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Kunutsor SK, Jae SY, Kurl S, Laukkanen JA. Sauna bathing and mortality risk: unraveling the interaction with systolic blood pressure in a cohort of Finnish men. SCAND CARDIOVASC J 2024; 58:2302159. [PMID: 38410962 DOI: 10.1080/14017431.2024.2302159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/01/2024] [Indexed: 02/28/2024]
Abstract
Objectives: This cohort study aimed to investigate the potential interplay between systolic blood pressure (SBP), frequency of sauna bathing (FSB), and all-cause mortality risk among Caucasian men. Design: A prospective study was conducted, involving 2575 men aged 42 to 61 years. Baseline assessments included resting blood pressure measurements and self-reported sauna bathing habits. SBP levels were categorized as normal (<140 mmHg) or high (≥140 mmHg), while FSB was classified as low (≤2 sessions/week) or high (3-7 sessions/week). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox regression analysis, while adjusting for lifestyle factors, lipids, inflammation, and comorbidities. Results: Over a median follow-up of 27.8 years, 1,618 deaths were recorded. In the adjusted analysis, individuals with high SBP versus low SBP showed a 29% increased all-cause mortality risk (HR 1.29, 95% CI 1.16-1.43). Similarly, those with low FSB versus high FSB exhibited a 16% elevated mortality risk (HR 1.16, 95% CI 1.02-1.31). When considering combined effects, participants with high SBP-low FSB had a 47% higher mortality risk (HR 1.47, 95% CI 1.24-1.74) compared to those with normal SBP-high FSB. However, no significant association was observed between individuals with high SBP-high FSB and mortality risk (HR 1.24, 95% CI 0.98-1.57). There were potential additive and multiplicative interactions between SBP and sauna bathing concerning mortality risk. Conclusions: This study reveals a potential interplay between SBP, sauna bathing, and mortality risk in Finnish men. Frequent sauna bathing may mitigate the increased mortality risk associated with elevated SBP.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Sae Young Jae
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea
- Department of Sport Science, University of Seoul, Seoul, South Korea
- Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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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 2024:01273116-990000000-00148. [PMID: 38836690 DOI: 10.1097/hcr.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [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.
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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
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Laukkanen JA, Kunutsor SK. The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna. Temperature (Austin) 2024; 11:27-51. [PMID: 38577299 PMCID: PMC10989710 DOI: 10.1080/23328940.2023.2300623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 04/06/2024] Open
Abstract
Passive heat therapy is characterized by exposure to a high environmental temperature for a brief period. There are several types of passive heat therapy which include hot tubs, Waon therapy, hydrotherapy, sanarium, steam baths, infrared saunas and Finnish saunas. The most commonly used and widely studied till date are the Finnish saunas, which are characterized by high temperatures (ranging from 80-100°C) and dry air with relative humidity varying from 10-20%. The goal of this review is to provide a summary of the current evidence on the impact of passive heat therapies particularly Finnish saunas on various health outcomes, while acknowledging the potential of these therapies to contribute to the extension of healthspan, based on their demonstrated health benefits and disease prevention capabilities. The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity. Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity. The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function. Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations.
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Affiliation(s)
- Jari A. Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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Jiang WI, De Belly H, Wang B, Wong A, Kim M, Oh F, DeGeorge J, Huang X, Guang S, Weiner OD, Ma DK. Early-life stress triggers long-lasting organismal resilience and longevity via tetraspanin. SCIENCE ADVANCES 2024; 10:eadj3880. [PMID: 38266092 PMCID: PMC10807809 DOI: 10.1126/sciadv.adj3880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024]
Abstract
Early-life stress experiences can produce lasting impacts on organismal adaptation and fitness. How transient stress elicits memory-like physiological effects is largely unknown. Here, we show that early-life thermal stress strongly up-regulates tsp-1, a gene encoding the conserved transmembrane tetraspanin in C. elegans. TSP-1 forms prominent multimers and stable web-like structures critical for membrane barrier functions in adults and during aging. Increased TSP-1 abundance persists even after transient early-life heat stress. Such regulation requires CBP-1, a histone acetyltransferase that facilitates initial tsp-1 transcription. Tetraspanin webs form regular membrane structures and mediate resilience-promoting effects of early-life thermal stress. Gain-of-function TSP-1 confers marked C. elegans longevity extension and thermal resilience in human cells. Together, our results reveal a cellular mechanism by which early-life thermal stress produces long-lasting memory-like impact on organismal resilience and longevity.
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Affiliation(s)
- Wei I. Jiang
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Henry De Belly
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Bingying Wang
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew Wong
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Minseo Kim
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Fiona Oh
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Jason DeGeorge
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Xinya Huang
- The USTC RNA Institute, Division of Life Sciences and Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, Anhui, China
| | - Shouhong Guang
- The USTC RNA Institute, Division of Life Sciences and Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, Anhui, China
| | - Orion D. Weiner
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Dengke K. Ma
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Physiology, University of California, San Francisco, San Francisco, CA, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA, USA
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Jiang WI, De Belly H, Wang B, Wong A, Kim M, Oh F, DeGeorge J, Huang X, Guang S, Weiner OD, Ma DK. Early-life stress triggers long-lasting organismal resilience and longevity via tetraspanin. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.25.550452. [PMID: 37546737 PMCID: PMC10402089 DOI: 10.1101/2023.07.25.550452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Early-life stress experiences can produce lasting impacts on organismal adaptation and fitness. How transient stress elicits memory-like physiological effects is largely unknown. Here we show that early-life thermal stress strongly up-regulates tsp-1, a gene encoding the conserved transmembrane tetraspanin in C. elegans. TSP-1 forms prominent multimers and stable web-like structures critical for membrane barrier functions in adults and during aging. The up-regulation of TSP-1 persists even after transient early-life stress. Such regulation requires CBP-1, a histone acetyl-transferase that facilitates initial tsp-1 transcription. Tetraspanin webs form regular membrane structures and mediate resilience-promoting effects of early-life thermal stress. Gain-of-function TSP-1 confers marked C. elegans longevity extension and thermal resilience in human cells. Together, our results reveal a cellular mechanism by which early-life thermal stress produces long-lasting memory-like impact on organismal resilience and longevity.
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Affiliation(s)
- Wei I. Jiang
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Henry De Belly
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Bingying Wang
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Andrew Wong
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Minseo Kim
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Fiona Oh
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Jason DeGeorge
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
| | - Xinya Huang
- The USTC RNA Institute, Division of Life Sciences and Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, Anhui, China
| | - Shouhong Guang
- The USTC RNA Institute, Division of Life Sciences and Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, Anhui, China
| | - Orion D. Weiner
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Dengke K. Ma
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, USA
- Department of Physiology, University of California, San Francisco, San Francisco, CA, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA, USA
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Wang T, Wang X, Fu T, Ma Y, Wang Q, Zhang S, Zhang X, Zhou H, Chang X, Tong Y. Roles of mitochondrial dynamics and mitophagy in diabetic myocardial microvascular injury. Cell Stress Chaperones 2023; 28:675-688. [PMID: 37755621 PMCID: PMC10746668 DOI: 10.1007/s12192-023-01384-3] [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: 07/28/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
Myocardial microvessels are composed of a monolayer of endothelial cells, which play a crucial role in maintaining vascular barrier function, luminal latency, vascular tone, and myocardial perfusion. Endothelial dysfunction is a key factor in the development of cardiac microvascular injury and diabetic cardiomyopathy. In addition to their role in glucose oxidation and energy metabolism, mitochondria also participate in non-metabolic processes such as apoptosis, intracellular ion handling, and redox balancing. Mitochondrial dynamics and mitophagy are responsible for regulating the quality and quantity of mitochondria in response to hyperglycemia. However, these endogenous homeostatic mechanisms can both preserve and/or disrupt non-metabolic mitochondrial functions during diabetic endothelial damage and cardiac microvascular injury. This review provides an overview of the molecular features and regulatory mechanisms of mitochondrial dynamics and mitophagy. Furthermore, we summarize findings from various investigations that suggest abnormal mitochondrial dynamics and defective mitophagy contribute to the development of diabetic endothelial dysfunction and myocardial microvascular injury. Finally, we discuss different therapeutic strategies aimed at improving endothelial homeostasis and cardiac microvascular function through the enhancement of mitochondrial dynamics and mitophagy.
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Affiliation(s)
- Tong Wang
- Heilongjiang Academy of Chinese Medicine, Harbin, 150000, China
| | - Xinwei Wang
- Heilongjiang Academy of Chinese Medicine, Harbin, 150000, China
| | - Tong Fu
- Brandeis University, Waltham, MA, 02453, USA
| | - Yanchun Ma
- Heilongjiang Academy of Chinese Medicine, Harbin, 150000, China
| | - Qi Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Shuxiang Zhang
- Heilongjiang Academy of Chinese Medicine, Harbin, 150000, China
| | - Xiao Zhang
- Senior Department of Cardiology, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, 100048, China
| | - Hao Zhou
- Senior Department of Cardiology, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, 100048, China
| | - Xing Chang
- Cardiovascular Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Ying Tong
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
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Laukkanen JA, Isiozor NM, Willeit P, Kunutsor SK. Hemodynamic Gain Index Is Associated With Cardiovascular Mortality and Improves Risk Prediction: A PROSPECTIVE COHORT STUDY. J Cardiopulm Rehabil Prev 2023; 43:368-376. [PMID: 36867712 PMCID: PMC10467812 DOI: 10.1097/hcr.0000000000000777] [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] [Indexed: 03/05/2023]
Abstract
PURPOSE The hemodynamic gain index (HGI) and cardiorespiratory fitness (CRF) are parameters assessed during cardiopulmonary exercise testing (CPX). The association between the HGI and cardiovascular disease (CVD) mortality is uncertain. We evaluated the association between the HGI and CVD mortality risk using a prospective study. METHODS The HGI was calculated using heart rate (HR) and systolic blood pressure (SBP) measured in 1634 men aged 42-61 yr during CPX, using the formula: [(HR peak × SBP peak ) - (HR rest × SBP rest )]/(HR rest × SBP rest ). Cardiorespiratory fitness was directly measured using a respiratory gas exchange analyzer. RESULTS During a median (IQR) follow-up of 28.7 (19.0, 31.4) yr, 439 CVD deaths occurred. The risk of CVD mortality decreased continuously with the increasing HGI ( P value for nonlinearity = .28). Each unit higher HGI (1.06 bpm/mm Hg) was associated with a decreased risk of CVD mortality (HR = 0.80: 95% CI, 0.71-0.89), which was attenuated after further adjustment for CRF (HR = 0.92: 95% CI, 0.81-1.04). Cardiorespiratory fitness was associated with CVD mortality and the association remained after adjustment for the HGI: (HR = 0.86: 95% CI, 0.80-0.92) per each unit (MET) higher CRF. Addition of the HGI to a CVD mortality risk prediction model improved risk discrimination (C-index change = 0.0285; P < .001) and reclassification (net reclassification improvement = 8.34%; P < .001). The corresponding values for CRF were a C-index change of 0.0413 ( P < .001) and a categorical net reclassification improvement of 14.74% ( P < .001). CONCLUSIONS The higher HGI is inversely associated with CVD mortality in a graded fashion, but the association is partly dependent on CRF levels. The HGI improves the prediction and reclassification of the risk for CVD mortality.
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Affiliation(s)
- Jari A. Laukkanen
- Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (Dr Laukkanen); Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland (Drs Laukkanen and Isiozor); Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria, and Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (Dr Willeit); and Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom, and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, United Kingdom (Dr Kunutsor)
| | - Nzechukwu M. Isiozor
- Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (Dr Laukkanen); Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland (Drs Laukkanen and Isiozor); Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria, and Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (Dr Willeit); and Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom, and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, United Kingdom (Dr Kunutsor)
| | - Peter Willeit
- Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (Dr Laukkanen); Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland (Drs Laukkanen and Isiozor); Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria, and Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (Dr Willeit); and Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom, and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, United Kingdom (Dr Kunutsor)
| | - Setor K. Kunutsor
- Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (Dr Laukkanen); Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland (Drs Laukkanen and Isiozor); Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria, and Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (Dr Willeit); and Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom, and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, United Kingdom (Dr Kunutsor)
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Kaiser P, Seeher U, Krasniqi A, Keiler A, Crazzolara R, Meryk A. Injuries related to sauna bathing. Injury 2023:110825. [PMID: 37211472 DOI: 10.1016/j.injury.2023.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Awareness of well-being and health issues have contributed to increased popularity of sauna bathing. However, little is known about potential risks and injuries. The aim of this study was to identify the causes for injuries, the affected body regions and to define recommendations for prevention. METHODS A retrospective chart data analysis was conducted among patients treated for an injury related to sauna bathing at the local trauma centre of the Medical University of Innsbruck between January 1, 2005 and December 31, 2021. Patients' demographics, the cause for the injury, the diagnosis, the body region of the trauma and the treatment methods were collected. RESULTS Two hundred and nine patients with injuries related to sauna bathing (83 female [39.7%] and 126 male [60.3%]) were identified. Fifty-one patients showed more than one injuries leading to a total of 274 diagnosis: contusions/distorsions (113; 41.2%), wounds (79; 28.8%), fractures (42; 15.3%), ligament injuries (17; 6.2%), concussions (15; 5.5%), burns (4; 1.5%) and brain bleeding (3; 1.1%). The most common cause for an injury was a slip/fall (157; 57.5%) followed by dizziness/syncope (82; 30.0%). Interestingly, head and face injuries were mostly caused by dizziness/syncope, whereas slip/fall was the leading cause for injuries of foot, hand, forearm and wrist. Nine patients(4.3%) needed surgical treatment mainly due to fractures. Eight patients got injured by wood splinters. One patient sustained grade IIB-III burns lying unconscious with an alcohol intoxication of 3.6‰ in the sauna. CONCLUSION The main causes for injuries during sauna bathing were slip/falls and dizziness/syncopes. The latter one might be prevented by improved of the personal behaviour (e.g. drink enough water before and after each sauna bathing), whereas slip/falls might be prevented by the revision of safety regulations, particularly the obligation to wear slip resistant slippers. Thus, everyone himself as well as the operators can contribute to reduce injuries related sauna bathing.
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Affiliation(s)
- Peter Kaiser
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Ulrike Seeher
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Arbnor Krasniqi
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Alexander Keiler
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Roman Crazzolara
- Department of Pediatrics, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria
| | - Andreas Meryk
- Department of Pediatrics, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
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Chen J, Chew K, Mary S, Boder P, Bagordo D, Rossi G, Touyz R, Delles C, Rossitto G. Skin-specific mechanisms of body fluid regulation in hypertension. Clin Sci (Lond) 2023; 137:239-250. [PMID: 36648486 PMCID: PMC10621731 DOI: 10.1042/cs20220609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/18/2023]
Abstract
Increasing evidence suggests excess skin Na+ accumulation in hypertension; however, the role of skin-specific mechanisms of local Na+/water regulation remains unclear. We investigated the association between measures of sweat and trans-epidermal water loss (TEWL) with Na+ content in the skin ([Na+]skin) and clinical characteristics in consecutive hypertensive patients. We obtained an iontophoretic pilocarpine-induced sweat sample, a skin punch biopsy for chemical analysis, and measures of TEWL from the upper limbs. Serum vascular endothelial growth factor-c (VEGF-c) and a reflectance measure of haemoglobin skin content served as surrogates of skin microvasculature. In our cohort (n = 90; age 21-86 years; females = 49%), sweat composition was independent of sex and BMI. Sweat Na+ concentration ([Na+]sweat) inversely correlated with [K+]sweat and was higher in patients on ACEIs/ARBs (P < 0.05). A positive association was found between [Na+]sweat and [Na+]skin, independent of sex, BMI, estimated Na+ intake and use of ACEi/ARBs (Padjusted = 0.025); both closely correlated with age (P < 0.01). Office DBP, but not SBP, inversely correlated with [Na+]sweat independent of other confounders (Padjusted = 0.03). Total sweat volume and Na+ loss were lower in patients with uncontrolled office BP (Padjusted < 0.005 for both); sweat volume also positively correlated with serum VEGF-c and TEWL. Lower TEWL was paralleled by lower skin haemoglobin content, which increased less after vasodilatory pilocarpine stimulation when BMI was higher (P = 0.010). In conclusion, measures of Na+ and water handling/regulation in the skin were associated with relevant clinical characteristics, systemic Na+ status and blood pressure values, suggesting a potential role of the skin in body-fluid homeostasis and therapeutic targeting of hypertension.
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Affiliation(s)
- Jun Yu Chen
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Khai Syuen Chew
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Sheon Mary
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Philipp Boder
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Domenico Bagordo
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
| | - Gian Paolo Rossi
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
| | - Rhian M. Touyz
- Research Institute of McGill University Health Centre, McGill University, Montreal, Canada
| | - Christian Delles
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Giacomo Rossitto
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
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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: 0] [Impact Index Per Article: 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.
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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:
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11
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Ahmad MZ, Ansari AN, Nayab M. Efficacy of Ḥammām-i-yābis (dry bath) in metabolic syndrome: a single arm, open-labelled clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:1019-1024. [PMID: 34265883 DOI: 10.1515/jcim-2021-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study intended to evaluate the efficacy of Ḥammām-i-yabis (dry bath) in metabolic syndrome as primary objective and perceived improvement and changes in quality of life as secondary objective. METHODS The study was designed as single arm, open-labelled, pre and post without control clinical trial comprising 30 diagnosed cases of metabolic syndrome belonging to 20-50 years of age of either sex. The enrolled patients were exposed to the dry heat of Ḥammām-i-yābis for 15 min at a temperature of 60 degree centigrade on every third day for a duration of 30 days (a total of 10 sittings). Objective parameters comprising systolic and diastolic blood pressure and waist circumference were assessed on every follow up, while other objective parameters (FBS, HDL and Serum Triglycerides) were assessed before and after the study. RESULTS Significant statistical difference was observed in objective parameters. Two tailed paired Student's t-test, (for pre and post) and repeated measure ANOVA (for 0, 15th and 30th day) were used to find the significance of mean change in study parameters. No significant adverse change appeared in safety parameters. CONCLUSIONS Ḥammām-i-yābis was found effective, safer, more feasible and less expensive regimenal modality for the patients of metabolic syndrome.
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Affiliation(s)
- Mohammad Zaki Ahmad
- Department of Ilaj Bit Tadbeer (Regimenal Therapy), National Institute of Unani Medicine, Bengaluru, India
| | - Abdul Nasir Ansari
- Department of Ilaj Bit Tadbeer (Regimenal Therapy), National Institute of Unani Medicine, Bengaluru, India
| | - Mohd Nayab
- Department of Ilaj Bit Tadbeer (Regimenal Therapy), National Institute of Unani Medicine, Bengaluru, India
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12
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Pettit-Mee RJ, Power G, Cabral-Amador FJ, Ramirez-Perez FI, Nogueira Soares R, Sharma N, Liu Y, Christou DD, Kanaley JA, Martinez-Lemus LA, Manrique-Acevedo CM, Padilla J. Endothelial HSP72 is not reduced in type 2 diabetes nor is it a key determinant of endothelial insulin sensitivity. Am J Physiol Regul Integr Comp Physiol 2022; 323:R43-R58. [PMID: 35470695 DOI: 10.1152/ajpregu.00006.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Impaired endothelial insulin signaling and consequent blunting of insulin-induced vasodilation is a feature of type 2 diabetes (T2D) that contributes to vascular disease and glycemic dysregulation. However, the molecular mechanisms underlying endothelial insulin resistance remain poorly known. Herein, we tested the hypothesis that endothelial insulin resistance in T2D is attributed to reduced expression of heat shock protein 72(HSP72). HSP72 is a cytoprotective chaperone protein that can be upregulated with heating and is reported to promote insulin sensitivity in metabolically active tissues, in part via inhibition of JNK activity. Accordingly, we further hypothesized that, in T2D individuals, seven days of passive heat treatment via hot water immersion to waist-level would improve leg blood flow responses to an oral glucose load (i.e., endogenous insulin stimulation) via induction of endothelial HSP72. In contrast, we found that: 1) endothelial insulin resistance in T2D mice and humans was not associated with reduced HSP72 in aortas and venous endothelial cells, respectively; 2) after passive heat treatment, improved leg blood flow responses to an oral glucose load did not parallel with increased endothelial HSP72; 3) downregulation of HSP72 (via small-interfering RNA) or upregulation of HSP72 (via heating) in cultured endothelial cells did not impair or enhance insulin signaling, respectively, nor was JNK activity altered. Collectively, these findings do not support the hypothesis that reduced HSP72 is a key driver of endothelial insulin resistance in T2D but provide novel evidence that lower-body heating may be an effective strategy for improving leg blood flow responses to glucose ingestion-induced hyperinsulinemia.
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Affiliation(s)
- Ryan J Pettit-Mee
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Gavin Power
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | | | | | | | - Neekun Sharma
- Department of Medicine, University of Missouri, Columbia, MO, United States
| | - Ying Liu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Luis A Martinez-Lemus
- Department of Medicine, University of Missouri, Columbia, MO, United States.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
| | - Camila M Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Missouri, Columbia, MO, United States.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
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13
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Vakkayil KL, Hoppe T. Temperature-Dependent Regulation of Proteostasis and Longevity. FRONTIERS IN AGING 2022; 3:853588. [PMID: 35821840 PMCID: PMC9261408 DOI: 10.3389/fragi.2022.853588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022]
Abstract
Temperature is an important environmental condition that determines the physiology and behavior of all organisms. Animals use different response strategies to adapt and survive fluctuations in ambient temperature. The hermaphrodite Caenorhabditis elegans has a well-studied neuronal network consisting of 302 neurons. The bilateral AFD neurons are the primary thermosensory neurons in the nematode. In addition to regulating thermosensitivity, AFD neurons also coordinate cellular stress responses through systemic mechanisms involving neuroendocrine signaling. Recent studies have examined the effects of temperature on altering various signaling pathways through specific gene expression programs that promote stress resistance and longevity. These studies challenge the proposed theories of temperature-dependent regulation of aging as a passive thermodynamic process. Instead, they provide evidence that aging is a well-defined genetic program. Loss of protein homeostasis (proteostasis) is one of the key hallmarks of aging. Indeed, proteostasis pathways, such as the heat shock response and aggregation of metastable proteins, are also controlled by thermosensory neurons in C. elegans. Prolonged heat stress is thought to play a critical role in the development of neurodegenerative protein misfolding diseases in humans. This review presents the latest evidence on how temperature coordinates proteostasis and aging. It also discusses how studies of poikilothermic organisms can be applied to vertebrates and provides new therapeutic strategies for human disease.
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Affiliation(s)
- Kavya Leo Vakkayil
- Institute for Genetics and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Thorsten Hoppe
- Institute for Genetics and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- *Correspondence: Thorsten Hoppe,
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14
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Hägglund H. Title sauna bathing and lower urinary tract symptoms- the heat is on? Scand J Urol 2022; 56:168. [PMID: 35083961 DOI: 10.1080/21681805.2022.2028898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hans Hägglund
- Hematology Department of Medical Sciences Uppsala University Hospital, Uppsala, Sweden
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15
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Hägglund H. Title sauna bathing and lower urinary tract symptoms - the heat is on? Scand J Urol 2022; 56:83. [PMID: 35084264 DOI: 10.1080/21681805.2022.2029005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hans Hägglund
- Hematology Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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16
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Kunutsor SK, Jae SY, Kurl S, Kauhanen J, Laukkanen JA. Inflammation, sauna bathing, and all-cause mortality in middle-aged and older Finnish men: a cohort study. Eur J Epidemiol 2022; 37:1225-1231. [PMID: 36255556 PMCID: PMC9792415 DOI: 10.1007/s10654-022-00926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/26/2022] [Indexed: 12/30/2022]
Abstract
Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42-61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13-1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12-1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81-1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.
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Affiliation(s)
- Setor K. Kunutsor
- grid.410421.20000 0004 0380 7336National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB UK ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Gwendolen Road, Leicester, LE5 4WP UK
| | - Sae Young Jae
- grid.267134.50000 0000 8597 6969Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea ,grid.267134.50000 0000 8597 6969Department of Sport Science, University of Seoul, Seoul, South Korea ,grid.267134.50000 0000 8597 6969Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A. Laukkanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland ,grid.460356.20000 0004 0449 0385Department of Medicine, Central Finland Health Care District, Hospital District, Jyvaskyla, Finland
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17
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Larson EA, Ely BR, Brunt VE, Francisco MA, Harris SM, Halliwill JR, Minson CT. Brachial and carotid hemodynamic response to hot water immersion in men and women. Am J Physiol Regul Integr Comp Physiol 2021; 321:R823-R832. [PMID: 34643115 DOI: 10.1152/ajpregu.00110.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M) (24 ± 4 yr) completed a 60-min HWI session immersed to the level of the sternum in 40°C water. Brachial and carotid artery hemodynamics (Doppler ultrasound) were measured at baseline (seated rest) and every 15 min throughout HWI. Within the brachial artery, total shear rate was elevated to a greater extent in women [+479 (+364, +594) s-1] than in men [+292 (+222, +361) s-1] during HWI (P = 0.005). As shear rate is inversely proportional to blood vessel diameter and directly proportional to blood flow velocity, the sex difference in brachial shear response to HWI was the result of a smaller brachial diameter among women at baseline (P < 0.0001) and throughout HWI (main effect of sex, P < 0.0001) and a greater increase in brachial velocity seen in women [+48 (+36, +61) cm/s] compared with men [+35 (+27, +43) cm/s] with HWI (P = 0.047) which allowed for a similar increase in brachial blood flow between sexes [M: +369 (+287, +451) mL/min, W: +364 (+243, +486) mL/min, P = 0.943]. In contrast, no differences were seen between sexes in carotid total shear rate, flow, velocity, or diameter at baseline or throughout HWI. These data indicate the presence of an artery-specific sex difference in the hemodynamic response to a single bout of HWI.
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Affiliation(s)
- Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Sarianne M Harris
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
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18
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Sebők J, Édel Z, Váncsa S, Farkas N, Kiss S, Erőss B, Török Z, Balogh G, Balogi Z, Nagy R, Hooper PL, Geiger PC, Wittmann I, Vigh L, Dembrovszky F, Hegyi P. Heat therapy shows benefit in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Int J Hyperthermia 2021; 38:1650-1659. [PMID: 34808071 DOI: 10.1080/02656736.2021.2003445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIMS Type-2 diabetes mellitus (T2DM) is a common health condition which prevalence increases with age. Besides lifestyle modifications, passive heating could be a promising intervention to improve glycemic control. This study aimed to assess the efficacy of passive heat therapy on glycemic and cardiovascular parameters, and body weight among patients with T2DM. METHODS A systematic review and meta-analysis were reported according to PRISMA Statement. We conducted a systematic search in three databases (MEDLINE, Embase, CENTRAL) from inception to 19 August 2021. We included interventional studies reporting on T2DM patients treated with heat therapy. The main outcomes were the changes in pre-and post-treatment cardiometabolic parameters (fasting plasma glucose, glycated plasma hemoglobin, and triglyceride). For these continuous variables, weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated. Study protocol number: CRD42020221500. RESULTS Five studies were included in the qualitative and quantitative synthesis, respectively. The results showed a not significant difference in the hemoglobin A1c [WMD -0.549%, 95% CI (-1.262, 0.164), p = 0.131], fasting glucose [WMD -0.290 mmol/l, 95% CI (-0.903, 0.324), p = 0.355]. Triglyceride [WMD 0.035 mmol/l, 95% CI (-0.130, 0.200), p = 0.677] levels were comparable regarding the pre-, and post intervention values. CONCLUSION Passive heating can be beneficial for patients with T2DM since the slight improvement in certain cardiometabolic parameters support that. However, further randomized controlled trials with longer intervention and follow-up periods are needed to confirm the beneficial effect of passive heat therapy.
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Affiliation(s)
- Judit Sebők
- 2nd Department of Medicine and Nephrology-Diabetes Center, Medical School, University of Pécs, Pécs, Hungary
| | - Zsófia Édel
- 2nd Department of Medicine and Nephrology-Diabetes Center, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Szabolcs Kiss
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Zsolt Török
- LipidArt Ltd., Szeged, Hungary.,Institute of Biochemistry, Biological Research Centre, Eötvös Loránd Research Network, Szeged, Hungary
| | - Gábor Balogh
- LipidArt Ltd., Szeged, Hungary.,Institute of Biochemistry, Biological Research Centre, Eötvös Loránd Research Network, Szeged, Hungary
| | - Zsolt Balogi
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Rita Nagy
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Philip L Hooper
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Paige C Geiger
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary
| | - István Wittmann
- 2nd Department of Medicine and Nephrology-Diabetes Center, Medical School, University of Pécs, Pécs, Hungary
| | - László Vigh
- LipidArt Ltd., Szeged, Hungary.,Institute of Biochemistry, Biological Research Centre, Eötvös Loránd Research Network, Szeged, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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19
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Impact of Sauna Bathing on Risk of Pneumonia in Men With Low Socioeconomic Status: A Cohort Study. J Cardiopulm Rehabil Prev 2021; 41:289-291. [PMID: 34158458 DOI: 10.1097/hcr.0000000000000611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Cardiometabolic Health Benefits of Sauna Exposure in Individuals with High-Stress Occupations. A Mechanistic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031105. [PMID: 33513711 PMCID: PMC7908414 DOI: 10.3390/ijerph18031105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 01/11/2023]
Abstract
Components of the metabolic syndrome (i.e., hypertension, insulin resistance, obesity, atherosclerosis) are a leading cause of death in the United States and result in low-grade chronic inflammation, excessive oxidative stress, and the eventual development of cardiometabolic diseases (CMD). High-stress occupations (HSO: firefighters, police, military personnel, first responders, etc.) increase the risk of developing CMD because they expose individuals to chronic and multiple stressors (i.e., sleep deprivation, poor nutrition habits, lack of physical activity, psychological stress). Interestingly, heat exposure and, more specifically, sauna bathing have been shown to improve multiple markers of CMD, potentially acting as hormetic stressors, at the cellular level and in the whole organism. Therefore, sauna bathing might be a practical and alternative intervention for disease prevention for individuals with HSO. The purpose of this review is to detail the mechanisms and pathways involved in the response to both acute and chronic sauna bathing and collectively present sauna bathing as a potential treatment, in addition to current standard of care, for mitigating CMD to both clinicians and individuals serving in HSO.
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21
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Liikkanen LA, Laukkanen JA. Sauna bathing frequency in Finland and the impact of COVID-19. Complement Ther Med 2020; 56:102594. [PMID: 33197669 DOI: 10.1016/j.ctim.2020.102594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Recent research has revealed multiple potential health benefits of frequent sauna bathing. Finland is a country with extraordinary sauna culture and bathing opportunities. However, coronavirus disease 2019 (COVID-19) pandemic introduced regulations and unprecedented closures to shared sauna facilities. In this study we aimed to examine the previously unknown baseline bathing frequency and its possible change during the epidemic. DESIGN We investigated several aspects of sauna bathing with self-reports: the frequency, its possible changes, reasons for change, and beliefs about its health effects among a representative sample of thousand Finns aged 18-75 years. This online survey was administered in May 2020. RESULTS Before the pandemic, 59 % of our respondents had enjoyed sauna at least once a week. Since the pandemic began, up to 23 % had reduced or stopped their bathing. This was often due to restricted sauna access. However, 11 % of respondents bathed more frequently and attributed this change to seeking relaxation and passing time. These findings demonstrate a surprising flexibility in this health-promoting national pastime. Men were more active bathers than women overall and women under 35 enjoy sauna more seldom than older women. Only 7.9 % of all respondents bathed at least four times a week, exceeding a suggested threshold for maximum health benefits. CONCLUSIONS Finnish people are active sauna bathers. The COVID-19 pandemic demonstrated that the frequency of bathing is dependent on good access to sauna facilities. This flexibility and wide access could be exploited to improve public health in the long term if more frequent bathing became a standard.
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Affiliation(s)
- Lassi A Liikkanen
- Aalto Design Factory, School of Engineering, Aalto University, P.O. Box 17700, FI-00076 Aalto, Finland; Qvik Ltd., Helsinki, Finland.
| | - Jari A Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland
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22
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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.
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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
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Multiple Progressive Thermopreconditioning Improves Cardiac Ischemia/Reperfusion-induced Left Ventricular Contractile Dysfunction and Structural Abnormality in Rat. Transplantation 2020; 104:1869-1878. [PMID: 32058468 DOI: 10.1097/tp.0000000000003176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Triple progressive thermopreconditioning (3PTP) may induce high Hsp-70 expression to maintain cardiac function. We suggest that 3PTP may reduce myocardial ischemia/reperfusion (I/R) injury during organ transplantation through Bag3/Hsp-70 mediated defense mechanisms. METHODS Male Wistar rats were divided into sham control group and 72 h after 3PTP in a 42°C water bath (3PTP) group. Rats underwent 60 min of ischemia by occlusion of the left anterior descending coronary artery followed by 240 min reperfusion. Hemodynamic parameters, including the electrocardiogram, microcirculation, heart rate, left ventricular end-diastolic pressure, maximal rate of rise (+dp/dt), and fall (-dp/dt) in the left ventricular pressure for index of contraction and relaxation were determined. Myocardial infarct size was evaluated by the Evans blue-2,3,5-triphenyltetrazolium chloride method. 3PTP-induced protective mechanisms were determined by Western blot and immunohistochemistry. RESULTS Cardiac I/R depressed cardiac microcirculation, induced S-T segment elevation, and R-R and P-R interval elongation increased infarct size associated with erythrocyte extravasation, leukocytes and macrophage/monocyte infiltration, granulocyte colony-stimulating factor, poly(ADP-ribose) polymerase 1 stain, and transferase-mediated dUTP-biotin nick end labeling positive cells. However, 3PTP evoked significant cardioprotection against I/R injury, characterized by the increased +dp/dt value and the decreased elevated left ventricular end-diastolic pressure, erythrocyte extravasation, leukocyte and macrophage/monocyte infiltration, granulocyte colony-stimulating factor expression, poly(ADP-ribose) polymerase 1 expression, transferase-mediated dUTP-biotin nick end labeling positive cells, and fragmentation and infarct area. In addition, 3PTP increased Hsp-70 and Bag3 expression and decreased Bax/Bcl-2 ratio, but did not affect the Beclin-1 and LC3-II/LC3-I ratio in the heart with I/R injury. CONCLUSIONS 3PTP therapies may through Bag3 upregulation alleviate I/R injury-induced left ventricular structural deterioration and dysfunction.
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O'Keefe EL, O'Keefe JH, Lavie CJ. Exercise Counteracts the Cardiotoxicity of Psychosocial Stress. Mayo Clin Proc 2019; 94:1852-1864. [PMID: 31451292 DOI: 10.1016/j.mayocp.2019.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/15/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Physical inactivity and psychosocial stress are prevalent in residents of the United States. The purpose of this article is to review the interaction between these 2 conditions and examine the effects of exercise on stress and cardiovascular (CV) health. A query of scientific references between 1974 to 2018 was performed using the PubMed search engine accessing the MEDLINE database using the search terms psychosocial stress, CV disease (CVD), physical activity, exercise, cardiac rehabilitation, and team sports. Psychosocial stress is a strong independent risk factor for adverse CV events. Conversely, people who experience CV events subsequently have drastically elevated rates of new-onset mental health disorders, including depression and anxiety. Psychosocial stress and CVD often trigger self-reinforcing feedback loops that can worsen mental health and cardiac prognosis. Exercise predictably improves CV health and prognosis and also is effective at lowering levels of psychosocial stress. Group exercise in particular seems to provide social support while at the same time boosting fitness levels and, thus, may be the single most important intervention for patients with concomitant CVD and emotional stress. Collaborative physical activity, such as group exercise, team sports, interactive physical play, and cardiac rehabilitation programs, have the potential to improve mental health and CV prognosis.
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Affiliation(s)
- Evan L O'Keefe
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - James H O'Keefe
- University of Missouri-Kansas City and Saint Luke's Mid America Heart Institute, New Orleans, LA
| | - Carl J Lavie
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA.
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25
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Craighead DH, Freeberg KA, Seals DR. The protective role of regular aerobic exercise on vascular function with aging. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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