With a reasonable amount of snow finally on the ground, driveway and walkway clearing has begun in earnest in the Upper Peninsula. And a great deal of it is accomplished by out-of-shape homeowners looking to save a little money by doing it themselves.

That’s where the trouble can start. According to one medical study, about 100 people die each year from heart attacks related to snow shoveling. An unknown number of people are stricken but survive — perhaps to shovel again.

According to the American Heart Association, one of the reasons heart attacks can occur during snow shoveling is the combination of colder temperatures and physical exertion, which increases the workload on the heart. As a result, too much strain on the heart during these conditions can cause a heart attack.

Here are some commonsense but often ignored tips to avoid a heart attack while shoveling snow this winter:

— If you have a medical condition or don’t exercise on a regular basis, schedule a meeting with your doctor to check how advisable it is to shovel.

— Take frequent breaks during shoveling so you don’t overstress your heart.

— Don’t eat a heavy meal before or soon after shoveling, since it can place an extra load on your heart.

— Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.

— Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. Wear a hat and dress in layers of warm clothing, which traps air between layers, forming a protective insulation.

— Use a small shovel or consider a snow thrower. Lifting heavy snow can raise blood pressure acutely. It is safer to lift smaller amounts more times than to lug a few huge shovelfuls of snow. When possible, simply push the snow.

— Listen to your body. If you feel the warning signs for heart attack, stop what you’re doing immediately and call 911.

Be smart. Be safe. The life you save may be your own.