361 during mountain hiking. About 90% of all SCDs were attributed to men over 34 years of age. The mountain-sport-related SCD risk to male nonmembers of mountaineering associations, over 34 years of age, was 2.2 (1.7 to 3.0) for skiers and 4.2 (3.5 to 5.1) for hikers, when compared with the SCD risk (1.0) for the entire Austrian male population (after adjustment for age and exposure time). However, a great increase in risk for skiers was observed above the age of 50. In contrast, a diminished risk was found for hikers and for skiers who practiced mountain sports more regularly. Therefore, regular physical activity may be considered the best prevention, especially for the main risk group.