Saunas are very popular around the world, especially in some specific regions like Finland. Sitting in a temperature of 45-110°C with intervals often including cold baths influence our bodies in different aspects. Apart from being an addition to asthma or depression treatment, it works well as prevention of heart diseases and hypertension. Sauna is also believed to be able to reduce increased blood pressure values. Because of its safety it can be easily prescribed for all patients without few contraindications

Kozioł, Magdalena

Lorenc, Karol

Misztal, Zofia

Pawlicki, Bartłomiej

Pawlicki, Mateusz Maciej

Łopuszyńska, Anna Małgorzata

English

Akademicka Platforma Czasopism

Pawlicki Mateusz, Pawlicki Bartłomiej, Łopuszyńska Anna, Misztal Zofia, Kozioł Magdalena, Lorenc Karol. Sauna in patients withhypertension. Journal  of  Education,  Health  and  Sport.  2019;9(8):753-757.  eISSN  2391-8306.  DOIhttp://dx.doi.org/10.5281/zenodo.3407581http://ojs.ukw.edu.pl/index.php/johs/article/view/7226The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017).1223 Journal of Education, Health and Sport eISSN 2391-8306 7© The Authors 2019;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, PolandOpen Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.The authors declare that there is no conflict of interests regarding the publication of this paper.Received: 05.07.2019. Revised: 25.07.2019. Accepted: 12.08.2019.Sauna in patients with hypertensionMateusz Pawlicki1, Bartłomiej Pawlicki2, Anna Łopuszyńska1, Zofia Misztal3,Magdalena Kozioł1, Karol Lorenc11Student Scientific Association at Department of Epidemiology and Clinical ResearchMethodology, Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080,Poland2Apteka “Pod Łysicą”, Ostrowiec Świętokrzyski3Medical University of Łódź, al. Tadeusza Kościuszki 4, 90-419 Łodź, PolandCorresponding author: Mateusz Pawlicki, pawlak32@gmail.comORCID ID:Mateusz Pawlicki https://orcid.org/0000-0001-8318-6573, pawlak32@gmail.comBartłomiej Pawlicki https://orcid.org/0000-0003-4278-4168, bp.pawlak@gmail.comAnna Łopuszyńska https://orcid.org/0000-0001-5133-4180, lopuszynskaania@gmail.comZofia Misztal https://orcid.org/0000-0003-2317-9667, zosia.misztal6@gmail.comMagdalena Kozioł https://orcid.org/0000-0002-8671-5968, magdalena.koziol@icloud.comKarol Lorenc https://orcid.org/0000-0002-6414-5984, lorenckarol2@gmail.comAbstract:Saunas are very popular around the world, especially in some specific regions likeFinland.  Sitting  in  a  temperature  of  45-110°C  with  intervals  often  including  cold  bathsinfluence  our  bodies  in  different  aspects.  Apart  from  being  an  addition  to  asthma  ordepression treatment, it works well as prevention of heart diseases and hypertension. Sauna isalso believed to be able to reduce increased blood pressure values. Because of its safety it canbe easily prescribed for all patients without few contraindications.753Key words: sauna; hypertension; blood pressureIntroduction: Saunas by definition are small rooms or huts used for dry or wet heat sessions. Thetemperature  that  is  crucial  for  such  experience  comes  from either  steam produced  by  afurnace  located  in  the  facility  or  devices  emitting  infrared  radiation.  According  to  thatdifference,  we can divide saunas into separate types like smoke, steam or infrared sauna.Since that kind of spending spare time is quite popular in many countries around the world,also  its  process  may  vary  depending  on  the  region.  For  example  in  Finland  saunas  arecommon in households while in Japan public places are more popular.Their impact on health has been already widely examined. It is said that saunas canbring relieve in some diseases like autoimmune inflammatory diseases affecting the joints,for example rheumatoid arthritis or ankylosing spondylitis. While some studies decline theirimpact on objective measures of RA (rheumatoid arthritis) [1], other report significant dropof pain, stiffness and fatigue when the beginning and the end of the treatment are compared[2]. After all, none of them points any harmful effects, so sauna can be used as a method torelieve patients’ discomfort. Further listed disorders are pulmonary obstructive disorders likeasthma, chronic bronchitis  or obstructive pulmonary disease.  Hannuksela et  al.  states thatsauna can increase both static and dynamic spirometric parameters of the lungs (VC=VitalCapacity, TV=Tidal Volume, minute ventilation, FEV=Forced Expiratory Volume). What ismore,  patients  with asthma,  chronic  bronchitis  or  obstructive  pulmonary  disease reportedimprovement in breathing after adding sauna into their rehabilitation programme [3]. Largestudy carried out on a cohort of 1935 Caucasian men by Kunutsor et al. demonstrated reducedrisk of chronic and acute respiratory diseases among people without such diseases at  thebeginning of the study. Hazard ratio of respiratory diseases in groups taking 2-3 and ≥4 bathsper week in comparison to control group taking ≤1 were 0,66 and 0,49. What is more, similarscores were obtained in models including other factors like physical activity, years of school,energy intake etc. [4]. Sauna is also used to treat neurological and psychological disorders.Studies  from Japan and New Zealand  showed reduced headache  intensivity  and reducedanger in patients with chronic headache after sauna therapy. Improvement was also noticed inpatients  with  depression.  They  had  improved  somatic  complaints,  relaxation  scores  andhunger scores [5, 6].Despite all of these examples, sauna is mostly associated with cardiovascular system.What  is  interesting,  some  of  its  disorders  are  listed  as  indications,  while  other  ascontraindications even though they are similar to each other. As an example severe aorticstenosis,  unstable  angina  pectoris  and  recent  myocardial  infarction  are  typicallycontraindications [7]. Patients with arrhythmias or decompensated heart failure have relativecontraindications but those with stable coronary heart disease should be safe. Furthermore,studies carried out in Finland have not shown any relationship between sauna bathing andmyocardial infarction. It is not even linked with reinfarction or sudden death [3]. Laukkanenet al. examined the hazard ratio of fatal cardiovascular disease (CVD) in men. The resultswere 0,71 (0,52 to 0,98) and 0,30 (0,14 to 0,64) for men taking 2-3 and 4-7 baths a weekcompared to men taking only one bath per week. It shows that sauna strongly reduces the riskof fatal CVD event in middle-aged or elderly people [8].Hypertension is described as a chronically elevated blood pressure in arteries. It isdiagnosed  if  the  value  of  systolic  blood  pressure  is  ≥140  mmHg and/or  diastolic  bloodpressure is ≥90 mmHg. According to WHO this problem affects about 1,13 billion peoplearound the world becoming one of the most common diseases of affluence [9].  Its  after-effects are the reason of about 12,8% deaths worldwide [10]. Because of its various reasons,754hypertension can be classified as primary or secondary disease. Likewise risk factors are verydiverse. The best known are probably excess body weight, too much salt in a diet, smoking,alcohol and lack of exercise. Genes are also considered as an important aspect of developinghypertension  [11].  The  disorder  is  often  downplayed  by  patients  unaware  of  its  seriouscomplications. Heart diseases, strokes, chronic kidney disease or impaired vision are only afew examples [12]. If it is not treated well it can lead straight to patient’s death. This is whythe search for new methods of well tolerated treatment is needed.Description of knowledge: The very first step of hypertension management are changes in lifestyle. Taking upphysical exercise, altered dietary habits, quitting smoking or reducing alcohol are crucial forefficient therapy. Patients often require pharmaceutical treatment as well. However selectionof  drugs  for  a  specific  patients  is  difficult  and  needs  time  and  observation.  Thereforeadditional ways of decreasing blood pressure are still wanted. Sauna is believed to be safeand accessible  alternative.  Hannuksela  et  al.  does not mark differences  in hemodynamicsbetween  healthy  people  and  hypertensive  patients  [3].  Also  Kukkonen-Harjula  andKauppinen did not find any risk for people at all ages, even children [13].In a research carried out by Zaccardi et al. on 1621 Finnish men a correlation betweenfrequency of taking sauna baths and episodes of hypertension was examined. Median time ofobservation was 24,7 years. In this time 251 events occured. When compared to participantstaking only one bath per week, those taking 2-3 had hazard ratio of 0,76. Men who usedsauna 4-7 times a week had it even lower with a value of 0,54. Adjustment for factors likeglucose,  creatinine,  alcohol  intake  etc.  did  not  alter  these  rates  much  (0,83  and  0,53respectively).  This  shows  that  sauna  sessions  highly  reduce  the  risk  of  developinghypertension.  Increasing  their  amount  enhances  that  effect  [14].  Another  study  led  byLaukkanen et al. gathered data of 102 patients (56 male and 46 female). 63% of them haddyslipidaemia and 14% had hypertension. They were tested after 30 minutes long sessionswith two-minute cold shower during the break between fifteen-minute halves. Researchesshow lower scores of PWV (pulse wave velocity),  AIx (augmentation  index) or diastolictime. First two remained dropped even after 30 minutes. Also blood pressure was reduced.Systolic  blood pressure dropped from mean 136,5 mmHg to 130,3 mmHg right after  thesession and stopped at  129,8 mmHg after  30 minutes.  Diastolic  blood pressure was 82,1mmHg,  75,1  mmHg  and  80,6  mmHg  respectively  [15].  Both  studies  indicate  positiveinfluence of heat on blood pressure values and arterial compliance.There are also many studies looking for connection between exercise and sauna baths.Gayda et al. enlisted a group of 16 adults (13 men and 3 women) eight of whom had stage Ihypertension and the rest was prehypertensive. All of them were not treated for hypertension.Both  24-hour  ABPM  and  acute  blood  pressure  at  baseline,  15  and  120  minutes  weremeasured. Results demonstrated a set of exercise and sauna as the most efficient. Mean SBPand DBP (systolic blood pressure and diastolic blood pressure) for a control group at baselinewas 134/85 mmHg and for sauna group it was 136/86 mmHg. At 15 minutes it was 135/83mmHg and 136/85 mmHg and at 120 minutes these values jumped to 142/84 mmHg and139/84  mmHg.  Sauna  and  exercise  group  showed  values  of  134/83,  126/81  and  135/83mmHg respectively. 24-hour ABPM results were similar. Sauna and exercise group’s meandaytime blood pressure was 100 mmHg while only sauna and control groups both obtained102  mmHg [16].On  the  other  hand  Podstawski  et  al.  in  a  research  engaging  45  overweight  andsedentary men presented completely opposite findings. Average BP (blood pressure) duringthe last of four 10-minute sessions (with 5-minute breaks) reached 140/91 mmHg. This valueis  described  as  stage  I  hypertension.  However  in  opposition  to  previous  analyses,  the755participants were not frequent sauna users [17]. Comparable data was found in another Polishresearch  led  by  Pilch  et  al.  Ten  healthy  men  with  BMI  indicating  obesity  were  told  toundergo three 15-minute sauna sessions with 5-minute breaks. They did not train any sport oruse sauna regularly. Scientists used dry and steam heat saunas. Both of them caused increasein systolic blood pressure (122,6 mmHg to 142,6 mmHg in dry sauna and 123,4 mmHg to141,1 mmHg in wet sauna) and reduction in diastolic blood pressure (78,7 mmHg to 63,7mmHg in dry sauna and 77,7 mmHg to 57,7 mmHg in wet sauna) [18]. These discoveriesmay reveal  a fact of different behaviour of blood pressure depending on patient’s  habits.Regular sauna bathing is better tolerated and leads to greater and healthier changes in itsvalues.ConclusionSauna bathing have several confirmed effects on our health which can be used to treatvarious  diseases,  especially  cardiovascular  ones.  Only a  few studies  take up the topic  oflinkage of sauna and hypertension and their results are often opposite. Nonetheless most ofthem  indicate  greater  or  smaller  drop  of  mean  blood  pressure  in  patients  using  saunafrequently. The effects are even better if patients exercise alongside with sauna bathing. Verysmall  risk  of  harm and  joy  reported  by  subjects  makes  this  method  of  therapy  a  goodsupplement for conventional schemes. On the other hand many of researches are limited bysmall number of participants. Because of this condition, it is hard to draw conclusions basedonly on their results. This means that further research is still needed.References:1. Welch V, Brosseau L, Shea B, McGowan J, Wells G, Tugwell P. Thermotherapy fortreating  rheumatoid  arthritis.  Cochrane Database Syst  Rev.  2001;  CD002826.  doi:10.1002/14651858.CD0028262. Agrawal  S.  Effects  of  moderate  whole-body  hyperthermia  and  complementarymedicine in the treatment of rheumatoid arthritis: a preliminary study. OncothermiaJournal. 2018;22:8-19. 3. Hannuksela ML, Ellahham S. Benefits and risks of sauna bathing. American Journalof Medicine. 2001;110(2):118-126.4. Kunutsor  SK,  Laukkanen  T,  Laukkanen  JA.  Sauna  bathing  reduces  the  risk  ofrespiratory  diseases:  a  long-term  prospective  cohort  study.  European  Journal  ofEpidemiology. 2017;32(12):1107-1111.5. Hussain J, Cohen M. Clinical Effects of Regular Dry Sauna Bathing: A SystematicReview.  Evid  Based Complement  Alternat  Med.  2018 Apr  24;2018:1857413.  doi:10.1155/2018/1857413.  PubMed  PMID:  29849692;  PubMed  Central  PMCID:PMC5941775.6. Masuda A,  Nakazato  M,  Kihara  T,  Minagoe S,  Tei  C.  Repeated  thermal  therapydiminishes  appetite  loss  and  subjective  complaints  in  mildly  depressed  patients.Psychosomatic Medicine. 2005;67(4):643–647.7. Blum N, Blum A. Beneficial effects of sauna bathing for heart failure patients.  ExpClin Cardiol. 2007 Spring;12(1):29-32. PubMed PMID: 18650976; PubMed CentralPMCID: PMC2359619.8. Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Saunabathing  is  associated  with  reduced  cardiovascular  mortality  and  improves  riskprediction in men and women: a prospective cohort study. BMC Med. 2018;16(1):219.9. WHO. Available  at:  https://www.who.int/health-topics/hypertension/  (accessed July18, 2019.)75610. Baszczuk A, Kopczyński Z, Musialik K. Rozpowszechnienie nadciśnienia tętniczegona świecie iw Polsce. In Forum Zaburzeń Metabolicznych. 2014;5(4):141-147.11. Ehret  GB,  Caulfield  MJ.  Genes  for  blood  pressure:  an  opportunity  to  understandhypertension. Eur Heart J. 2013;34(13):951–961.12. WHO.  Available  at:https://apps.who.int/iris/bitstream/handle/10665/254746/9789290618034-hyp-mod7-eng.pdf?sequence=7 (accessed July 18, 2019.)13. Kukkonen-Harjula  K,  Kauppinen  K.Health  effects  and  risks  of  sauna  bathing.International Journal of Circumpolar Health. 2006;65(3):195-205.14. Zaccardi  F,Laukkanen  T,Willeit  P,Kunutsor  SK,Kauhanen  J,Laukkanen JA.  SaunaBathing and Incident Hypertension: A Prospective Cohort Study.  American Journalof Hypertension. 2017;30(11):1120-1125.15. Lee E, Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA.Sauna  exposure  leads  to  improved  arterial  compliance:  findings  from  a  non-randomised  experimental  study.  European  journal  of  preventive  cardiology.2018;25(2):130-138.16. Gayda M, Paillard F,  Sosner  P,  Juneau M, Garzon M, Gonzalez  M, Bélanger  M,Nigam A. Effects of Sauna Alone and Postexercise Sauna Baths on Blood Pressureand Hemodynamic Variables in Patients With Untreated Hypertension. The Journal ofClinical Hypertension. 2012;14:553-560.17. Podstawski  R,  Borysławski  K,  Clark  CCT,  Choszcz  D,  Finn  KJ,  Gronek  P.Correlations between Repeated Use of Dry Sauna for 4 x 10 Minutes, PhysiologicalParameters,  Anthropometric  Features,  and Body Composition  in  Young Sedentaryand  Overweight  Men:  Health  Implications.  Biomed  Res  Int.  2019  Jan21;2019:7535140. doi: 10.1155/2019/7535140. PubMed PMID: 30800676; PubMedCentral PMCID: PMC6360547.18. Pilch W, Szygula Z, Palka T, Pilch P, Cison T, Wiecha S, Tota L. Comparison ofphysiological reactions and physiological strain in healthy men under heat stress indry  and  steam  heat  saunas.  Biol  Sport.  2014  Jun;31(2):145-9.  doi:10.5604/20831862.1099045. Epub 2014 Apr 5. PubMed PMID: 24899780; PubMedCentral PMCID: PMC4042662.757

Sauna in patients with hypertension

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Sauna in patients with hypertension

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