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Interesting. Three causal factors are mentioned, altitude, (lower oxygen contant), temperature, (constricted blood vessels), and lack of fitness.
"It was found that over half of the heart attacks occurred in the first two days and within two hours of hitting the slopes"
Pretty conclusive. The authors recommend a minimum of 2 hours a week of sport. That, I would suggest is not the same as 2 hours a week in the gym!
My view wouldbe that 2 hours a week is pretty near useless to maintain any kind of standard fitness for skiing.
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