ROCKFORD, Ill. (WTVO) — Each winter in Illinois brings heavy snowfall, but doctors warn that shoveling snow over a certain age could lead to a heart attack.

According to USA Today, a study estimated that nearly 200,000 people were sent to the emergency room for snow-shoveling-related health incidents over a 17-year period, or roughly 11,500 a year.

Of those, 1,647 were cardiac-related deaths.

The American Heart Association has warned middle-aged adults about shoveling snow, calling it a “perfect storm for acute cardiac events.”

Cold weather, plus stressful activity, puts a strain on the heart, experts warn.

Dr. Barry Franklin, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, who conducted studies on the phenomenon after he knew two people who died shoveling snow, recommended against shoveling snow for anyone over the age of 45.

“If you’re over age 45, I’m pretty sure you’ve got underlying heart disease,” Franklin said. “I’d say you’re probably better off to hire a neighborhood kid to do your driveway.”

According to the Centers for Disease Control and Prevention, about 60% of U.S. adults have at least one chronic disease, or cardiovascular risk factor, including vascular disease, obesity, smoking, high blood pressure, high cholesterol, or diabetes.

According to AARP, Franklin’s research showed that healthy young men had an average heart rate of 170 beats per minute when shoveling snow, versus 120 beats per minute when using a snowblower.

Franklin also said shoveling should not be undertaken immediately after eating, as digestion requires additional blood flow, which competes with the added blood flow needed for the physical demands of shoveling.

However, Adbulla Damluji, a cardiologist at Inova Health System and an associate professor at Johns Hopkins University School of Medicine, said age alone isn’t the only criterion. “If you are an older adult who is fit — you exercise daily and you perform at high physical activity levels — shoveling snow is less risky.”