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Kunutsor SK, Jae SY, Kurl S, Laukkanen JA. Sauna bathing and mortality risk: unraveling the interaction with systolic blood pressure in a cohort of Finnish men. SCAND CARDIOVASC J 2024; 58:2302159. [PMID: 38410962 DOI: 10.1080/14017431.2024.2302159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/01/2024] [Indexed: 02/28/2024]
Abstract
Objectives: This cohort study aimed to investigate the potential interplay between systolic blood pressure (SBP), frequency of sauna bathing (FSB), and all-cause mortality risk among Caucasian men. Design: A prospective study was conducted, involving 2575 men aged 42 to 61 years. Baseline assessments included resting blood pressure measurements and self-reported sauna bathing habits. SBP levels were categorized as normal (<140 mmHg) or high (≥140 mmHg), while FSB was classified as low (≤2 sessions/week) or high (3-7 sessions/week). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox regression analysis, while adjusting for lifestyle factors, lipids, inflammation, and comorbidities. Results: Over a median follow-up of 27.8 years, 1,618 deaths were recorded. In the adjusted analysis, individuals with high SBP versus low SBP showed a 29% increased all-cause mortality risk (HR 1.29, 95% CI 1.16-1.43). Similarly, those with low FSB versus high FSB exhibited a 16% elevated mortality risk (HR 1.16, 95% CI 1.02-1.31). When considering combined effects, participants with high SBP-low FSB had a 47% higher mortality risk (HR 1.47, 95% CI 1.24-1.74) compared to those with normal SBP-high FSB. However, no significant association was observed between individuals with high SBP-high FSB and mortality risk (HR 1.24, 95% CI 0.98-1.57). There were potential additive and multiplicative interactions between SBP and sauna bathing concerning mortality risk. Conclusions: This study reveals a potential interplay between SBP, sauna bathing, and mortality risk in Finnish men. Frequent sauna bathing may mitigate the increased mortality risk associated with elevated SBP.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Sae Young Jae
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea
- Department of Sport Science, University of Seoul, Seoul, South Korea
- Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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2
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Chen R, Yang Q, Wang Y, Fang Y, Cao F. Association between baseline blood pressure variability and left heart function following short-term extreme cold exposure. J Clin Hypertens (Greenwich) 2024. [PMID: 38940288 DOI: 10.1111/jch.14862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/01/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
Extreme cold exposure has been widely considered as a cardiac stress and may result in cardiac function decompensation. This study was to examine the risk factors that contribute to changes in cardiovascular indicators of cardiac function following extreme cold exposure and to provide valuable insights into the preservation of cardiac function and the cardiac adaptation that occur in real-world cold environment. Seventy subjects were exposed to cold outside (Mohe, mean temperature -17 to -34°C) for one day, and were monitored by a 24-h ambulatory blood pressure device and underwent echocardiography examination before and after extreme cold exposure. After exposure to extreme cold, 41 subjects exhibited an increase in ejection fraction (EF), while 29 subjects experienced a decrease. Subjects with elevated EF had lower baseline coefficients of variation (CV) in blood pressure compared to those in the EF decrease group. Additionally, the average real variability (ARV) of blood pressure was also significantly lower in the EF increase group. Multivariate regression analysis indicated that both baseline CV and ARV of blood pressure were independent risk factors for EF decrease, and both indicators proved effective for prognostic evaluation. Correlation analysis revealed a correlation between baseline blood pressure CV and ARV, as well as EF variation after exposure to extreme cold environment. Our research clearly indicated that baseline cardiovascular indicators were closely associated with the changes in EF after extreme cold exposure. Furthermore, baseline blood pressure variability could effectively predict alterations in left cardiac functions when individuals were exposed to extreme cold environment.
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Affiliation(s)
- Renzheng Chen
- National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Emergency, The 967th Hospital of Joint Logistics Support Force of Chinese PLA, Dalian, China
| | - Qian Yang
- National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yabin Wang
- National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yan Fang
- National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Feng Cao
- National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
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Laukkanen JA, Kunutsor SK. The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna. Temperature (Austin) 2024; 11:27-51. [PMID: 38577299 PMCID: PMC10989710 DOI: 10.1080/23328940.2023.2300623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 04/06/2024] Open
Abstract
Passive heat therapy is characterized by exposure to a high environmental temperature for a brief period. There are several types of passive heat therapy which include hot tubs, Waon therapy, hydrotherapy, sanarium, steam baths, infrared saunas and Finnish saunas. The most commonly used and widely studied till date are the Finnish saunas, which are characterized by high temperatures (ranging from 80-100°C) and dry air with relative humidity varying from 10-20%. The goal of this review is to provide a summary of the current evidence on the impact of passive heat therapies particularly Finnish saunas on various health outcomes, while acknowledging the potential of these therapies to contribute to the extension of healthspan, based on their demonstrated health benefits and disease prevention capabilities. The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity. Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity. The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function. Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations.
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Affiliation(s)
- Jari A. Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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4
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Podstawski R, Borysławski K, Józefacka NM, Snarska J, Hinca B, Biernat E, Podstawska A. The influence of extreme thermal stress on the physiological and psychological characteristics of young women who sporadically use the sauna: practical implications for the safe use of the sauna. Front Public Health 2024; 11:1303804. [PMID: 38344040 PMCID: PMC10853428 DOI: 10.3389/fpubh.2023.1303804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/19/2023] [Indexed: 02/15/2024] Open
Abstract
Background Many individuals who use the sauna at a temperature of 120°C of higher are not aware of the negative consequences of extreme thermal stress. Despite extensive research into sauna use, the impact of extreme thermal stress on the physiological and psychological characteristics of sauna users have not been examined to date. Aim The aim was to determine the effect of 20 min sauna sessions with a temperature of 80°C and 120°C on the physiological and psychological characteristics of women who sporadically visit the sauna. Methods The study was conducted on 22 full-time female university students. Physical activity (PA) levels were evaluated with the Polish short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric characteristics were measured before the first sauna session by the InBody270 body composition analyzer. Physiological parameters, including heart, energy expenditure, physical effort, and blood pressure (systolic blood pressure - SBP, and diastolic blood pressure - DBP), were assessed indirectly using Polar V800 heart rate monitors and the Omron M6 Comfort blood pressure monitor. The participants' wellbeing was assessed with the Profile of Mood States (POMS) questionnaire. The presence of significant correlations between heat exhaustion and heat stress variables and syncope during the second sauna session was examined with the use of classification and regression trees (CRT) and the cross-validation technique. Results Twenty-minute sauna sessions with a temperature of 80°C and 120°C induced a significant (p < 0.001) decrease in the values of SBP (excluding the temperature of 120°C), DBP, and body mass, as well as a significant increase in HR and forehead temperature. Exposure to a temperature of 80°C led to a significant (p < 0.001) increase in vigor with a simultaneous decrease in tension, depression, anger, fatigue, and confusion. In turn, sauna bathing at a temperature of 120°C had an opposite effect on the above mood parameters. Vomiting and confusion were the main predictors of syncope that occurred in some of the surveyed women. Conclusion Excessive air temperature can induce symptoms characteristic of heat exhaustion and heat stress nausea, heavy sweating, fast weak or strong HR, high body temperature, and confusion. Therefore, sauna bathing at a temperature of 80°C can be recommended to women who sporadically use the sauna, whereas exposure to a temperature of 120°C is not advised in this group of sauna users. The present findings provide highly valuable inputs for managing wellness and SPA centers.
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Affiliation(s)
- Robert Podstawski
- School of Public Health, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Krzysztof Borysławski
- Angelus Silesius University of Applied Sciences, Institute of Health, Wałbrzych, Poland
| | | | - Jadwiga Snarska
- School of Public Health, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Bożena Hinca
- Department of Physical Education and Sport, University of Gdańsk, Gdańsk, Poland
| | - Elżbieta Biernat
- Collegium of World Economy, SGH Warsaw School of Economics, Warsaw, Poland
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Kujawski S, Zalewski P, Godlewska BR, Cudnoch-Jędrzejewska A, Murovska M, Newton JL, Sokołowski Ł, Słomko J. Effects of whole-body cryotherapy and static stretching are maintained 4 weeks after treatment in most patients with chronic fatigue syndrome. Cryobiology 2023; 112:104546. [PMID: 37230457 DOI: 10.1016/j.cryobiol.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 05/27/2023]
Abstract
In the previous study, whole-body cryotherapy (WBC)+static stretching (SS) has been shown to reduce the severity of some symptoms in Chronic Fatigue Syndrome (CFS) noted just after the therapy. Here we consider the effects of treatment and explore the sustainability of symptom improvements at four weeks (one-month) follow-up. Twenty-two CFS patients were assessed one month after WBC + SS programme. Parameters related to fatigue (Chalder Fatigue Questionnaire (CFQ), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS)), cognitive function (Trial Making test part A and B (TMT A and TMT B and its difference (TMT B-A)), Coding) hemodynamic, aortic stiffness (aortic systolic blood pressure (sBP aortic)) and autonomic nervous system functioning were measured. TMT A, TMT B, TMT B-A and Coding improved at one month after the WBC + SS programme. WBC + SS had a significant effect on the increase in sympathetic nervous system activity in rest. WBC + SS had a significant, positive chronotropic effect on the cardiac muscle. Peripheral and aortic systolic blood pressure decreased one month after WBC + SS in comparison to before. Effects of WBC + SS on reduction of fatigue, indicators of aortic stiffness and symptoms severity related to autonomic nervous system disturbance and improvement in cognitive function were maintained at one month. However, improvement in all three fatigue scales (CFQ, FIS and FSS) was noted in 17 of 22 patients. In addition, ten patients were treated initially but they were not assessed at 4 weeks, and are thus not included in the 22 patients who were examined on follow-up. The overall effects of WBC + SS noted at one month post-treatment should be interpreted with caution.
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Affiliation(s)
- Sławomir Kujawski
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń, Świętojańska 20, 85-077, Bydgoszcz, Poland.
| | - Paweł Zalewski
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń, Świętojańska 20, 85-077, Bydgoszcz, Poland; Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Warsaw Medical University, 1b Banacha Street, 02-097, Warsaw, Poland.
| | - Beata R Godlewska
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom.
| | - Agnieszka Cudnoch-Jędrzejewska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Warsaw Medical University, 1b Banacha Street, 02-097, Warsaw, Poland.
| | - Modra Murovska
- Institute of Microbiology and Virology, Riga Stradinš University, LV-1067, Riga, Latvia.
| | - Julia L Newton
- Population Health Sciences Institute, The Medical School, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, UK.
| | - Łukasz Sokołowski
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń, Świętojańska 20, 85-077, Bydgoszcz, Poland.
| | - Joanna Słomko
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń, Świętojańska 20, 85-077, Bydgoszcz, Poland.
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Okada A, Yamana H, Pan R, Yamaguchi S, Kumazawa R, Matsui H, Fushimi K, Honda Y, Nangaku M, Yamauchi T, Yasunaga H, Kadowaki T, Kim Y. Effect modification of the association between temperature variability and hospitalization for cardiovascular disease by comorbid diabetes mellitus: A nationwide time-stratified case-crossover analysis. Diabetes Res Clin Pract 2023; 202:110771. [PMID: 37276982 DOI: 10.1016/j.diabres.2023.110771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023]
Abstract
AIMS We aimed to explore the association between short-term exposure to temperature variability (TV), and cardiovascular hospitalization stratified by the presence of comorbid diabetes. METHODS We collected data on nationwide hospitalization for cardiovascular diseases and daily weather conditions during 2011-2018 in Japan. TV was calculated as the standard deviation of daily minimum and maximum temperatures within 0-7 lag days. We applied a two-stage time-stratified case-crossover design to estimate the association between TV and cardiovascular hospitalization with and without comorbid diabetes, adjusting for temperature and relative humidity. Furthermore, specific cardiovascular disease causes, demographic characteristics, and seasons were used for stratification. RESULTS In 3,844,910 hospitalizations for cardiovascular disease, each 1 °C increase in TV was associated with a 0.44% (95% CI: 0.22%, 0.65%) increase in the risk of cardiovascular admission. We observed a 2.07% (95% CI: 1.16%, 2.99%) and 0.61% (95% CI: -0.02%, 1.23%) increase per 1 °C in risk of heart failure admission in individuals with and those without diabetes, respectively. The higher risk among individuals with diabetes was mostly consistent in the analyses stratified by age, sex, body mass index, smoking status, and season. CONCLUSION Comorbid diabetes may increase susceptibility to TV in relation to acute cardiovascular disease hospitalization.
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Affiliation(s)
- Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Data Science Center, Jichi Medical University, Shimotsuke, Japan
| | - Rui Pan
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoko Yamaguchi
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryosuke Kumazawa
- Department of Clinical Epidemiology and Health Economics, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolism, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Diabetes and Metabolism, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Toranomon Hospital, Tokyo, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Kunutsor SK, Laukkanen JA. Does the Combination of Finnish Sauna Bathing and Other Lifestyle Factors Confer Additional Health Benefits? A Review of the Evidence. Mayo Clin Proc 2023; 98:915-926. [PMID: 37270272 DOI: 10.1016/j.mayocp.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/05/2023]
Abstract
Sauna bathing, a tradition deeply rooted in the Finnish culture, has been used for thousands of years for leisure, relaxation, and wellness. Sauna bathing is linked with substantial health benefits beyond its use for leisure and relaxation. Several observational and interventional studies suggest that regular or frequent sauna bathing reduces the incidence of vascular and nonvascular diseases, such as hypertension, cardiovascular disease, dementia, and respiratory conditions; may improve the severity of conditions such as musculoskeletal disorders, COVID-19, headache, and influenza; and increases the life span. The beneficial effects of sauna bathing on adverse outcomes have been linked to its blood pressure-reducing, anti-inflammatory, antioxidant, cytoprotective, and stress-reducing properties and its synergistic effect on neuroendocrine, circulatory, cardiovascular, and immune function. Evidence suggests that frequent sauna bathing is an emerging protective risk factor that may augment the beneficial effects of other protective risk or lifestyle factors, such as physical activity and cardiorespiratory fitness, or attenuate or offset the adverse effects of other risk factors, such as high blood pressure, systemic inflammation, and low socioeconomic status. This review summarizes the available epidemiologic and interventional evidence linking the combined effects of Finnish sauna bathing and other risk factors on vascular outcomes including cardiovascular disease and intermediate cardiovascular phenotypes, nonvascular outcomes, and mortality. We also discuss the mechanistic pathways underlying the joint contributions of Finnish sauna bathing and other risk factors on health outcomes, the public health and clinical implications of the findings, gaps in the existing evidence base, and future directions.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland
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8
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Siquier-Coll J, Bartolomé I, Pérez-Quintero M, Toro-Román V, Grijota FJ, Maynar-Mariño M. Heart Rate and Body Temperature Evolution in an Interval Program of Passive Heat Acclimation at High Temperatures (100 ± 2 °C) in a Sauna. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2082. [PMID: 36767447 PMCID: PMC9916041 DOI: 10.3390/ijerph20032082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Heat exposure provokes stress on the human body. If it remains constant, it leads to adaptations such as heat acclimation. This study aims to observe the evolution of heart rate (HR), core temperature (Tcore), and skin temperature (Tskin) in an intervallic program of exposure to extreme heat. Twenty-nine healthy male volunteers were divided into a control group (CG; n = 14) and an experimental group (EG; n = 15). EG experienced nine sessions (S) of intervallic exposure to high temperatures (100 ± 2 °C), whereas CG was exposed to ambient temperatures (22 ± 2 °C). HR, Tskin, and Tcore were monitored in S1, 4, 5, 8, and 9. An important increase in HR occurred in the S4 compared to the rest (p < 0.05) in EG. A lower HR was discovered in S8 and S9 compared to S4 and in S9 in relation to S1 (p < 0.05) in EG. EG experiences a gradual decrease in Tcore and Tskin, which was detected throughout the assessments, although it was only significant in the S8 and S9 (p < 0.05). Interval exposure to heat at 100 ± 2 °C elicits stress on the human organism, fundamentally increasing Tcore, Tskin, and FC. This recurring stress in the full program caused a drop in the thermoregulatory response as an adaptation or acclimation to heat.
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Affiliation(s)
- Jesús Siquier-Coll
- SER Research Group, Center of Higher Education Alberta Giménez, Comillas Pontifical University, Costa de Saragossa 16, 07013 Palma Mallorca, Spain
| | - Ignacio Bartolomé
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, C/Henry Collet, 52-70, 37007 Salamanca, Spain
| | - Mario Pérez-Quintero
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Víctor Toro-Román
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Francisco J. Grijota
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Marcos Maynar-Mariño
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
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Changes in the Blood Pressure, Heart Rate and Body Mass of Physically Active Men in Response to Thermal Stress. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2022. [DOI: 10.18276/cej.2022.1-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Kunutsor SK, Jae SY, Kurl S, Kauhanen J, Laukkanen JA. Inflammation, sauna bathing, and all-cause mortality in middle-aged and older Finnish men: a cohort study. Eur J Epidemiol 2022; 37:1225-1231. [PMID: 36255556 PMCID: PMC9792415 DOI: 10.1007/s10654-022-00926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/26/2022] [Indexed: 12/30/2022]
Abstract
Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42-61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13-1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12-1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81-1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.
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Affiliation(s)
- Setor K. Kunutsor
- grid.410421.20000 0004 0380 7336National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB UK ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Gwendolen Road, Leicester, LE5 4WP UK
| | - Sae Young Jae
- grid.267134.50000 0000 8597 6969Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea ,grid.267134.50000 0000 8597 6969Department of Sport Science, University of Seoul, Seoul, South Korea ,grid.267134.50000 0000 8597 6969Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A. Laukkanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland ,grid.460356.20000 0004 0449 0385Department of Medicine, Central Finland Health Care District, Hospital District, Jyvaskyla, Finland
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Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial. Complement Ther Med 2021; 64:102798. [PMID: 34954348 DOI: 10.1016/j.ctim.2021.102798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/29/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas. OBJECTIVE To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise. STUDY DESIGN Randomized controlled crossover trial with balanced allocations. SETTING Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ± 9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 oC ± SEM 0.12 oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 oC ± SEM 0.12 oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ± SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ± SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions. CONCLUSIONS These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.
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12
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Li Z, Jiang W, Diao J, Chen C, Xu K, Fan H, Yan F. Segmentary strategy in modeling of cardiovascular system with blood supply to regional skin. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Debnath S, Levy TJ, Bellehsen M, Schwartz RM, Barnaby DP, Zanos S, Volpe BT, Zanos TP. A method to quantify autonomic nervous system function in healthy, able-bodied individuals. Bioelectron Med 2021; 7:13. [PMID: 34446089 PMCID: PMC8394599 DOI: 10.1186/s42234-021-00075-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/20/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The autonomic nervous system (ANS) maintains physiological homeostasis in various organ systems via parasympathetic and sympathetic branches. ANS function is altered in common diffuse and focal conditions and heralds the beginning of environmental and disease stresses. Reliable, sensitive, and quantitative biomarkers, first defined in healthy participants, could discriminate among clinically useful changes in ANS function. This framework combines controlled autonomic testing with feature extraction during physiological responses. METHODS Twenty-one individuals were assessed in two morning and two afternoon sessions over two weeks. Each session included five standard clinical tests probing autonomic function: squat test, cold pressor test, diving reflex test, deep breathing, and Valsalva maneuver. Noninvasive sensors captured continuous electrocardiography, blood pressure, breathing, electrodermal activity, and pupil diameter. Heart rate, heart rate variability, mean arterial pressure, electrodermal activity, and pupil diameter responses to the perturbations were extracted, and averages across participants were computed. A template matching algorithm calculated scaling and stretching features that optimally fit the average to an individual response. These features were grouped based on test and modality to derive sympathetic and parasympathetic indices for this healthy population. RESULTS A significant positive correlation (p = 0.000377) was found between sympathetic amplitude response and body mass index. Additionally, longer duration and larger amplitude sympathetic and longer duration parasympathetic responses occurred in afternoon testing sessions; larger amplitude parasympathetic responses occurred in morning sessions. CONCLUSIONS These results demonstrate the robustness and sensitivity of an algorithmic approach to extract multimodal responses from standard tests. This novel method of quantifying ANS function can be used for early diagnosis, measurement of disease progression, or treatment evaluation. TRIAL REGISTRATION This study registered with Clinicaltrials.gov , identifier NCT04100486 . Registered September 24, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04100486 .
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Affiliation(s)
- Shubham Debnath
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Todd J Levy
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Mayer Bellehsen
- Department of Psychiatry, Unified Behavioral Health Center and World Trade Center Health Program, Northwell Health, Bay Shore, NY, USA
| | - Rebecca M Schwartz
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Center for Disaster Health, Trauma, and Resilience, New York, NY, USA
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Douglas P Barnaby
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Northwell Health, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Stavros Zanos
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Bruce T Volpe
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Northwell Health, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Theodoros P Zanos
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA.
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14
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Kominami K, Takahiza E, Tabuchi M, Akino M. Blood pressure-lowering effect of repeated Waon therapy in non-smokers with hypertension. Medicine (Baltimore) 2021; 100:e26266. [PMID: 34115020 PMCID: PMC8202594 DOI: 10.1097/md.0000000000026266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/21/2021] [Indexed: 12/02/2022] Open
Abstract
Waon therapy (WT) has been used as a thermal therapy in chronic heart failure patients. However, its effect in patients with hypertension is unclear. This study aimed to reveal the hypotensive effect of WT in patients with hypertension. WT was performed on 31 patients with hypertension (63.9 ± 11.9 years, male: 17) on standard hypertension treatment focusing on lifestyle modification and medication. Systolic and diastolic blood pressures were measured before and after WT using an upper arm automated sphygmomanometer. We investigated the effect of single and repeated (1 time/d, >5 times) WT sessions on blood pressure and further compared its effect between current smoking (n = 11, 55.4 ± 6.4 years, 8.5 ± 2.4 times) and non-smoking (n = 11, 66.9 ± 8.5 years, 12.2 ± 5.9 times) groups. A total of 370 sessions of WT were conducted. Systolic and diastolic blood pressures significantly decreased after a single WT session (systolic blood pressure: 118.5 ± 10.1 to 115.1 ± 9.0 mm Hg, P < .001; diastolic blood pressure: 70.5 ± 6.4 to 65.9 ± 5.3 mm Hg, P < .001). The blood pressure decrease following repeated WT was not significant when all participants were considered (systolic blood pressure: 122.3 ± 15.2 to 116.9 ± 19.6 mm Hg; diastolic blood pressure: 73.8 ± 16.7 to 68.2 ± 13.2 mm Hg); however, it was significant in the non-smoking group (systolic blood pressure: 124.2 ± 11.3 to 108.8 ± 13.4 mm Hg, P < .001; diastolic blood pressure: 73.6 ± 4.9 to 62.1 ± 7.6 mm Hg, P < .001). Repeated WT (at least 5 sessions) decreased blood pressure in patients with hypertension, especially in non-smokers. WT is a simple method to reduce blood pressure in non-smoking patients with hypertension.
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Affiliation(s)
| | | | | | - Masatoshi Akino
- Cardiac Rehabilitation Center
- Department of Cardiovascular Medicine, Sapporo Ryokuai Hospital, Sapporo, Japan
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15
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Brunt VE, Minson CT. Heat therapy: mechanistic underpinnings and applications to cardiovascular health. J Appl Physiol (1985) 2021; 130:1684-1704. [PMID: 33792402 DOI: 10.1152/japplphysiol.00141.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide, and novel therapies are drastically needed to prevent or delay the onset of CVD to reduce the societal and healthcare burdens associated with these chronic diseases. One such therapy is "heat therapy," or chronic, repeated use of hot baths or saunas. Although using heat exposure to improve health is not a new concept, it has received renewed attention in recent years as a growing number of studies have demonstrated robust and widespread beneficial effects of heat therapy on cardiovascular health. Here, we review the existing literature, with particular focus on the molecular mechanisms that underscore the cardiovascular benefits of this practice.
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Affiliation(s)
- Vienna E Brunt
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado.,Department of Human Physiology, University of Oregon, Eugene, Oregon
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16
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Liu J, Tan Y, Ao H, Feng W, Peng C. Aqueous extracts of Aconite promote thermogenesis in rats with hypothermia via regulating gut microbiota and bile acid metabolism. Chin Med 2021; 16:29. [PMID: 33741035 PMCID: PMC7980327 DOI: 10.1186/s13020-021-00437-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/08/2021] [Indexed: 12/15/2022] Open
Abstract
Background Intermittent or prolonged exposure to severe cold stress disturbs energy homeostasis and can lead to hypothermia, heart failure, Alzheimer’s disease, and so on. As the typical “hot” traditional Chinese medicine, Aconite has been widely used to treat cold-associated diseases for thousands of years, but its critical mechanisms for the promotion of thermogenesis are not fully resolved. Gut microbiota and its metabolites play a crucial role in maintaining energy homeostasis. Here, we investigated whether the aqueous extracts of Aconite (AA) can enhance thermogenesis through modulation of the composition and metabolism of gut microbiota in hypothermic rats. Methods The therapeutic effects of AA on body temperature, energy intake, and the histopathology of white adipose tissue and brown adipose tissue of hypothermic rats were assessed. Microbiota analysis based on 16 S rRNA and targeted metabolomics for bile acids (BAs) were used to evaluate the composition of gut microbiota and BAs pool. The antibiotic cocktail treatment was adopted to further confirm the relationship between the gut microbiota and the thermogenesis-promoting effects of AA. Results Our results showed a sharp drop in rectal temperature and body surface temperature in hypothermic rats. Administration of AA can significantly increase core body temperature, surface body temperature, energy intake, browning of white adipose tissue, and thermogenesis of brown adipose tissue. Importantly, these ameliorative effects of AA were accompanied by the shift of the disturbed composition of gut microbiota toward a healthier profile and the increased levels of BAs. In addition, the depletion of gut microbiota and the reduction of BAs caused by antibiotic cocktails reduced the thermogenesis-promoting effect of AA. Conclusions Our results demonstrated that AA promoted thermogenesis in rats with hypothermia via regulating gut microbiota and BAs metabolism. Our findings can also provide a novel solution for the treatment of thermogenesis-associated diseases such as rheumatoid arthritis, obesity, and type 2 diabetes. ![]()
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Affiliation(s)
- Juan Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.,National Key Laboratory Breeding Base of Systematic Research, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China
| | - Yuzhu Tan
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China
| | - Hui Ao
- National Key Laboratory Breeding Base of Systematic Research, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China
| | - Wuwen Feng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China. .,National Key Laboratory Breeding Base of Systematic Research, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.
| | - Cheng Peng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China. .,National Key Laboratory Breeding Base of Systematic Research, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.
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17
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Gravel H, Behzadi P, Cardinal S, Barry H, Neagoe PE, Juneau M, Nigam A, Sirois MG, Gagnon D. Acute Vascular Benefits of Finnish Sauna Bathing in Patients With Stable Coronary Artery Disease. Can J Cardiol 2021; 37:493-499. [DOI: 10.1016/j.cjca.2020.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 01/20/2023] Open
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18
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Gravel H, Coombs GB, Behzadi P, Marcoux-Clément V, Barry H, Juneau M, Nigam A, Gagnon D. Acute effect of Finnish sauna bathing on brachial artery flow-mediated dilation and reactive hyperemia in healthy middle-aged and older adults. Physiol Rep 2020; 7:e14166. [PMID: 31293098 PMCID: PMC6640592 DOI: 10.14814/phy2.14166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022] Open
Abstract
Regular Finnish sauna bathing is associated with a reduced risk of all‐cause and cardiovascular mortality in middle‐aged and older adults. Potential acute physiological adaptations induced by sauna bathing that underlie this relationship remain to be fully elucidated. The purpose of this study was to determine if typical Finnish sauna sessions acutely improve brachial artery flow‐mediated dilation (FMD) and reactive hyperemia (RH) in healthy middle‐aged and older adults. Using a randomized crossover design, FMD and RH were evaluated in 21 healthy adults (66 ± 6 years, 10 men/11 women) before and after each of the following conditions: (1) 1 × 10 min of Finnish sauna bathing (80.2 ± 3.2°C, 23 ± 2% humidity); (2) 2 × 10 min of sauna bathing separated by 10 min of rest outside the sauna; (3) a time control period (10 min of seated rest outside the sauna). FMD was taken as the peak change from baseline in brachial artery diameter following 5 min of forearm ischemia, whereas RH was quantified as both peak and area‐under‐the‐curve forearm vascular conductance postischemia. FMD was statistically similar pre to post 1 × 10 min (4.69 ± 2.46 to 5.41 ± 2.64%, P = 0.20) and 2 × 10 min of sauna bathing (4.16 ± 1.79 to 4.55 ± 2.14%, P = 0.58). Peak and area‐under‐the‐curve forearm vascular conductance were also similar following both sauna interventions. These results suggest that typical Finnish sauna bathing sessions do not acutely improve brachial artery FMD and RH in healthy middle‐aged and older adults.
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Affiliation(s)
- Hugo Gravel
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Geoff B Coombs
- School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, Canada
| | - Parya Behzadi
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Virginie Marcoux-Clément
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Daniel Gagnon
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
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Demori I, Piccinno T, Saverino D, Luzzo E, Ottoboni S, Serpico D, Chiera M, Giuria R. Effects of winter sea bathing on psychoneuroendocrinoimmunological parameters. Explore (NY) 2020; 17:122-126. [PMID: 32224255 DOI: 10.1016/j.explore.2020.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/10/2020] [Accepted: 02/20/2020] [Indexed: 11/30/2022]
Abstract
CONTEXT Many people claim winter sea bathing gives them energy and health. According to the psychoneuroendocrinoimmunology (PNEI) paradigm, the stress response elicited by cold water immersion could indeed induce several beneficial psychophysical alterations. OBJECTIVE To determine the effects of winter sea bathing on psychological wellbeing, stress and immune markers. DESIGN A cross-sectional study. PARTICIPANTS 228 people, between 19 and 88 years, including 107 winter sea bathers and 121 controls. MAIN OUTCOME MEASURES A battery of questionnaires was administered to assess sociodemographic characteristics, self-perception of mental and physical heath, the number, duration and intensity of Upper Respiratory Tract Infections (URTIs) in the last year, and Big Five personality traits. 17 winter sea bathers and 15 controls (mean age 67 years) were further examined to evaluate physiological health, underwent one ear-nose-throat (ENT) examination, and provided saliva samples for measurements of biological markers (cortisol, sIgA, IL-1β, IL-6). RESULTS Winter sea bathing was associated with lower levels of self-reported stress and higher wellbeing. The ENT examinations did not reveal signs of URTIs in winter sea bathers, who exhibited significantly higher levels of salivary sIgA compared to controls. Neither salivary IL-1β nor cortisol levels were significantly different between the two groups. CONCLUSIONS Winter sea bathers (even the elderly) had a perception of higher wellbeing and reported better health: thus, they appeared to take advantage of potential distress (cold water exposure) to improve their health.
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Affiliation(s)
- Ilaria Demori
- Department of Earth, Environment and Life Sciences (DISTAV), University of Genoa, Corso Europa 26, 16132 Genoa, Italy; Italian Society of Psychoneuroendocrinoimmunology (SIPNEI), Rome, Italy.
| | - Tommaso Piccinno
- VIE - Valutazione Innovazione Empowerment s.r.l., Via della Libertà 9/3, 16129 Genoa, Italy
| | - Daniele Saverino
- Department of Experimental Medicine (DIMES), University of Genoa, Via Leon Battista Alberti 2, 16132 Genoa, Italy
| | - Erika Luzzo
- Italian Society of Psychoneuroendocrinoimmunology (SIPNEI), Rome, Italy
| | - Stefano Ottoboni
- Department of Surgery Sciences and Integrated Diagnostics (DISC), University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Davide Serpico
- Italian Society of Psychoneuroendocrinoimmunology (SIPNEI), Rome, Italy; Department of Classics, Philosophy and History, University of Genoa, Via Balbi 2, 16126 Genoa, Italy
| | - Marco Chiera
- Italian Society of Psychoneuroendocrinoimmunology (SIPNEI), Rome, Italy
| | - Roberto Giuria
- Italian Society of Psychoneuroendocrinoimmunology (SIPNEI), Rome, Italy
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20
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Sun XH, Zhang YH, Zhang YT. Effect of shortening preoperative time of fasting and forbidding water on clinical outcome of elderly patients with gastrointestinal cancer. Shijie Huaren Xiaohua Zazhi 2020; 28:58-64. [DOI: 10.11569/wcjd.v28.i2.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Prolonged fasting and water deprivation before surgery can easily lead to adverse reactions such as hunger, thirst, hypoglycemia, etc., especially in elderly patients. At present, most studies support shortening the duration of preoperative fasting and water, while domestic guidelines for preoperative fasting and water deprivation are for children, and there is no authoritative guide for adults.
AIM To observe the effect of shortening preoperative time of fasting and forbidding water on the clinical outcome of elderly patients with gastrointestinal cancer.
METHODS One hundred elderly patients with gastrointestinal cancer were divided into two groups (n = 50 each): experimental group and control group. The experimental group was fasted for 12 h and forbidden to drink water for 6 h before operation, and the control group was fasted for 6 h and forbidden to drink water for 2 h before operation. The changes of preoperative response, anesthesia effect, recovery time, hemodynamic index [mean arterial pressure (MAP), heart rate (HR)], and pulse oxygen saturation (SPO2) before and 5 min after surgery were recorded. Postoperative rehabilitation effect was also recorded.
RESULTS There were 6 (12%) cases in the experimental group and 29 (58%) in the control group. Preoperative reactions such as thirst, starvation, fatigue, and hope for eating occurred; the incidence between the two groups was statistically significant (χ2 = 23.253, P < 0.001). The MAP, HR, and SPO2 were significantly decreased in the experimental group and the control group at 5 min after operation (P < 0.05). The HR and SPO2 at 5 min after operation in the experimental group were significantly higher than those in the control group (P > 0.05), although there was no significant difference in the MAP between the two groups (P < 0.05). There was no significant difference in the anesthesia effect between the two groups (P > 0.05), but there was a significant difference in the recovery time between them (t = -3.121, P = 0.002). There were significant differences in time to postoperative gastric tube removal, time to anal exhaust, time to body temperature recovery, and hospitalization days between the two groups (P < 0.05). There were no significant differences in postoperative nausea, postoperative vomiting, postoperative thirst, hunger, or postoperative pneumonia between the two groups (P > 0.05).
CONCLUSION Reasonable arrangement of preoperative fasting time in elderly patients with gastrointestinal cancer may reduce the preoperative discomfort of patients and effectively improve the therapeutic effects, which is of great significance for the smooth performance of surgery and the promotion of postoperative rehabilitation.
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Affiliation(s)
- Xue-Hua Sun
- Department of outpatient, Coast Guard Hospital of Armed Police, Jiaxing 314000, Zhejiang Province, China
| | - Yue-Hua Zhang
- Department of abdominal surgery, Coast Guard Hospital of Armed Police, Jiaxing 314000, Zhejiang Province, China
| | - Yong-Tao Zhang
- Department of abdominal surgery, Coast Guard Hospital of Armed Police, Jiaxing 314000, Zhejiang Province, China
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21
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Laukkanen T, Lipponen J, Kunutsor SK, Zaccardi F, Araújo CGS, Mäkikallio TH, Khan H, Willeit P, Lee E, Poikonen S, Tarvainen M, Laukkanen JA. Recovery from sauna bathing favorably modulates cardiac autonomic nervous system. Complement Ther Med 2019; 45:190-197. [PMID: 31331560 DOI: 10.1016/j.ctim.2019.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/15/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Sauna bathing is becoming a common activity in many countries and it has been linked to favorable health outcomes. However, there is limited data on the heart rate (HR) and heart rate variability (HRV) responses to an acute sauna exposure. DESIGN We conducted a single-group, longitudinal study utilizing a pre-post design to examine acute effects of sauna bathing on the autonomic nervous system as reflected by HRV. A total of 93 participants (mean [SD] age: 52.0 [8.8] years, 53.8% males) with cardiovascular risk factors were exposed to a single sauna session (duration: 30 min; temperature: 73 °C; humidity: 10-20%) and data on HRV variables were collected before, during and after sauna. RESULTS Time and frequency-domain HRV variables were significantly modified (p < 0.001) by the single sauna session, with most of HRV variables tending to return near to baseline values after 30 min recovery. Resting HR was lower at the end of recovery (68/min) compared to pre-sauna (77/min). A sauna session transiently diminished the vagal component, whereas the cooling down period after sauna decreased low frequency power (p < 0.001) and increased high frequency power in HRV (p < 0.001), favorably modulating the autonomic nervous system balance. CONCLUSIONS This study demonstrates that a session of sauna bathing induces an increase in HR. During the cooling down period from sauna bathing, HRV increased which indicates the dominant role of parasympathetic activity and decreased sympathetic activity of cardiac autonomic nervous system. Future randomized controlled studies are needed to show if HR and HRV changes underpins the long-term cardiovascular effects induced by regular sauna bathing.
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Affiliation(s)
- Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Internal Medicine, Jyväskylä, Finland
| | - Jukka Lipponen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | | | - Timo H Mäkikallio
- Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Hassan Khan
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, United States
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Earric Lee
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Mika Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Internal Medicine, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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22
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Laukkanen JA, Kunutsor SK. Is sauna bathing protective of sudden cardiac death? A review of the evidence. Prog Cardiovasc Dis 2019; 62:288-293. [PMID: 31102597 DOI: 10.1016/j.pcad.2019.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
Sudden cardiac death (SCD) is a global public health burden accounting for 15-20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. Sauna bathing is a traditional Finnish activity that is mainly used for the purposes of relaxation and pleasure. Beyond its use for these purposes, sauna bathing has been linked with several health benefits. Emerging evidence suggests that sauna bathing is associated with reduced risk of adverse cardiovascular (CV) disease (CVD) and non-CVD outcomes as well as mortality. A number of reports have linked sauna bathing with reduced or increased risk of SCD, but the evidence is uncertain. This review summarizes available studies linking sauna bathing with SCD, the postulated mechanistic pathways underlying these associations, outlines areas of outstanding uncertainty, and the implications for prevention. We employed a comprehensive search for observational studies, randomized controlled trials (RCTs), and non-RCTs from MEDLINE and Embase since their inception until March 2019. Observational data suggest that regular sauna bathing is associated with a substantial risk reduction in SCD. Furthermore, the data suggest that a combination of regular physical activity and sauna baths confers substantial risk reduction for SCD compared with either modality alone. Few reports have linked sauna baths with SCDs, but these single case incidents have been attributed to the effects of dehydration, hypotension, and cardiac arrhythmias due to a combination of sauna exposure and alcohol consumption. Sauna bathing is generally safe for most healthy people and even among patients with stable CVD, if used sensibly and with caution. Plausible pathways underlying the protective effect of sauna bathing on SCD may be linked to the impact on CV function via reduced arterial stiffness, decreases in inflammation and oxidative stress, stabilization of the autonomic nervous system, beneficial changes in circulating lipid profiles and other CVD risk markers, and lowering of systemic blood pressure. Sauna is a potential novel tool to promote SCD prevention in addition to other known means, being an enjoyable way to take care of general health and well-being.
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Affiliation(s)
- Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Central Finland Healthcare District, Department of Internal Medicine, Jyväskylä, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
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The blood pressure and heart rate during sauna bath correspond to cardiac responses during submaximal dynamic exercise. Complement Ther Med 2019; 44:218-222. [PMID: 31126559 DOI: 10.1016/j.ctim.2019.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES In the present study, the reaction of blood pressure and heart rate are examined during and after a single acute sauna application. DESIGN In 19 healthy adult volunteers (7 women, aged 46.4±10.2 years, BMI 24.4±2 kg /m2), blood pressure (BP) and heart rate (HR) were measured during a 25-minute sauna session (93°C, 13 % humidity) and during a subsequent 30-minute rest period. The parameters obtained were compared with the BP and HR responses during submaximal dynamic exercise testing. RESULTS The heat exposure resulted in a significant (p<0.01) and progressive increase in systolic and diastolic BP. After the sauna bath, BP decreased and showed significantly (p<0.001) lower values compared to baseline. HR also increased continuously during heat application (p<0.001), resulting in a significant increase (p<0.001) in systolic BP x HR as a measure of myocardial oxygen consumption. After the end of the sauna session, both the BP and the HR decreased steadily (p<0.001).When comparing BP and HR during the sauna session with the reaction during a dynamic exercise test, sauna bathing was equivalent to an exercise load of about 60-100 watts. CONCLUSIONS Contrary to popular belief, acute sauna use does not lead to a reduction, but to an increase in BP and HR with a consequent increase in myocardial oxygen consumption. The cardiac load during the sauna use corresponds to a moderate physical load of 60-100 watts.
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Putting the flight in "fight-or-flight": Testosterone reactivity to skydiving is modulated by autonomic activation. Biol Psychol 2019; 143:93-102. [PMID: 30836116 DOI: 10.1016/j.biopsycho.2019.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 01/03/2023]
Abstract
Sensation-seeking (SS) involves the tendency to pursue exciting activities, potentially including risky behaviors (e.g., substance use, risky sexual behavior). Testosterone is associated with cortisol, SS, and autonomic nervous system (ANS) functioning. Testosterone reactivity/recovery during sky-diving and its relationship to cortisol response, ANS response and SS were examined. Forty-four participants provided reactive saliva samples and autonomic activity data before, during and after sky-diving and as well as basal day saliva samples. Testosterone reactivity/recovery to skydiving was significantly greater than basal day measurements. Testosterone responsivity to skydiving was predicted by increased cortisol, increased sympathetic activity (heart rate) and reduced parasympathetic activity (RMSSD). Independent of physiological effects, increased SS predicted testosterone responsivity to skydiving. These data suggest that testosterone reactivity, and its relationship to ANS responsivity, may be associated with pleasurable responses to risky/intense situations. These data may be useful in developing novel intervention strategies for risky behaviors.
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Sarris J, de Manincor M, Hargraves F, Tsonis J. Harnessing the Four Elements for Mental Health. Front Psychiatry 2019; 10:256. [PMID: 31105604 PMCID: PMC6491965 DOI: 10.3389/fpsyt.2019.00256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/04/2019] [Indexed: 12/12/2022] Open
Abstract
Humans are intimately connected to nature, and our physical and mental health is influenced strongly by our environment. The "elements," classically described in humoral theory as Fire, Water, Earth, and Air, all may impact our mental health. In a contemporary sense, these elements reflect a range of modifiable factors: UV light or heat therapy (Fire); sauna, hydrotherapy, and balneotherapy (Water); nature-based exposure therapy and horticulture (Earth); oxygen-rich/clean air exposure; and breathing techniques (Air). This theoretical scoping review paper details the emerging evidence for a range of these elements, covering epidemiological and interventional data, and provides information on how we can engage in "biophilic" activities to harness their potential benefits. Interventional examples with emerging evidentiary support include "forest-bathing," heat therapy, sauna, light therapy, "greenspace" and "bluespace" exercise, horticulture, clay art therapy activities, and pranayamic yoga breathing exercises. Further robust research is however required to firmly validate many of these interventions, and to establish their therapeutic applications for the benefit of specific mental health disorders.
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Affiliation(s)
- Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia.,Professorial Unit, The Melbourne Clinic, Department of Psychiatry, Melbourne University, Melbourne, VIC, Australia
| | - Michael de Manincor
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Fiona Hargraves
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Jack Tsonis
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia.,THRI, Western Sydney University, Campbelltown, NSW, Australia
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Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study. BMC Med 2018; 16:219. [PMID: 30486813 PMCID: PMC6262976 DOI: 10.1186/s12916-018-1198-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 10/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. METHODS Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53-74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with CVD mortality. RESULTS A total of 181 fatal CVD events occurred during a median follow-up of 15.0 years (interquartile range, 14.1-15.9). The risk of CVD mortality decreased linearly with increasing sauna sessions per week with no threshold effect. In age- and sex-adjusted analysis, compared with participants who had one sauna bathing session per week, HRs (95% CIs) for CVD mortality were 0.71 (0.52 to 0.98) and 0.30 (0.14 to 0.64) for participants with two to three and four to seven sauna sessions per week, respectively. After adjustment for established CVD risk factors, potential confounders including physical activity, socioeconomic status, and incident coronary heart disease, the corresponding HRs (95% CIs) were 0.75 (0.52 to 1.08) and 0.23 (0.08 to 0.65), respectively. The duration of sauna use (minutes per week) was inversely associated with CVD mortality in a continuous manner. Addition of information on sauna bathing frequency to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change (0.0091; P = 0.010), difference in - 2 log likelihood (P = 0.019), and categorical net reclassification improvement (4.14%; P = 0.004). CONCLUSIONS Higher frequency and duration of sauna bathing are each strongly, inversely, and independently associated with fatal CVD events in middle-aged to elderly males and females. The frequency of sauna bathing improves the prediction of the long-term risk for CVD mortality.
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Affiliation(s)
- Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.,Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Hassan Khan
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland. .,Central Finland Health Care District, Jyväskylä, Finland. .,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Goley A, Mooventhan A, Manjunath NK. Comparative study on effect of neutral spinal bath and neutral spinal spray on blood pressure, heart rate and heart rate variability in healthy volunteers. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2018; 16:/j/jcim.ahead-of-print/jcim-2018-0118/jcim-2018-0118.xml. [PMID: 30335610 DOI: 10.1515/jcim-2018-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
Background Hydrotherapeutic applications to the head and spine have shown to improve cardiovascular and autonomic functions. There is lack of study reporting the effect of either neutral spinal bath (NSB) or neutral spinal spray (NSS). Hence, the present study was conducted to evaluate and compare the effects of both NSB and NSS in healthy volunteers. Methods Thirty healthy subjects were recruited and randomized into either neutral spinal bath group (NSBG) or neutral spinal spray group (NSSG). A single session of NSB, NSS was given for 15 min to the NSBG and NSSG, respectively. Assessments were taken before and after the interventions. Results Results of this study showed a significant reduction in low-frequency (LF) to high-frequency (HF) (LF/HF) ratio of heart rate variability (HRV) spectrum in NSBG compared with NSSG (p=0.026). Within-group analysis of both NSBG and NSSG showed a significant increase in the mean of the intervals between adjacent QRS complexes or the instantaneous heart rate (HR) (RRI) (p=0.002; p=0.009, respectively), along with a significant reduction in HR (p=0.002; p=0.004, respectively). But, a significant reduction in systolic blood pressure (SBP) (p=0.037) and pulse pressure (PP) (p=0.017) was observed in NSSG, while a significant reduction in diastolic blood pressure (DBP) (p=0.008), mean arterial blood pressure (MAP) (p=0.008) and LF/HF ratio (p=0.041) was observed in NSBG. Conclusion Results of the study suggest that 15 min of both NSB and NSS might be effective in reducing HR and improving HRV. However, NSS is particularly effective in reducing SBP and PP, while NSB is particularly effective in reducing DBP and MAP along with improving sympathovagal balance in healthy volunteers.
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Affiliation(s)
- Arundhati Goley
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), A Deemed to be University, #19, Eknath Bhavan, Gavipuram Circle, Kepegowda Nagar, Bengaluru, Karnataka,India
| | - A Mooventhan
- Division of Yoga and Life Sciences, Department of Research and Development, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), A Deemed to be University, #19, Eknath Bhavan, Gavipuram Circle, Kepegowda Nagar, Bengaluru, Karnataka,India
| | - N K Manjunath
- Division of Yoga and Life Sciences & Head, Department of Research and Development, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), A Deemed to be University, #19, Eknath Bhavan, Gavipuram Circle, Kepegowda Nagar, Bengaluru, Karnataka,India
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Shah P, Pellicori P, Kallvikbacka-Bennett A, Zhang J, Pan D, Clark AL. Warm water immersion in patients with chronic heart failure: a pilot study : Shah immerse: HF. Clin Res Cardiol 2018; 108:468-476. [PMID: 30267153 PMCID: PMC6484774 DOI: 10.1007/s00392-018-1376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/24/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with chronic conditions, such as heart failure, swim regularly and most rehabilitation exercises are conducted in warm hydrotherapy pools. However, little is known about the acute effects of warm water immersion (WWI) on cardiac haemodynamics in patients with chronic heart failure (CHF). METHODS Seventeen patients with CHF (NYHA I and II; mean age 67 years, 88% male, mean left ventricular ejection fraction 33%) and 10 age-matched normal subjects were immersed up to the neck in a hydrotherapy pool (33-35 °C). Cardiac haemodynamics were measured non-invasively, and echocardiography was performed at baseline, during WWI, 3 min after kicking in the supine position and after emerging. RESULTS In patients with CHF, compared to baseline, WWI immediately increased stroke volume (SV, mean ± standard deviation; from 65 ± 21 to 82 ± 22 mL, p < 0.001), cardiac output (CO, from 4.4 ± 1.4 to 5.7 ± 1.6 L/min, p < 0.001) and cardiac index (CI, from 2.3 ± 0.6 to 2.9 ± 0.70 L/min/m², p < 0.001) with decreased systemic vascular resistance (from 1881 ± 582 to 1258 ± 332 dynes/s/cm5, p < 0.001) and systolic blood pressure (132 ± 21 to 115 ± 23 mmHg, p < 0.001). The haemodynamic changes persisted for 15 min of WWI. In normal subjects, compared to baseline, WWI increased SV (from 68 ± 11 to 80 ± 18 mL, p < 0.001), CO (from 5.1 ± 1.9 to 5.7 ± 1.8 L/min, p < 0.001) and CI (from 2.7 ± 0.9 to 2.9 ± 1.0 L/min/m², p < 0.001).In patients with CHF, compared to baseline, WWI caused an increase in left atrial volume (from 57 ± 44 to 72 ± 46 mL, p = 0.04), without any changes in left ventricular size or function or amino terminal pro B-type natriuretic peptide. CONCLUSIONS In patients with CHF, WWI causes an acute increase in cardiac output and a fall in systemic vascular resistance. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT02949544) https://clinicaltrials.gov/ct2/show/NCT02949544?cond=NCT02949544&rank=1 .
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Affiliation(s)
- Parin Shah
- Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK.
| | - Pierpaolo Pellicori
- Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK
| | - Anna Kallvikbacka-Bennett
- Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK
| | - Jufen Zhang
- Clinical Trials Unit, Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex, CM1 1SQ, UK
| | - Daniel Pan
- Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK
| | - Andrew L Clark
- Department of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK
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Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin Proc 2018; 93:1111-1121. [PMID: 30077204 DOI: 10.1016/j.mayocp.2018.04.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 11/20/2022]
Abstract
Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases; nonvascular conditions such as pulmonary diseases; mortality; as well as amelioration of conditions such as arthritis, headache, and flu. The beneficial effects of sauna bathing on these outcomes have been linked to its effect on circulatory, cardiovascular, and immune functions. It has been postulated that regular sauna bathing may improve cardiovascular function via improved endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system, beneficial changes in circulating lipid profiles, and lowering of systemic blood pressure. This review summarizes the available epidemiological, experimental, and interventional evidence linking Finnish sauna bathing and its effects on cardiovascular outcomes and other disease conditions on the basis of a comprehensive search for observational studies, randomized controlled trials, and non-randomized controlled trials from MEDLINE and EMBASE from their inception until February 24, 2018. An overview of the postulated biological mechanisms underlying the associations between sauna bathing and its health benefits, areas of outstanding uncertainty, and implications for clinical practice is also provided.
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Affiliation(s)
- Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Internal Medicine, Central Finland Health Care District, Jyväskylä, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Short-term effects of Finnish sauna bathing on blood-based markers of cardiovascular function in non-naive sauna users. Heart Vessels 2018; 33:1515-1524. [PMID: 29971466 PMCID: PMC6267405 DOI: 10.1007/s00380-018-1202-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/15/2018] [Indexed: 12/15/2022]
Abstract
Emerging evidence suggests that sauna bathing is associated with reduced risk of cardiovascular and all-cause mortality events. However, the biochemical pathways by which sauna bathing might confer its effects on cardiovascular function are not certain. We aimed to study the acute effects of Finnish sauna bathing on various blood-based cardiovascular biomarkers. The study included 102 non-naive sauna users (54% male) with mean age of 51.9 years, who had at least one cardiovascular risk factor. Participants underwent a 30-min single sauna session (mean temperature, 73 °C). Biochemical profiling was conducted before, immediately after sauna and 30-min post-sauna. Overall median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (n = 20 participants) was 46.0 ng/L before sauna exposure, which increased to 50.5 ng/l immediately after sauna (median change, + 12.00%; p < 0.001) and remained persistent at 30-min post-sauna (median change from pre-sauna to post-30-min sauna, + 13.93%; p < 0.001). The changes were more evident in males compared with females. There were no significant changes in overall levels of high sensitivity C-reactive protein, creatine kinase, high sensitivity troponin I, and creatine kinase-MBm. However, levels of creatine kinase increased in males (median change immediately after sauna, + 2.99%; p = 0.024). Levels of NT-proBNP increased after sauna exposure. The increase in levels of creatine kinase was more evident in males. Long-term interventional studies are warranted to evaluate if these biomarkers are involved in pathways underlying the associations of sauna bathing with cardiovascular outcomes.
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Castelletti S, Adami PE. EuroPrevent 2018, cardiovascular prevention at its highest levels. Eur J Prev Cardiol 2018; 25:1127-1130. [DOI: 10.1177/2047487318785792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Silvia Castelletti
- IRCCS Istituto Auxologico Italiano, Centre for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - Paolo Emilio Adami
- Università degli studi di Roma ‘Foro Italico’, Italy
- Health and Science Department, International Association of Athletics Federation – IAAF, Monaco
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Abstract
It is not clear whether swimming is safe in patients with chronic heart failure. Ten studies examining the hemodynamic effects of acute water immersion (WI) (155 patients; average age 60 years; 86% male; mean left ventricular ejection fraction (LVEF) 29%) and 6 randomized controlled trials of rehabilitation comparing swimming with either medical treatment only (n = 3) or cycling (n = 1) or aerobic exercise (n = 2), (136 patients, average age 59 years; 84% male, mean LVEF 31%) were considered. In 7 studies of warm WI (30-35°C): heart rate (HR) fell (2% to -15%), and both cardiac output (CO) (7-37%) and stroke volume (SV) increased (13-41%). In 1 study of hot WI (41°C), systemic vascular resistance (SVR) fell (41%) and HR increased (33%). In 2 studies of cold WI (12-22°C), there were no consistent effects on HR and CO. Compared with medical management, swimming led to a greater increase in peak VO2 (7-14%) and 6 minute walk test (6MWT) (7-13%). Compared with cycle training, combined swimming and cycle training led to a greater reduction in resting HR (16%), a greater increase in resting SV (23%) and SVR (15%), but no changes in resting CO and a lesser increase in peak VO2 (6%). Compared with aerobic training, combined swimming and aerobic training lead to a reduction in resting HR (19%) and SVR (54%) and a greater increase in SV (34%), resting CO (28%), LVEF (9%), and 6MWT (70%). Although swimming appears to be safe, the studies conducted have been small, very heterogeneous, and inconclusive.
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Kunutsor SK, Khan H, Zaccardi F, Laukkanen T, Willeit P, Laukkanen JA. Sauna bathing reduces the risk of stroke in Finnish men and women: A prospective cohort study. Neurology 2018; 90:e1937-e1944. [PMID: 29720543 DOI: 10.1212/wnl.0000000000005606] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/03/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess the association between frequency of sauna bathing and risk of future stroke. METHODS Baseline habits of sauna bathing were assessed in 1,628 adult men and women aged 53-74 years (mean age, 62.7 years) without a known history of stroke in the Finnish Kuopio Ischemic Heart Disease prospective cohort study. Three sauna bathing frequency groups were defined: 1, 2-3, and 4-7 sessions per week. Hazard ratios (HRs) (95% confidence intervals [CIs]) were estimated for incident stroke. RESULTS During a median follow-up of 14.9 years, 155 incident stroke events were recorded. Compared with participants who had one sauna bathing session per week, the age- and sex-adjusted HR (95% CI) for stroke was 0.39 (0.18-0.83) for participants who had 4-7 sauna sessions per week. After further adjustment for established cardiovascular risk factors and other potential confounders, the corresponding HR (95% CI) was 0.39 (0.18-0.84) and this remained persistent on additional adjustment for physical activity and socioeconomic status at 0.38 (0.18-0.81). The association between frequency of sauna bathing and risk of stroke was not modified by age, sex, or other clinical characteristics (p for interaction > 0.10 for all subgroups). The association was similar for ischemic stroke but modest for hemorrhagic stroke, which could be attributed to the low event rate (n = 34). CONCLUSIONS This long-term follow-up study shows that middle-aged to elderly men and women who take frequent sauna baths have a substantially reduced risk of new-onset stroke.
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Affiliation(s)
- Setor K Kunutsor
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland.
| | - Hassan Khan
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland
| | - Francesco Zaccardi
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland
| | - Tanjaniina Laukkanen
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland
| | - Peter Willeit
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland
| | - Jari A Laukkanen
- From National Institute for Health Research Bristol Biomedical Research Centre (S.K.K.), University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK; Translational Health Sciences (S.K.K.), Bristol Medical School, Southmead Hospital, University of Bristol, UK; Division of Cardiology (H.K.), Emory University, Atlanta, GA; Diabetes Research Centre (F.Z.), Leicester General Hospital, University of Leicester, UK; Institute of Public Health and Clinical Nutrition (T.L., J.A.L.), University of Eastern Finland, Kuopio; Department of Public Health and Primary Care (P.W.), University of Cambridge, UK; Department of Neurology (P.W.), Medical University Innsbruck, Austria; Department of Internal Medicine (J.A.L.), Central Finland Hospital District, Jyväskylä; and Faculty of Sport and Health Sciences (J.A.L.), University of Jyväskylä, Finland
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Heinonen I, Laukkanen JA. Effects of heat and cold on health, with special reference to Finnish sauna bathing. Am J Physiol Regul Integr Comp Physiol 2018; 314:R629-R638. [DOI: 10.1152/ajpregu.00115.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Environmental stress such as extremely warm or cold temperature is often considered a challenge to human health and body homeostasis. However, the human body can adapt relatively well to heat and cold environments, and recent studies have also elucidated that particularly heat stress might be even highly beneficial for human health. Consequently, the aim of the present brief review is first to discuss general cardiovascular and other responses to acute heat stress, followed by a review of beneficial effects of Finnish sauna bathing on general and cardiovascular health and mortality as well as dementia and Alzheimer's disease risk. Plausible mechanisms included are improved endothelial and microvascular function, reduced blood pressure and arterial stiffness, and possibly increased angiogenesis in humans, which are likely to mediate the health benefits of sauna bathing. In addition to heat exposure with physiological adaptations, cold stress-induced physiological responses and brown fat activation on health are also discussed. This is important to take into consideration, as sauna bathing is frequently associated with cooling periods in cold(er) environments, but their combination remains poorly investigated. We finally propose, therefore, that possible additive effects of heat- and cold-stress-induced adaptations and effects on health would be worthy of further investigation.
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Affiliation(s)
- Ilkka Heinonen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
- Division of Experimental Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Central Finland Health Care District, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:1857413. [PMID: 29849692 PMCID: PMC5941775 DOI: 10.1155/2018/1857413] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/14/2017] [Accepted: 01/08/2018] [Indexed: 12/13/2022]
Abstract
Introduction Many health benefits are claimed by individuals and facilities promoting sauna bathing; however the medical evidence to support these claims is not well established. This paper aims to systematically review recent research on the effects of repeated dry sauna interventions on human health. Methods A systematic search was made of medical databases for studies reporting on the health effects of regular dry sauna bathing on humans from 2000 onwards. Risk of bias was assessed according to the Cochrane Collaboration guidelines. Results Forty clinical studies involving a total of 3855 participants met the inclusion criteria. Only 13 studies were randomized controlled trials and most studies were small (n < 40). Reported outcome measures were heterogeneous with most studies reporting beneficial health effects. Only one small study (n = 10) reported an adverse health outcome of disrupted male spermatogenesis, demonstrated to be reversible when ceasing sauna activity. Conclusions Regular dry sauna bathing has potential health benefits. More data of higher quality is needed on the frequency and extent of adverse side effects. Further study is also needed to determine the optimal frequency and duration of distinct types of sauna bathing for targeted health effects and the specific clinical populations who are most likely to benefit.
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Combined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study. Prog Cardiovasc Dis 2018; 60:635-641. [DOI: 10.1016/j.pcad.2018.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/09/2018] [Indexed: 02/08/2023]
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Kunutsor SK, Khan H, Laukkanen T, Laukkanen JA. Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study. Ann Med 2018; 50:139-146. [PMID: 28972808 DOI: 10.1080/07853890.2017.1387927] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE We aimed to evaluate the joint impact of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) on the risk of cardiovascular and all-cause mortality. DESIGN CRF measured by respiratory gas analyses and sauna exposure were assessed at baseline in a prospective study of 2277 men. CRF was categorized as low and high (median cut-offs) and FSB as low and high (≤2 and 3-7 sessions/week, respectively). RESULTS During a median follow-up of 26.1 years, 520 cardiovascular and 1124 all-cause deaths occurred. Comparing high versus low CRF, the multivariate-adjusted hazard ratios (HRs) 95% CIs for cardiovascular and all-cause mortality were 0.51 (0.41-0.63) and 0.65 (0.57-0.75), respectively. Comparing high versus low FSB, the corresponding HRs were 0.74 (0.59-0.94) and 0.84 (0.72-0.97), respectively. Compared to low CRF & low FSB, the HRs of CVD mortality for high CRF & high FSB; high CRF & low FSB; and low CRF & high FSB were 0.42 (0.28-0.62), 0.50 (0.39-0.63) and 0.72 (0.54-0.97), respectively. For all-cause mortality, the corresponding HRs were 0.60 (0.48-0.76), 0.63 (0.54-0.74) and 0.78 (0.64-0.96), respectively. CONCLUSIONS A combination of high CRF and frequent sauna bathing confers stronger long-term protection on mortality outcomes compared with high CRF or high FSB alone. KEY MESSAGES Cardiorespiratory fitness (CRF) and frequency of sauna bathing are independently associated with reduced mortality risk; a combination of good CRF and frequent sauna bathing may confer additional survival benefits. In a population-based prospective cohort study, a combination of high CRF levels and frequent sauna bathing (3-7 sessions per week) was associated with a substantial risk reduction in fatal cardiovascular and all-cause mortality events compared with good CRF or frequent sauna bathing alone. A combination of good fitness levels produced by aerobic exercises and frequent sauna bathing may have added health benefits and confer more protection on the risk of mortality.
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Affiliation(s)
- Setor K Kunutsor
- a Translational Health Sciences , Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital , Bristol , UK
| | - Hassan Khan
- b Division of Cardiology, Department of Medicine , Emory University , Atlanta , GA , USA
| | - Tanjaniina Laukkanen
- c Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland
| | - Jari A Laukkanen
- c Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland.,d Central Finland Central Hospital , Jyväskylä , Finland
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Ikäheimo TM. Cardiovascular diseases, cold exposure and exercise. Temperature (Austin) 2018; 5:123-146. [PMID: 30377633 DOI: 10.1080/23328940.2017.1414014] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 12/11/2022] Open
Abstract
Both acute and prolonged cold exposure affect cardiovascular responses, which may be modified by an underlying cardiovascular disease. In addition, exercise in a cold environment increases cardiovascular strain further, but its effects among persons with cardiovascular diseases are not well known. Controlled studies employing whole-body or local cold exposure demonstrate comparable or augmented increase in cardiac workload, but aggravated cutaneous vasoconstriction in persons with mild hypertension. A strong sympathetic stimulation of a cold pressor test, increases cardiac workload in persons with coronary artery disease (CAD), but does not markedly differ from those with less severe disease or healthy. However, cold exposure reduces myocardial oxygen supply in CAD, which may lead to ischemia. Exercise in cold often augments cardiac workload in persons with CAD more than when performed in thermoneutral conditions. At the same time, reduced myocardial perfusion may lead to earlier ischemia, angina and impaired performance. Also having a heart failure deteriorates submaximal and maximal performance in the cold. Antianginal medication is beneficial in the cold in lowering blood pressure, but does not affect the magnitude of cold-related cardiovascular responses in hypertension. Similarly, the use of blood pressure lowering medication improves exercise performance in cold both among persons with CAD and heart failure. Both the acute and seasonal effects of cold and added with exercise may contribute to the higher morbidity and mortality of those with cardiovascular diseases. Yet, more controlled studies for understanding the pathophysiological mechanisms behind the adverse cold-related health effects are warranted.
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Affiliation(s)
- Tiina M Ikäheimo
- Center For Environmental and Respiratory Health Research, University of Oulu, FI-90014 University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, FI-90029 OYS, Oulu, Finland
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Piepoli MF. Editor’s Presentation. Eur J Prev Cardiol 2018; 25:115-117. [DOI: 10.1177/2047487317750306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Massimo F Piepoli
- Heart Failure Unit, Cardiology G da Saliceto Hospital, Piacenza, Italy
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Lee E, Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Sauna exposure leads to improved arterial compliance: Findings from a non-randomised experimental study. Eur J Prev Cardiol 2017; 25:130-138. [PMID: 29048215 DOI: 10.1177/2047487317737629] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Heat therapy has been suggested to improve cardiovascular function. However, the effects of hot sauna exposure on arterial compliance and the dynamics of blood flow and pressure have not been well documented. Thus, we investigated the short-term effects of sauna bathing on arterial stiffness and haemodynamics. Design The design was an experimental non-randomised study. Methods There were 102 asymptomatic participants (mean age, 51.9 years) who had at least one cardiovascular risk factor. Participants were exposed to a single sauna session (duration: 30 min; temperature: 73℃; humidity: 10-20%). Pulse wave velocity, augmentation index, heart rate, blood pressure, mean arterial pressure, pulse pressure, augmented pressure and left ventricular ejection time were assessed before, immediately after, and 30 min after a single sauna session. Results Sauna bathing led to reductions in pulse wave velocity, blood pressure, mean arterial pressure and left ventricular ejection time. Mean pulse wave velocity value before sauna was 9.8 m/s and decreased to 8.6 m/s immediately after sauna bathing ( p < 0.001 for difference), and was 9.0 m/s after the 30-minute recovery period ( p < 0.001 for analysis of variance). Systolic blood pressure was 137 mm Hg before sauna bathing, decreasing to 130 mm Hg after sauna ( p < 0.001), which remained sustained during the 30-minute recovery phase ( p < 0.001 for analysis of variance). After a single sauna session, diastolic blood pressure decreased from 82 to 75 mm Hg, mean arterial pressure from 99.4 to 93.6 mm Hg and left ventricular ejection time from 307 to 278 m/s ( p < 0.001 for all differences). Pulse pressure was 42.7 mm Hg before the sauna, 44.9 mm Hg immediately after the sauna, and reduced to 39.3 mm Hg after 30-minutes recovery ( p < 0.001 for analysis of variance). Heart rate increased from 65 to 81 beats/min post-sauna ( p < 0.001); there were no significant changes for augmented pressure and pulse pressure amplification. Conclusion This study shows that pulse wave velocity, systolic blood pressure, diastolic blood pressure, mean arterial pressure, left ventricular ejection time and diastolic time decreased immediately after a 30-minute sauna session. Decreases in systolic blood pressure and left ventricular ejection time were sustained during the 30-minute recovery phase.
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Affiliation(s)
- Earric Lee
- 1 Department of Biology of Physical Activity, University of Jyväskylä, Finland
| | - Tanjaniina Laukkanen
- 2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Setor K Kunutsor
- 3 Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Hassan Khan
- 4 Division of Cardiology, Department of Medicine, Emory University, USA
| | - Peter Willeit
- 5 Department of Neurology, Medical University Innsbruck, Austria.,6 Department of Public Health and Primary Care, University of Cambridge, UK
| | | | - Jari A Laukkanen
- 2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,8 Department of Internal Medicine, Central Finland Hospital District, Finland
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Heat adaptation from regular hot water immersion decreases proinflammatory responses, HSP70 expression, and physical heat stress. J Therm Biol 2017; 69:95-103. [DOI: 10.1016/j.jtherbio.2017.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/09/2017] [Accepted: 06/30/2017] [Indexed: 01/13/2023]
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