PROVIDENCE, R.I. ? Every year, people die from heart attacks triggered by snow shoveling, and uncounted numbers hurt their backs. In the recent snowstorm, two fairly young Rhode Island men — one was in his late 20s — died while shoveling snow, according to Nancy Thomas, spokeswoman for the American Heart Assn.

Research shows that heart rate and blood pressure during shoveling increase as much or more than during maximum exercise testing. To make matters worse, when it’s cold, blood vessels narrow. If the vessels are already partially blocked by fatty deposits, the sudden, extreme exertion in cold temperatures can be fatal.

Less dangerous is the back strain. But it sure does hurt, and you may be able to avoid it with a few precautions.

Nancy D. Owen, a senior staff physical therapist with the Southern New England Rehabilitation Center, has tips on shoveling technique: Don’t bend from the waist. Keep your back straight, bend your knees, and use your legs to lift the snow. While you’re lifting, pull in your abdominal muscles; they support and protect the spine.