1
|
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.
Collapse
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
| |
Collapse
|
2
|
Kunutsor SK, Isiozor NM, Kurl S, Laukkanen JA. Enhancing Cardiorespiratory Fitness Through Sauna Bathing: Insights From the Kuopio Ischemic Heart Disease Prospective Study. J Cardiopulm Rehabil Prev 2024; 44:295-300. [PMID: 38836690 DOI: 10.1097/hcr.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
PURPOSE The physiological adaptations stimulated by a sauna bath (SB) are similar to those produced by moderate- or high-intensity physical activity (PA), but the relationship between SB and cardiorespiratory fitness (CRF) is not clear. The objective of this study was to evaluate the cross-sectional and longitudinal associations between frequency and duration of SB with CRF. METHODS Baseline SB habits were assessed in 2012 men aged 42 -61 yr. CRF was directly measured using a respiratory gas exchange analyzer during cardiopulmonary exercise testing at baseline and 11 yr later. The associations of SB frequency and duration with baseline and 11-yr levels of CRF were examined using robust regression analyses adjusted for several confounders, including lifestyle factors such as PA. RESULTS In baseline analysis, a unit increase in sauna sessions/wk was associated with an increase in CRF 0.30 mL/kg/min (standard error [SE]: 0.14; P = .034). Alternatively, compared with a single sauna sessions/wk, 2-3 and 4-7 sauna sessions/wk was each associated with significant increases in levels of CRF: 0.84 mL/kg/min (SE: 0.32; P = .008) and 1.17 mL/kg/min (SE: 0.57; P = .041), respectively. In longitudinal analysis, frequent SB was associated with increases in 11-yr CRF levels, but this was only significant for 2-3 sauna sessions/wk compared with a single sauna sessions/wk: 1.22 mL/kg/min (SE: 0.59; P = .038). Duration of SB was not significantly associated with CRF levels in cross-sectional and longitudinal analyses. CONCLUSIONS Frequent SB may improve levels of CRF independently of PA. These results warrant replication in robust definitive randomized controlled trials.
Collapse
Affiliation(s)
- Setor K Kunutsor
- Author Affiliations: Leicester Real World Evidence Unit, Diabetes Research Centre (Dr Kunutsor), University of Leicester, Leicester General Hospital, Leicester, United Kingdom; Institute of Clinical Medicine (Drs Isiozor and Laukkanen), Institute of Public Health and Clinical Nutrition (Drs Kurl and Laukkanen), University of Eastern Finland, Kuopio, Finland; and Wellbeing Services County of Central Finland, Department of Medicine (Dr Laukkanen), Jyväskylä, Finland
| | | | | | | |
Collapse
|
3
|
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.
Collapse
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
| | | |
Collapse
|
4
|
Franklin D, Tzavelis A, Lee JY, Chung HU, Trueb J, Arafa H, Kwak SS, Huang I, Liu Y, Rathod M, Wu J, Liu H, Wu C, Pandit JA, Ahmad FS, McCarthy PM, Rogers JA. Synchronized wearables for the detection of haemodynamic states via electrocardiography and multispectral photoplethysmography. Nat Biomed Eng 2023; 7:1229-1241. [PMID: 37783757 PMCID: PMC10653655 DOI: 10.1038/s41551-023-01098-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/18/2023] [Indexed: 10/04/2023]
Abstract
Cardiovascular health is typically monitored by measuring blood pressure. Here we describe a wireless on-skin system consisting of synchronized sensors for chest electrocardiography and peripheral multispectral photoplethysmography for the continuous monitoring of metrics related to vascular resistance, cardiac output and blood-pressure regulation. We used data from the sensors to train a support-vector-machine model for the classification of haemodynamic states (resulting from exposure to heat or cold, physical exercise, breath holding, performing the Valsalva manoeuvre or from vasopressor administration during post-operative hypotension) that independently affect blood pressure, cardiac output and vascular resistance. The model classified the haemodynamic states on the basis of an unseen subset of sensor data for 10 healthy individuals, 20 patients with hypertension undergoing haemodynamic stimuli and 15 patients recovering from cardiac surgery, with an average precision of 0.878 and an overall area under the receiver operating characteristic curve of 0.958. The multinodal sensor system may provide clinically actionable insights into haemodynamic states for use in the management of cardiovascular disease.
Collapse
Affiliation(s)
- Daniel Franklin
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Onatrio, Canada.
| | - Andreas Tzavelis
- Medical Scientist Training Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | | | | | - Jacob Trueb
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Hany Arafa
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Sung Soo Kwak
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Ivy Huang
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Department of Materials Science and Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Yiming Liu
- Department of Electrical and Computer Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Megh Rathod
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Onatrio, Canada
| | - Jonathan Wu
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Onatrio, Canada
| | - Haolin Liu
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Onatrio, Canada
| | - Changsheng Wu
- Department of Materials Science and Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Jay A Pandit
- Scripps Research Translational Institute, San Diego, CA, USA
| | - Faraz S Ahmad
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University, Chicago, IL, USA
| | - Patrick M McCarthy
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, IL, USA
| | - John A Rogers
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA.
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
- Department of Materials Science and Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA.
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
5
|
Debray A, Gravel H, Garceau L, Bartlett AA, Chaseling GK, Barry H, Behzadi P, Ravanelli N, Iglesies-Grau J, Nigam A, Juneau M, Gagnon D. Finnish sauna bathing and vascular health of adults with coronary artery disease: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:795-804. [PMID: 37650138 DOI: 10.1152/japplphysiol.00322.2023] [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: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023] Open
Abstract
Regular Finnish sauna use is associated with a reduced risk of cardiovascular mortality. However, physiological mechanisms underlying this association remain unknown. This study determined if an 8-wk Finnish sauna intervention improves peripheral endothelial function, microvascular function, central arterial stiffness, and blood pressure in adults with coronary artery disease (CAD). Forty-one adults (62 ± 6 yr, 33 men/8 women) with stable CAD were randomized to 8 wk of Finnish sauna use (n = 21, 4 sessions/wk, 20-30 min/session, 79°C, 13% relative humidity) or a control intervention (n = 20, lifestyle maintenance). Brachial artery flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cf-PWV), total (area under the curve) and peak postocclusion forearm reactive hyperemia, and blood pressure (automated auscultation) were measured before and after the intervention. After the sauna intervention, resting core temperature was lower (-0.27°C [-0.54, -0.01], P = 0.046) and sweat rate during sauna exposure was greater (0.3 L/h [0.1, 0.5], P = 0.003). The change in brachial artery FMD did not differ between interventions (control: 0.07% [-0.99, +1.14] vs. sauna: 0.15% [-0.89, +1.19], interaction P = 0.909). The change in total (P = 0.031) and peak (P = 0.024) reactive hyperemia differed between interventions due to a nonsignificant decrease in response to the sauna intervention and an increase in response to control. The change in cf-PWV (P = 0.816), systolic (P = 0.951), and diastolic (P = 0.292) blood pressure did not differ between interventions. These results demonstrate that four sessions of Finnish sauna bathing per week for 8 wk does not improve markers of vascular health in adults with stable CAD.NEW & NOTEWORTHY This study determined if unsupervised Finnish sauna bathing for 8 wk improves markers of vascular health in adults with coronary artery disease. Finnish sauna bathing reduced resting core temperature and improved sweating capacity, indicative of heat acclimation. Despite evidence of heat acclimation, Finnish sauna bathing did not improve markers of endothelial function, microvascular function, arterial stiffness, or blood pressure.
Collapse
Affiliation(s)
- Amélie Debray
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Hugo Gravel
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Audrey-Ann Bartlett
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Nicholas Ravanelli
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
6
|
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: 7] [Impact Index Per Article: 7.0] [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.
Collapse
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
| |
Collapse
|
7
|
Laukkanen JA, Jae SY, Kauhanen J, Kunutsor SK. The Interplay between Systolic Blood Pressure, Sauna Bathing, and Cardiovascular Mortality in Middle-Aged and Older Finnish Men: A Cohort Study. J Nutr Health Aging 2023; 27:348-353. [PMID: 37248758 DOI: 10.1007/s12603-023-1895-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/25/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Elevated systolic blood pressure (SBP) is associated with an increased risk of cardiovascular disease (CVD) mortality, whereas frequent sauna bathing reduces the risk. Whether frequent sauna bathing mitigates CVD mortality among adults with elevated SBP has not been previously investigated. DESIGN AND SETTING We examined the interactions between SBP and frequency of sauna bathing (FSB) with the risk of CVD mortality in a cohort of Caucasian men. PARTICIPANTS The Kuopio Ischaemic Heart Disease Study cohort comprising of 2,575 men aged 42-61 years at baseline was employed for this prospective study analysis. MEASUREMENTS Resting blood pressure was measured using a standardized protocol and sauna bathing habits were assessed by a self-administered questionnaire. Systolic blood pressure was categorized as normal and high (<140 and ≥140 mmHg, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week, respectively). RESULTS A total of 744 CVD deaths were recorded during a median follow-up of 27.8 yr. Comparing high vs normal SBP, the multivariable-adjusted HR (95% CI) for CVD mortality was 1.44 (1.23-1.68). Comparing low vs high FSB, the multivariable-adjusted HR (95% CI) for CVD mortality was 1.24 (1.03-1.51). The associations persisted following mutual adjustment for each exposure. Compared with men with normal SBP-high FSB, high SBP-low FSB was associated with an increased risk of CVD mortality 1.81 (1.39-2.36), with attenuated but persisting evidence of an association for men with high SBP and high FSB 1.52 (1.06-2.16). When SBP was categorized as normal and high (<130 and ≥130 mmHg, respectively), there was no evidence of an association for men with high SBP and high FSB 1.11 (0.77-1.61). CONCLUSION There might be an interaction between SBP, sauna bathing and CVD mortality risk in middle-aged and older Caucasian males. Frequent sauna baths may offset the increased risk of CVD mortality in men with high-normal SBP but not elevated SBP.
Collapse
Affiliation(s)
- J A Laukkanen
- Prof. Jari Laukkanen, Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, P.O. Box 1627, FIN-70211 Kuopio, Finland, Fax: +358-17-162936, Tel +358-50-5053013, E-mail:
| | | | | | | |
Collapse
|
8
|
Kunutsor SK, Jae SY, Laukkanen JA. Frequent sauna bathing offsets the increased risk of death due to low socioeconomic status: A prospective cohort study of middle-aged and older men. Exp Gerontol 2022; 167:111906. [PMID: 35908583 DOI: 10.1016/j.exger.2022.111906] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/27/2022] [Accepted: 07/25/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM Low socioeconomic status (SES) and frequent sauna bathing are associated with increased and decreased risk of all-cause mortality, respectively. Whether there is an interplay among SES, sauna bathing and all-cause mortality risk is not known. We aimed to evaluate the separate and joint associations of SES and frequency of sauna bathing (FSB) with all-cause mortality risk in a prospective cohort study. METHODS We employed the Kuopio Ischaemic Heart Disease Study cohort comprising of 2575 men aged 42-61 years at study entry. Self-reported SES and sauna bathing habits were assessed at baseline. Socioeconomic status was categorized as low and high (median cutoff) and FSB as low and high (defined as ≤2 and 3-7 sessions/week, respectively). RESULTS During a median follow-up of 27.8 years, 1618 deaths occurred. Comparing low vs high SES, the multivariable-adjusted HR (95 % CI) for all-cause mortality was 1.31 (1.18-1.45). Comparing high vs low FSB, the multivariable-adjusted HR (95 % CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with high SES-low FSB, low SES-low FSB was associated with an increased risk of all-cause mortality 1.35 (1.20-1.51), without significant evidence of an association for low SES-high FSB and all-cause mortality risk 1.07 (0.89-1.29). Positive additive and multiplicative interactions were found between SES and FSB. CONCLUSIONS There exists an interplay among SES, sauna bathing and all-cause mortality risk in a general Finnish male population. Frequent sauna baths may offset the increased overall mortality risk due to low SES.
Collapse
Affiliation(s)
- Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the 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; Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Finland.
| | - 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
| | - Jari A Laukkanen
- Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Finland; 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
| |
Collapse
|
9
|
Lee E, Kolunsarka IA, Kostensalo J, Ahtiainen JP, Haapala EA, Willeit P, Kunutsor SK, Laukkanen JA. The effects of regular sauna bathing in conjunction with exercise on cardiovascular function: A multi-arm randomized controlled trial. Am J Physiol Regul Integr Comp Physiol 2022; 323:R289-R299. [PMID: 35785965 PMCID: PMC9394774 DOI: 10.1152/ajpregu.00076.2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Regular exercise and sauna bathing have each been shown to improve cardiovascular function in clinical populations. However, experimental data on the cardiovascular adaptations to regular exercise in conjunction with sauna bathing in the general population is lacking. Therefore, we compared the effects of exercise and sauna bathing, to regular exercise using a multi-arm randomized controlled trial. Participants (n = 47) aged 49 ± 9 years with low physical activity levels, and at least one traditional CVD risk factor were randomly assigned (1:1:1) to guideline-based regular exercise and 15-minute post-exercise sauna (EXS), guideline-based regular exercise (EXE), or control (CON), for eight weeks. The primary outcomes were blood pressure (BP) and cardiorespiratory fitness (CRF). Secondary outcomes included fat mass, total cholesterol levels, and arterial stiffness. EXE had a greater change in CRF (+6.2 ml/kg/min; 95% CI, +4.2. to +8.3 ml/kg/min) and fat mass, but no differences in BP when compared to CON. EXS displayed greater change in CRF (+2.7 ml/kg/min; 95% CI, +0.2. to +5.3 ml/kg/min), lower systolic BP (-8.0 mmHg; 95% CI, -14.6 to -1.4 mmHg) and lower total cholesterol levels compared to EXE. Regular exercise improved CRF and body composition in sedentary adults with CVD risk factors. However, when combined with exercise, sauna bathing demonstrated a substantially supplementary effect on CRF, systolic BP, and total cholesterol levels. Sauna bathing is a valuable lifestyle tool that complements exercise for improving CRF, and decreasing systolic BP. Future research should focus on the duration, and frequency of exposure to ascertain the dose-response relationship.
Collapse
Affiliation(s)
- Earric Lee
- Faculty of Sports and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Iiris A Kolunsarka
- Faculty of Sports and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Joel Kostensalo
- grid.22642.30Natural Resources Institute Finland, Joensuu, Finland
| | - Juha P Ahtiainen
- Department of Biology of Physical Activity, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Setor K Kunutsor
- Translational Health Sciences, grid.5337.2University of Bristol, Bristol, United Kingdom
| | | |
Collapse
|
10
|
Cui J, Gao Z, Leuenberger UA, Blaha C, Luck JC, Herr MD, Sinoway LI. Repeated warm water baths decrease sympathetic activity in humans. J Appl Physiol (1985) 2022; 133:234-245. [PMID: 35736952 DOI: 10.1152/japplphysiol.00684.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acute whole-body heat stress evokes sympathetic activation. However, the chronic effects of repeated moderate heat exposure (RMHE) on muscle sympathetic nerve activity (MSNA) in healthy individuals remains unclear. We performed RMHE with 4 weeks (5 days/week) warm baths (~40 °C, for 30 min) in 9 healthy older (59 ± 2 yrs) volunteers. Hemodynamic variables and MSNA were examined prior, 1 day after and 1 week following 4 weeks of RMHE in a laboratory at ~23 °C. Cold pressor test and handgrip exercise were performed during the tests. Under normothermic condition, the resting MSNA burst rate (prior, post, post 1-wk: 31.6 ± 2.0, 25.2 ± 2.0, 27.7 ± 1.7 bursts/min; P < 0.001) and burst incidence (P < 0.001) significantly decreased after RMHE. Moreover, the resting heart rate significantly decreased after RMHE (62.3 ± 1.6, 59.5 ± 2.0, 58.2 ± 1.6 beats/min, P = 0.031). The low frequency to high frequency ratio of heart rate variability, an index of sympathovagal balance, also decreased after RMHE. The sensitivity of baroreflex control of MSNA and heart rate were not altered by RMHE, although the operating points were reset. The MSNA and hemodynamic responses (i.e. changes) to handgrip exercise or cold pressor test were not significantly altered. These data suggest that the RMHE evoked by warm baths decreases resting sympathetic activity and HR, which can be considered beneficial effects. The mechanism(s) should be examined in future studies.
Collapse
Affiliation(s)
- Jian Cui
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Zhaohui Gao
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Urs A Leuenberger
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Cheryl Blaha
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Jonathan Carter Luck
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Michael D Herr
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| | - Lawrence I Sinoway
- Penn State Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, United States
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
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.
Collapse
|
13
|
Lee E, Kostensalo J, Willeit P, Kunutsor SK, Laukkanen T, Zaccardi F, Khan H, Laukkanen JA. Standalone sauna vs exercise followed by sauna on cardiovascular function in non-naïve sauna users: A comparison of acute effects. Health Sci Rep 2021; 4:e393. [PMID: 34622026 PMCID: PMC8485612 DOI: 10.1002/hsr2.393] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIMS Sauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross-over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure. METHODS Participants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30-minute sauna at 75°C (SAUNA) and (b) the combination of a 15-minute cycling exercise at 75% maximum heart rate followed by 15-minute sauna exposure (EX+SAUNA). Relative changes to arterial stiffness (PWV), augmentation index (Alx), brachial systolic and diastolic blood pressure (SBP and DBP), central SBP (cSBP), mean arterial pressure (MAP), and heart rate (HR) were compared PRE-POST and pre- to 30-minutes post-intervention (PRE-POST30). RESULTS Baseline SBP and DBP were 143 (SD 18) mmHg and 86 (SD 10) mmHg, respectively. From PRE-POST, SAUNA had lower DBP (mean difference [95% CI] 2.5 [1.0, 4.1], P = .002) and MAP (2.5 [0.6, 4.3], P = .01). However, EX+SAUNA had lower SBP (-2.7 [-4.8, -0.5], P = .02), DBP (-1.8 [-3.3, -0.4], P = .01), and MAP (-2.0 [-3.5, -0.5], P = .009) PRE-POST30. There were no statistically significant differences between SAUNA and EX+SAUNA for other measured parameters. CONCLUSION This study demonstrated that when matched for duration, EX+SAUNA and SAUNA elicit comparable acute hemodynamic alterations in middle-aged participants with cardiovascular risk factors. The sauna is a suitable option for acute blood pressure reductions in those who are unable to perform aerobic exercise, and may be a viable lifestyle treatment option to improve blood pressure control.
Collapse
Affiliation(s)
- Earric Lee
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Joel Kostensalo
- Faculty of Mathematics and Science University of Jyväskylä Jyväskylä Finland
| | - Peter Willeit
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol Bristol UK
- Translational Health Sciences, Bristol Medical School University of Bristol, Learning & Research Building (Level 1), Southmead Hospital Bristol UK
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | | | - Hassan Khan
- Division of Cardiology, Department of Medicine Emory University Atlanta Georgia USA
| | - 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 Clinical Medicine University of Eastern Finland Kuopio Finland
| |
Collapse
|
14
|
Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol 2021; 154:111509. [PMID: 34363927 DOI: 10.1016/j.exger.2021.111509] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Sauna use, sometimes referred to as "sauna bathing," is characterized by short-term passive exposure to high temperatures, typically ranging from 45 °C to 100 °C (113 °F to 212 °F), depending on modality. This exposure elicits mild hyperthermia, inducing a thermoregulatory response involving neuroendocrine, cardiovascular, and cytoprotective mechanisms that work in a synergistic fashion in an attempt to maintain homeostasis. Repeated sauna use acclimates the body to heat and optimizes the body's response to future exposures, likely due to the biological phenomenon known as hormesis. In recent decades, sauna bathing has emerged as a probable means to extend healthspan, based on compelling data from observational, interventional, and mechanistic studies. Of particular interest are the findings from large, prospective, population-based cohort studies of health outcomes among sauna users that identified strong dose-dependent links between sauna use and reduced morbidity and mortality. This review presents an overview of sauna practices; elucidates the body's physiological response to heat stress and the molecular mechanisms that drive the response; enumerates the myriad health benefits associated with sauna use; and describes sauna use concerns.
Collapse
Affiliation(s)
| | - Teresa L Johnson
- TLJ Communications, LLC, 36 Creek Harbour Blvd., Freeport, FL 32439, USA.
| |
Collapse
|
15
|
Koch Esteves N, Gibson OR, Khir AW, González‐Alonso J. Regional thermal hyperemia in the human leg: Evidence of the importance of thermosensitive mechanisms in the control of the peripheral circulation. Physiol Rep 2021; 9:e14953. [PMID: 34350727 PMCID: PMC8339537 DOI: 10.14814/phy2.14953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 02/04/2023] Open
Abstract
Hyperthermia is thought to increase limb blood flow through the activation of thermosensitive mechanisms within the limb vasculature, but the precise vascular locus in which hyperthermia modulates perfusion remains elusive. We tested the hypothesis that local temperature-sensitive mechanisms alter limb hemodynamics by regulating microvascular blood flow. Temperature and oxygenation profiles and leg hemodynamics of the common (CFA), superficial (SFA) and profunda (PFA) femoral arteries, and popliteal artery (POA) of the experimental and control legs were measured in healthy participants during: (1) 3 h of whole leg heating (WLH) followed by 3 h of recovery (n = 9); (2) 1 h of upper leg heating (ULH) followed by 30 min of cooling and 1 h ULH bout (n = 8); and (3) 1 h of lower leg heating (LLH) (n = 8). WLH increased experimental leg temperature by 4.2 ± 1.2ºC and blood flow in CFA, SFA, PFA, and POA by ≥3-fold, while the core temperature essentially remained stable. Upper and lower leg blood flow increased exponentially in response to leg temperature and then declined during recovery. ULH and LLH similarly increased the corresponding segmental leg temperature, blood flow, and tissue oxygenation without affecting these responses in the non-heated leg segment, or perfusion pressure and conduit artery diameter across all vessels. Findings demonstrate that whole leg hyperthermia induces profound and sustained elevations in upper and lower limb blood flow and that segmental hyperthermia matches the regional thermal hyperemia without causing thermal or hemodynamic alterations in the non-heated limb segment. These observations support the notion that heat-activated thermosensitive mechanisms in microcirculation regulate limb tissue perfusion during hyperthermia.
Collapse
Affiliation(s)
- Nuno Koch Esteves
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Ashraf W. Khir
- Department of Mechanical and Aerospace EngineeringCollege of Engineering, Design and Physical SciencesBrunel University LondonUxbridgeUK
| | - José González‐Alonso
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| |
Collapse
|
16
|
Pokora I, Sadowska-Krępa E, Wolowski Ł, Wyderka P, Michnik A, Drzazga Z. The Effect of Medium-Term Sauna-Based Heat Acclimation (MPHA) on Thermophysiological and Plasma Volume Responses to Exercise Performed under Temperate Conditions in Elite Cross-Country Skiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6906. [PMID: 34199101 PMCID: PMC8297353 DOI: 10.3390/ijerph18136906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/04/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
The influence of a series of ten sauna baths (MPHA) on thermophysiological and selected hematological responses in 14 elite cross-country skiers to a submaximal endurance exercise test performed under thermoneutral environmental conditions was studied. Thermal and physiological variables were measured before and after the exercise test, whereas selected hematological indices were studied before, immediately after, and during recovery after a run, before (T1) and after sauna baths (T2). MPHA did not influence the baseline internal, body, and skin temperatures. There was a decrease in the resting heart rate (HR: p = 0.001) and physiological strain (PSI: p = 0.052) after MPHA and a significant effect of MPHA on systolic blood pressure (p = 0.03), hematological indices, and an exercise effect but no combined effect of treatments and exercise on the tested variables. A positive correlation was reported between PSI and total protein (%ΔTP) in T2 and a negative between plasma volume (%ΔPV) and mean red cellular volume (%ΔMCV) in T1 and T2 in response to exercise and a positive one during recovery. This may suggest that MPHA has a weak influence on body temperatures but causes a moderate decrease in PSI and modifications of plasma volume restoration in response to exercise under temperate conditions in elite athletes.
Collapse
Affiliation(s)
- Ilona Pokora
- Department of Physiological-Medical Sciences, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland;
| | - Ewa Sadowska-Krępa
- Department of Physiological-Medical Sciences, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland;
| | - Łukasz Wolowski
- Doctoral Studies, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (Ł.W.); (P.W.)
| | - Piotr Wyderka
- Doctoral Studies, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72a, 40-065 Katowice, Poland; (Ł.W.); (P.W.)
| | - Anna Michnik
- The Silesian Centre for Education and Interdisciplinary Research, Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500 Chorzow, Poland; (A.M.); (Z.D.)
| | - Zofia Drzazga
- The Silesian Centre for Education and Interdisciplinary Research, Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500 Chorzow, Poland; (A.M.); (Z.D.)
| |
Collapse
|
17
|
Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY. J Cardiopulm Rehabil Prev 2021; 42:59-63. [PMID: 33797457 DOI: 10.1097/hcr.0000000000000598] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Inflammatory pathways are involved in the pathogenesis of pneumonia. Frequent sauna sessions may reduce the risk of respiratory tract infections including pneumonia independent of inflammation. We aimed to evaluate the independent and joint associations of high-sensitivity C-reactive protein (hsCRP) and frequency of sauna bathing (FSB) with risk of pneumonia in a prospective cohort study. METHODS Serum hsCRP as an inflammatory marker was measured using an immunometric assay and FSB was assessed by self-reported sauna bathing habits at baseline in 2264 men aged 42-61 yr. Serum hsCRP was categorized as normal and high (≤3 and >3 mg/L, respectively) and FSB as low and high (defined as ≤1 and 2-7 sessions/wk, respectively). Multivariable-adjusted HRs (CIs) were calculated for incident pneumonia. RESULTS A total of 528 cases of pneumonia occurred during a median follow-up of 26.6 yr. Comparing high versus normal hsCRP, the multivariable-adjusted risk for pneumonia was HR = 1.30 (95% CI, 1.04-1.62). The corresponding risk was HR = 0.79 (95% CI, 0.66-0.95) comparing high versus low FSB. Compared with men with normal hsCRP and low FSB, high hsCRP and low FSB was associated with an increased risk of pneumonia in multivariable analysis (HR = 1.67: 95% CI, 1.21-2.29), with no evidence of an association for high hsCRP and high FSB and pneumonia (HR = 0.94: 95% CI, 0.69-1.29). CONCLUSIONS In a general middle-aged to older male Caucasian population, frequent sauna baths attenuated the increased risk of pneumonia due to inflammation.
Collapse
|
18
|
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
|
19
|
Shepley BR, Ainslie PN, Hoiland RL, Donnelly J, Sekhon MS, Zetterberg H, Blennow K, Bain AR. Negligible influence of moderate to severe hyperthermia on blood-brain barrier permeability and neuronal parenchymal integrity in healthy men. J Appl Physiol (1985) 2021; 130:792-800. [PMID: 33444119 DOI: 10.1152/japplphysiol.00645.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With growing use for hyperthermia as a cardiovascular therapeutic, there is surprisingly little information regarding the acute effects it may have on the integrity of the neurovascular unit (NVU). Indeed, relying on animal data would suggest hyperthermia comparable to levels attained in thermal therapy will disrupt the blood-brain barrier (BBB) and damage the cerebral parenchymal cells. We sought to address the hypothesis that controlled passive hyperthermia is not sufficient to damage the NVU in healthy humans. Young men (n = 11) underwent acute passive heating until +2°C or absolute esophageal temperature of 39.5°C. The presence of BBB opening was determined by trans-cerebral exchange kinetics (radial-arterial and jugular venous cannulation) of S100B. Neuronal parenchymal damage was determined by the trans-cerebral exchange of tau protein, neuron-specific enolase (NSE), and neurofilament-light protein (NF-L). Cerebral blood flow to calculate exchange kinetics was measured by duplex ultrasound of the right internal carotid and left vertebral artery. Passive heating was performed via a warm-water perfused suit. In hyperthermia, there was no increase in the cerebral exchange of S100B (P = 0.327), tau protein (P = 0.626), NF-L (P = 0.447), or NSE (P = 0.908) suggesting the +2°C core temperature is not sufficient to acutely stress the NVU in healthy men. However, there was a significant condition effect (P = 0.028) of NSE, corresponding to a significant increase in arterial (P = 0.023) but not venous (P = 0.173) concentrations in hyperthermia, potentially indicating extra-cerebral release of NSE. Collectively, results from the present study support the notion that in young men there is little concern for NVU damage with acute hyperthermia of +2 °C.NEW & NOTEWORTHY The acute effects of passive whole-body hyperthermia on the integrity of the neurovascular unit (NVU) in humans have remained unclear. We demonstrate that passive heating for ∼1 h until an increase of +2°C esophageal temperature in healthy men does not increase the cerebral release of neuronal parenchymal stress biomarkers, suggesting the NVU integrity is maintained. This preliminary study indicates passive heating is safe for the brain, at least in young healthy men.
Collapse
Affiliation(s)
- Brooke R Shepley
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
| | - Philip N Ainslie
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada
| | - Ryan L Hoiland
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology, and Therapeutics, Vancouver General Hospital, Vancouver, BC, Canada
| | - Joseph Donnelly
- Brain Physics Laboratory, Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrookes Hospital, University of Cambridge, Cambridge, UK
| | - Mypinder S Sekhon
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Division of Critical Care Medicine and Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Anthony R Bain
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
| |
Collapse
|
20
|
Knekt P, Järvinen R, Rissanen H, Heliövaara M, Aromaa A. Does sauna bathing protect against dementia? Prev Med Rep 2020; 20:101221. [PMID: 33088678 PMCID: PMC7560162 DOI: 10.1016/j.pmedr.2020.101221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 12/29/2022] Open
Abstract
Frequent sauna bathing predicted decreased risk of dementia in a cohort from Finland. Result was independent of several dementia risk factors, and was not modified by sex. Findings support suggested benefits of sauna and passive body heating in the brain.
Repeated heat exposure like sauna bathing is suggested to beneficially affect against dementia development. The epidemiological evidence is, however, scarce. Therefore, we studied the association between heat exposure during sauna bathing (i.e., the frequency of sauna bathing, frequency of heat sessions, length of stay in heat, sauna temperature) and the subsequent risk of dementia. A prospective cohort study was conducted based on 13,994 men and women aged 30–69 and free from dementia diagnosis from the Finnish Mobile Clinic Follow-up Survey. During a follow-up of 39 years, a total of 1805 dementia patients were diagnosed. The sauna bathing data was gathered from a questionnaire. Analyses based on the Cox model included the sauna bathing variables and the potential confounding factors. Sauna bathing frequency was related to a reduced risk of dementia after adjustment for the potential sociodemographic, lifestyle, and metabolic risk factors of dementia considered. The hazard ratio of dementia between individuals sauna bathing 9–12 times per month in comparison with those not sauna bathing or sauna bathing less than four times per month was 0.47 (95% CI = 0.25–0.88) during the first 20 years of follow-up and 0.81 (95% CI = 0.69–0.97) during the whole follow-up. The results are in line with the hypothesis that sauna bathing provides protection against dementia. Further studies are required to verify the suggested benefits of sauna bathing.
Collapse
Affiliation(s)
- Paul Knekt
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Harri Rissanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Arpo Aromaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
Haapala EA, Lee E, Laukkanen JA. Associations of cardiorespiratory fitness, physical activity, and BMI with arterial health in middle-aged men and women. Physiol Rep 2020; 8:e14438. [PMID: 32441423 PMCID: PMC7243195 DOI: 10.14814/phy2.14438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/24/2022] Open
Abstract
We investigated the associations of cardiorespiratory fitness (CRF), physical activity (PA) with regard to aerobic and resistance training, and body mass index (BMI) with pulse wave velocity (PWV) and augmentation index (AIx) in middle-aged adults with at least one cardiovascular risk factor. A total of 84 (46 men and 38 women) participated in the study. Cardiorespiratory fitness was measured using a maximal graded exercise test on a cycle ergometer and was defined as maximal power output (Wmax ) normalized for body weight-0.35 . Participation in aerobic and resistance training was assessed by a detailed questionnaire and BMI was calculated as weight (kg)/[height (m2 )]. Pulse wave velocity and AIx were measured using an applanation tonometry before (pre), immediately after (post), and after 10 min (post10) of maximal exercise test. Cardiorespiratory fitness, PA, or BMI was not associated with PWV or AIx. Pulse wave velocity decreased significantly from pre to post10 among those in the highest third of CRF (mean difference=-0.793 m/s, 95% CI = -1.494 to -0.091, p = .023) and in normal weight participants (p = .084 for time*group interaction mean difference=-0.781 m/s, 95% CI = -1.496 to -0.066, p = .029), but not among those in the other thirds of CRF or overweight or obese participants. Participants who had regular resistance training had continuously higher AIx from pre to post10 than those who had no regular resistance training (mean difference = -1.98, 95% CI = -4.02 to 0.069, p = .058). In conclusion, exercise may decrease PWV and AIx. Our results suggest that positive arterial responses to exercise could be slightly improved in fit and normal weight individuals.
Collapse
Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Physiology, Institute of BiomedicineSchool of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Earric Lee
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Jari A. Laukkanen
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Department of Internal MedicineCentral Finland Healthcare DistrictJyväskyläFinland
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
| |
Collapse
|
23
|
Jae SY, Heffernan KS, Park JB, Kurl S, Kunutsor SK, Kim JY, Laukkanen JA. Association between estimated pulse wave velocity and the risk of cardiovascular outcomes in men. Eur J Prev Cardiol 2020; 28:e25-e27. [DOI: 10.1177/2047487320920767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Sae Young Jae
- Department of Sport Science, University of Seoul, Republic of Korea
| | | | | | - Sudhir Kurl
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Jang-Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Republic of Korea
| | - Jari A Laukkanen
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| |
Collapse
|
24
|
Glazachev OS, Kofler W, Dudnik EN, Zapara MA, Samartseva VG. Effect of Adaptation to Passive Hyperthermia on Aerobic Performance and Cardio-Respiratory Endurance in Amateur Athletes. ACTA ACUST UNITED AC 2020. [DOI: 10.1134/s0362119719060033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
25
|
Zapara MA, Dudnik EN, Samartseva VG, Kryzhanovskaya SY, Susta D, Glazachev OS. Passive Whole-Body Hyperthermia Increases Aerobic Capacity and Cardio-Respiratory Efficiency in Amateur Athletes. Health (London) 2020. [DOI: 10.4236/health.2020.121002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
26
|
Anker MS, von Haehling S, Papp Z, Anker SD. ESC Heart Failure receives its first impact factor. Eur J Heart Fail 2019; 21:1490-e8. [PMID: 31883221 DOI: 10.1002/ejhf.1665] [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: 11/11/2022] Open
Affiliation(s)
- Markus S Anker
- Division of Cardiology and Metabolism, Department of Cardiology, Charité and Berlin Institute of Health Center for Regenerative Therapies (BCRT) and DZHK (German Centre for Cardiovascular Research), partner site Berlin and Department of Cardiology, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, Heart Center Göttingen, University of Göttingen Medical Center, George August University, Göttingen, Germany and German Center for Cardiovascular Medicine (DZHK), partner site Göttingen, Göttingen, Germany
| | - Zoltán Papp
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Stefan D Anker
- Division of Cardiology and Metabolism, Department of Cardiology, Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany, DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| |
Collapse
|
27
|
Repeated hyperthermia exposure increases circulating Brain Derived Neurotrophic Factor levels which is associated with improved quality of life, and reduced anxiety: A randomized controlled trial. J Therm Biol 2019; 89:102482. [PMID: 32365000 DOI: 10.1016/j.jtherbio.2019.102482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 01/08/2023]
Abstract
CONTEXT Hyperthermia is known to be beneficial to patients affected by various diseases. Brain Derived Neurotrophic Factor (BDNF) is a marker of neuroplasticity usually increased as response to acute exposure to human body stressors. Little is known about BDNF changes after repeated exposure to hyperthermia. OBJECTIVE To investigate the effect of a repeated hyperthermia exposure programme (HTC) on serum BDNF in healthy humans. DESIGN, SETTING, PARTICIPANTS Randomized, single-blind, controlled trial in healthy humans conducted at Sechenov University Physiology Laboratory between December 2016 and November 2018. The treatment period was 10 weeks. Researchers analysing serum BDNF and questionnaires data were blinded to participants allocation. PARTICIPANTS Were 34 healthy male (age 20.2 ± 1.6 years). INTERVENTION Repeated Hyperthermia exposure programme, HTC, versus Light Intermittent Exercise, LIE, programme as control (10 weeks). MAIN OUTCOME MEASURE Change in BDNF from baseline to final visit three days after treatment completion. RESULTS 25 participants were analyzed. One participant withdrew before signing the informed consent and 8 participants (n = 3 in HTC and n = 5 in LIE) could not undertake the first assessment and were excluded. Mean change in BDNF was higher in HTC group vs LIE after both time points (after 12 and after 24 sessions). After 24 sessions BDNF was 30170 (SD 5268) pg/ml in HTC group a value that was significantly higher than 24104 (SD 2876) pg/ml measured in LIE group. BDNF concentrations were significantly higher than baseline values in HTC group only, 30170 (SD 5268) vs 26710 (SD 5437) pg/ml. CONCLUSION A 10-week programme consisting of repeated exposure to hyperthermia resulted in a significantly higher increase of circulating BDNF compared to a programme consisting of intermittent light intensity exercise.
Collapse
|
28
|
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: 26] [Impact Index Per Article: 5.2] [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.
Collapse
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.
| |
Collapse
|
29
|
Lee E, Willeit P, Laukkanen T, Kunutsor SK, Zaccardi F, Khan H, Laukkanen JA. Acute effects of exercise and sauna as a single intervention on arterial compliance. Eur J Prev Cardiol 2019; 27:1104-1107. [PMID: 31177835 DOI: 10.1177/2047487319855454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Earric Lee
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Austria.,Department of Public Health and Primary Care, University of Cambridge, UK
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.,Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, UK
| | - Hassan Khan
- Division of Cardiology, Department of Medicine, Emory University, USA
| | - Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.,Central Finland Health Care District, Department of Internal Medicine, Finland
| |
Collapse
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
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: 20] [Impact Index Per Article: 4.0] [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.
Collapse
|
32
|
Schlader ZJ, Okada Y, Best SA, Fu Q, Crandall CG. Arterial stiffness during whole-body passive heat stress in healthy older adults. Physiol Rep 2019; 7:e14094. [PMID: 31062476 PMCID: PMC6503298 DOI: 10.14814/phy2.14094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022] Open
Abstract
We tested the hypothesis that whole-body passive heat stress reduces arterial stiffness in older adults. At preheat stress (baseline) and when core temperature was elevated by 0.6 ± 0.2°C (mild) and 1.2 ± 0.3°C (moderate), arterial stiffness was measured in eight healthy younger (26 ± 5 years) and eight healthy older (70 ± 4 years) adults in the supine position. Arterial stiffness was estimated from carotid-to-femoral pulse wave velocity (cfPWV, applanation tonometry). cfPWV was higher at baseline in older adults (8.8 ± 2.3 m/sec vs. 5.6 ± 0.9 m/sec, P < 0.01) and this difference was maintained throughout passive heat stress (P < 0.01). cfPWV did not change (P ≥ 0.49) with passive heat stress in either younger (at moderate heat stress: 6.0 ± 1.0 m/sec) or older (at moderate heat stress: 8.5 ± 1.6 m/sec) adults. However, the influence of baseline cfPWV on the change in cfPWV during mild (r = -0.66, P = 0.04) and moderate (r = -0.87, P < 0.01) heat stress were inversely related in older adults, and the strength of these relations was not statistically different (P = 0.08). In younger adults, the influence of baseline cfPWV on the change in cfPWV during mild heat stress was also inversely related (r = -0.79, P = 0.01), while the strength of this relation was attenuated at moderate heat stress (r = -0.24, P = 0.30). Changes in arterial stiffness during passive heat stress in adults aged ≥65 year are likely dependent on the magnitude of baseline arterial stiffness and not necessarily age.
Collapse
Affiliation(s)
- Zachary J. Schlader
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Yoshiyuki Okada
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasUniversity of Texas Southwestern Medical CenterDallasTexas
- Department of Special Care DentistryHiroshima UniversityHiroshimaJapan
| | - Stuart A. Best
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasUniversity of Texas Southwestern Medical CenterDallasTexas
- Department of Kinesiology and Health PromotionUniversity of KentuckyLexingtonKentucky
| | - Qi Fu
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Craig G. Crandall
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasUniversity of Texas Southwestern Medical CenterDallasTexas
| |
Collapse
|
33
|
A hot topic for health: Results of the Global Sauna Survey. Complement Ther Med 2019; 44:223-234. [PMID: 31126560 DOI: 10.1016/j.ctim.2019.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Sauna-bathing is an ancient tradition that is gaining popularity across the world as a wellness tool. There is a growing body of medical evidence supporting the role of saunas, or whole-body thermotherapy, as a form of treatment for a range of health issues. However, the demographics, motivations and experiences of current sauna bathers have not yet been explored on a global scale. This study is designed to explore these themes. DESIGN An online 71-item questionnaire compiling information on the individual characteristics, sauna-related habits and perceived health and wellness experiences of regular sauna bathers was conducted from October 2016 to October 2017. The validated 'SF-12' quality of life scoring tool was incorporated into the questionnaire to measure physical and mental indicators of well-being. RESULTS Of 572 logins recorded, 482 valid responses were generated. Both men (51.3%) and women (48.7%) were represented, and respondents were predominantly well-educated (81.8%), non-smoking (90.6%), regularly-exercising (78.8%) individuals of normal-to-overweight status (87.1%) who sauna-bathed approximately 1-2 times per week. The key reasons indicated by respondents for sauna-bathing included relaxation/stress reduction, pain relief and socializing. Nearly a third of respondents reported medical conditions and of this subset, those with back/musculoskeletal pain and mental issues cited the greatest improvements in their conditions with sauna-bathing. Of all respondents, 83.5% reported sleep benefits after sauna use. Analysis of well-being scores after stratifying respondents into three groups by sauna-bathing frequency (group I: <5 times per month; group II: 5-15 times per month; group III: >15 times per month) revealed group II respondents had slightly higher mental well-being scores (Kruskal-Wallis testing: H = 6.603 > ꭔ2 of 5.991, p = 0.0368, df = 2 with post hoc analysis using Mann-Whitney U test: p = 0.016) as compared to respondents who were sauna-bathing less frequently (group I). No respective differences were detected between the physical well-being scores of any of the three groups. Adverse reactions to sauna-bathing were recorded as mostly minor (93.1%), including primarily symptoms of dizziness, dehydration and headache. However, there were two reports (0.3%) of chest pain and eye irritation requiring hospitalization. CONCLUSIONS This cross-sectional study documents that sauna-bathing participants, particularly those from Finland, Australia and the United States, are motivated to use saunas predominantly for relaxation, reporting health benefits especially around mental well-being and sleep, with relatively few adverse effects. While these results reinforce some of the known health benefits of sauna bathing, they indicate that further research and better dissemination of existing evidence is needed to fully develop the sauna's potential as a therapeutic intervention.
Collapse
|
34
|
Abstract
In addition to its role as an environmental stressor, scientists have recently demonstrated the potential for heat to be a therapy for improving or mitigating declines in arterial health. Many studies at both ends of the scientific controls spectrum (tightly controlled, experimental vs. practical) have demonstrated the beneficial effects of heating on microvascular function (e.g., reactive hyperemia, cutaneous vascular conductance); endothelial function (e.g., flow-mediated dilation); and arterial stiffness (e.g., pulse-wave velocity, compliance, β-stiffness index). It is important to note that findings of beneficial effects are not unanimous, likely owing to the varied methodology in both heating protocols and assessments of outcome measures. Mechanisms of action for the effects of both acute and chronic heating are also understudied. Heat science is a very promising area of human physiology research, as it has the potential to contribute to approaches addressing the global cardiovascular disease burden, particularly in aging and at risk populations, and those for whom exercise is not feasible or recommended.
Collapse
Affiliation(s)
- Jem L Cheng
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | | |
Collapse
|
35
|
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: 26] [Impact Index Per Article: 4.3] [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.
Collapse
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.
| |
Collapse
|
36
|
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: 87] [Impact Index Per Article: 14.5] [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.
Collapse
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
| |
Collapse
|
37
|
Kunutsor SK, Laukkanen T, Laukkanen JA. Longitudinal associations of sauna bathing with inflammation and oxidative stress: the KIHD prospective cohort study. Ann Med 2018; 50:437-442. [PMID: 29897261 DOI: 10.1080/07853890.2018.1489143] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We sought to determine cross-sectional and longitudinal associations of frequency of sauna bathing with high sensitivity C-reactive protein (hsCRP), fibrinogen, leucocyte count and gamma-glutamyltransferase (GGT). DESIGN Baseline sauna bathing habits were assessed in 2269 men aged 42-61 years. Concentrations of hsCRP, fibrinogen, leucocyte count, and GGT were determined at baseline and 11 years later. The associations of sauna bathing frequency with baseline and 11-year hsCRP, fibrinogen, leucocyte count, and GGT levels were examined using robust multivariate regression analyses. RESULTS In baseline analysis, 4-7 sauna sessions/week (compared with 1 sauna session/week) was associated with -0.84 mg/l (95% CI, -1.55, -0.14; p = .019) lower hsCRP; -0.07 g/l (95% CI, -0.15, 0.02; p = .112) lower fibrinogen; and -0.28 × 109/l (95% CI, -0.51, -0.06; p = .015) lower leucocyte count, after multivariable adjustment. In longitudinal analysis, the corresponding estimates were -1.66 mg/l (95% CI, -3.13, -0.19; p = .027); -0.16 g/l (95% CI, -0.31, -0.02; p = .031); and -0.49 × 109/l (95% CI, -0.85, -0.14; p = .007) respectively. Sauna bathing frequency was not associated with GGT at baseline and 11 years. CONCLUSION Observational evidence supports the hypothesis that reduction in inflammation may be one of the pathways linking frequent sauna bathing with decreased risk of acute and chronic disease conditions. KEY MESSAGES Cross-sectional evidence or short-term studies suggest Finnish sauna bathing may exert its beneficial health effects via reduction in inflammation and oxidative stress; however, the long-term effects of sauna bathing on these outcomes are uncertain. In this population-based prospective cohort study, frequent sauna sessions significantly decreased levels of inflammatory markers at baseline and 11-year follow-up; but had no effect on oxidative stress. The health benefits of sauna bathing may in part be mediated via reduced systemic inflammation.
Collapse
Affiliation(s)
- Setor K Kunutsor
- a National Institute for Health Research, Bristol Biomedical Research Centre, University of Bristol , Bristol , UK.,b Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol , Bristol , UK
| | - 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 Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland.,e Central Finland Health Care District Hospital , Jyväskylä , Finland
| |
Collapse
|
38
|
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.
Collapse
|
39
|
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
| |
Collapse
|
40
|
Habitual hot water bathing protects cardiovascular function in middle-aged to elderly Japanese subjects. Sci Rep 2018; 8:8687. [PMID: 29930309 PMCID: PMC6013438 DOI: 10.1038/s41598-018-26908-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/21/2018] [Indexed: 01/29/2023] Open
Abstract
Favorable effects of sauna bathing on cardiovascular disease have been demonstrated. Hot water bathing is an alternative, and could also have similar effects. Information pertaining to hot water bathing frequency and water temperature was obtained from 873 subjects. Carotid mean and max intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) were measured as indices of atherosclerosis. Central haemodynamics were evaluated using radial pulse waveform analyses. Plasma levels of B-type natriuretic peptide (BNP) were measured as an index for cardiac loading. The mean duration of a single hot bath was 12.4 ± 9.9 min. Subject bathing in hot water ≥5 times per week had significantly lower baPWV, central pulse pressure (PP), and BNP after correcting for possible confounding parameters. Stepwise regression analyses revealed that hot water temperature was negatively associated with baPWV, while bathing frequency was negatively related to central PP and BNP. A longitudinal follow-up in 164 subjects showed that hot water bathing ≥5 times per week was associated with significantly lower increase in BNP over time, while the temperature of the water tended to be related to lower increases in carotid max IMT and baPWV. Hot water bathing showed a favorable effect on atherosclerotic and central haemodynamic parameters.
Collapse
|
41
|
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: 56] [Impact Index Per Article: 9.3] [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.
Collapse
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
| |
Collapse
|
42
|
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.
Collapse
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
| |
Collapse
|
43
|
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]
|
44
|
Laukkanen JA, Laukkanen T. Sauna bathing and systemic inflammation. Eur J Epidemiol 2017; 33:351-353. [PMID: 29209938 DOI: 10.1007/s10654-017-0335-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 11/23/2017] [Indexed: 11/26/2022]
Abstract
We aimed to investigate whether frequency of sauna bathing is associated with the levels of serum C-reactive protein. C-reactive protein is a leading blood marker of systemic inflammation. The study consisted of 2084 men (42-60 years) without acute or chronic inflammation. A total of 533 (25.6%), 1368 (65.6%), and 183 (8.8%) participants reported having a sauna bath once a week, 2-3 times, and 4-7 times per week; mean serum C-reactive protein levels were 2.41 (standard deviation 2.91), 2.00 (2.41), 1.65 (1.63) mmol/L, respectively. In a multivariable analysis adjusted for baseline age, body mass index, systolic blood pressure, smoking, type 2 diabetes, previous myocardial infarction, and serum low density lipoprotein cholesterol, alcohol consumption and physical activity, there was a significant inverse association between the frequency of sauna bathing and the level of C-reactive protein. Further studies are warranted to investigate the relationship between sauna bathing and systemic inflammation.
Collapse
Affiliation(s)
- Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
- Department of Internal Medicine, Central Finland Health Care District, Jyväskylä, Finland.
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| |
Collapse
|