Risks

Hot tubs and heart disease: Trouble or treatment?

Dr. Larry Weinrauch Health Pro April 23, 2008
  • In many cultures throughout history and even today, the methods of bathing are different from ours. Some of the rituals would seem quite strange to those of us that have a shower and bathtub in our own homes or apartments. But as we travel, we become aware of other cultures and developments that at f...

6 Comments
  • suwantorof
    May. 11, 2010

    how the hot tub related to the heart disease

     

    from <a href="http://www.hottub-covers.org/">hot tub covers tips</a>

     

  • Anonymous
    l weinrauch md
    May. 19, 2008

    Looking on Pubmed (a site that is reliable) under sauna OR hot tub AND heart you should find the reference below. There is no reliable information regarding your child's condition. As I do not have adequate background in dealing with this condition I would suggest that you discuss this with his pediatric cardiologist.

    1: J Cardiol. 2007 Apr;49(4):187-91.
    Related...

    RHMLucky777

    Read More

    Looking on Pubmed (a site that is reliable) under sauna OR hot tub AND heart you should find the reference below. There is no reliable information regarding your child's condition. As I do not have adequate background in dealing with this condition I would suggest that you discuss this with his pediatric cardiologist.

    1: J Cardiol. 2007 Apr;49(4):187-91.
    Related Articles, Links

        Thermal therapy improves left ventricular diastolic function in patients with congestive heart failure: a tissue doppler echocardiographic study.

        Kisanuki A, Daitoku S, Kihara T, Otsuji Y, Tei C.

        School of Health Sciences, Faculty of Medicine, Kagoshima University, Sakuragaoka, Kagoshima. akira-k@health.nop.kagoshima-u.ac.jp

        OBJECTIVES: We previously reported that systemic thermal therapy using 60 degrees C dry sauna improves left ventricular systolic function and clinical symptoms in patients with chronic heart failure. The aim of this study was to investigate the effects of thermal therapy on left ventricular diastolic function. METHODS: We examined transmitral inflow and mitral annular velocity before and after sauna in 10 patients with congestive heart failure using pulsed and tissue Doppler echocardiography. RESULTS: Left ventricular and left atrial dimensions and left ventricular percentage fractional shortening did not change after sauna. Early diastolic mitral inflow velocity (E) increased and the deceleration time of the E wave decreased significantly after sauna compared to before sauna. Early diastolic mitral annular velocity (E') significantly increased after sauna. The deceleration time of E' significantly decreased after sauna compared to before sauna. The E/E' significantly decreased 30 min after sauna. CONCLUSIONS: Thermal therapy improves acute left ventricular diastolic function in patients with congestive heart failure.

    2: J Card Fail. 2005 Aug;11(6):432-6.

        Safety and efficacy of repeated sauna bathing in patients with chronic systolic heart failure: a preliminary report.

        Miyamoto H, Kai H, Nakaura H, Osada K, Mizuta Y, Matsumoto A, Imaizumi T.

        The Third Department of Internal Medicine, Kurume University School of Medicine, Japan.

        BACKGROUND: We sought to determine the safety and efficacy of repeated 60 degrees C sauna bathing in patients with chronic systolic congestive heart failure (CHF). METHODS AND RESULTS: This study included 15 hospitalized CHF patients (New York Heart Association class = 2.8 +/- 0.4) in stable clinical condition on conventional treatments. Sauna bathing was performed once per day for 4 weeks. Repeated sauna bathing was safely completed without any adverse effects in all patients. Symptoms improved in 13 of 15 patients after 4 weeks. Sauna bathing decreased systolic blood pressure without affecting heart rate, resulting in significant decrease in the rate-pressure product (6811 +/- 1323 to 6292 +/- 1093). Echocardiographic left ventricular ejection fraction was significantly increased from 30 +/- 11 to 34 +/- 11%. Sauna bathing significantly improved exercise tolerance manifested by prolonged 6-minute walking distance (388 +/- 110 to 448 +/- 118 m), increased peak respiratory oxygen uptake (13.3 +/- 1.8 to 16.3 +/- 2.1 mL/kg/min), and enhanced anaerobic threshold (9.4 +/- 1.2 to 11.5 +/- 1.9 mL/kg/min). Four-week bathing significantly reduced plasma epinephrine (40 +/- 42 to 21 +/- 23 pg/mL) and norepinephrine (633 +/- 285 to 443 +/- 292 pg/mL). Sauna bathing reduced the number of hospital admission for CHF (2.5 +/- 1.3 to 0.6 +/- 0.8 per year). CONCLUSION: Repeated 60 degrees C sauna bathing was safe and improved symptoms and exercise tolerance in chronic CHF patients. Sauna bathing may be an effective adjunctive therapy for chronic systolic CHF.

    3: Circ J. 2004 Dec;68(12):1146-51.
    Effects of repeated sauna treatment on ventricular arrhythmias in patients with chronic heart failure.

        Kihara T, Biro S, Ikeda Y, Fukudome T, Shinsato T, Masuda A, Miyata M, Hamasaki S, Otsuji Y, Minagoe S, Akiba S, Tei C.

        Department of Cardiovascular, Graduate School of Medicine, Kagoshima University, Sakuragaoka, Kagoshima, Japan.

        BACKGROUND: The aim of the present study was to determine whether repeated 60 degrees C sauna treatment improves cardiac arrhythmias in chronic heart failure (CHF) patients, because ventricular arrhythmias are an important therapeutic target in CHF. METHODS AND RESULTS: Thirty patients (59+/-3 years) with New York Heart Association functional class II or III CHF and at least 200 premature ventricular contractions (PVCs)/24 h assessed by 24-h Holter recordings were studied. They were randomized into sauna-treated (n=20) or non-treated (n=10) groups. The sauna-treated group underwent a 2-week program of a daily 60 degrees C far infrared-ray dry sauna for 15 min, followed by 30 min bed rest with blankets, for 5 days per week. Patients in the non-treated group had bed rest in a temperature-controlled room (24 degrees C) for 45 min. The total numbers of PVCs/24 h in the sauna-treated group decreased compared with the non-treated group [848+/-415 vs 3,097+/-1,033/24 h, p<0.01]. Heart rate variability (SDNN, standard deviation of normal-to-normal beat interval) increased [142+/-10 (n=16) vs 112+/-11 ms (n=8), p<0.05] and plasma brain natriuretic peptide concentrations decreased [229+/-54 vs 419+/-110 pg/ml, p<0.05] in the sauna-treated group compared with the non-treated group. CONCLUSION: Repeated sauna treatment improves ventricular arrhythmias in patients with CHF.

       

    4: CMAJ. 2003 Dec 9;169(12):1265-8.
    Are hot tubs safe for people with treated hypertension?

        Shin TW, Wilson M, Wilson TW.

        Departments of Medicine and Pharmacology and the Cardiovascular Risk Factor Reduction Unit, University of Saskatchewan, Saskatoon.

        BACKGROUND: People with hypertension are commonly warned to check with a physician before using a hot tub, but there is little literature on which to base this advice. We compared symptoms, heart rate, and systolic and diastolic blood pressure in response to 10 minutes of hot-tub immersion in a group of patients with treated hypertension and in a control group normotensive subjects. METHODS: We recruited 21 patients (18 men and 3 women aged 43-76 years) with stable, treated hypertension and 23 control subjects (14 men and 9 women aged 19-83 years) without hypertension. They were studied, in mid-afternoon, at a public facility. Systolic and diastolic blood pressure and heart rate were measured at baseline, during immersion in a hot tub at 40 degrees C and for 10 minutes after immersion. We asked each subject to report any symptoms. RESULTS: None of the subjects reported dizziness, chest pain or palpitations. During immersion, systolic blood pressure fell in both groups, from a mean (and standard deviation [SD]) of 144 (17) mm Hg to 122 (18) mm Hg in the hypertensive group (p < 0.05) and from 130 (14) mm Hg to 110 (17) mm Hg in the control group (p < 0.05). It returned toward baseline within 10 minutes after the subjects left the hot tub. Diastolic blood pressure also fell, whereas heart rate was increased in both groups. The hypertensive group showed a slightly lower maximal increase in heart rate than the normotensive group (5 [SD 5] v. 13 [SD 10] beats/minute, p < 0.05). INTERPRETATION: Immersion in a hot tub for 10 minutes lowers blood pressure in subjects with treated hypertension, but no more than in normotensive control subjects. Spending 10 minutes in a hot tub should be safe for most treated hypertensive patients.

    • Anonymous
      Sue
      Sep. 22, 2009

      i have heart disease and (congestive heart failure) i did not know i had until two episodes of staying in my hot tub for awhile to relax my muscles, and to my suprise when i went to get out, and could not breathe and was spitting up pinkish sputum i was told by my cardiologist not to use the 'HOT TUB" anymore for a long period---

      I'm a beliver!!! ...

      RHMLucky777

      Read More

      i have heart disease and (congestive heart failure) i did not know i had until two episodes of staying in my hot tub for awhile to relax my muscles, and to my suprise when i went to get out, and could not breathe and was spitting up pinkish sputum i was told by my cardiologist not to use the 'HOT TUB" anymore for a long period---

      I'm a beliver!!! 

  • Anonymous
    Concerned Parent
    May. 09, 2008

    Dear Dr. Weinrauch,

     

     

    What might be the mechanical effects of submersion (in 100 degree F water) on a patient with Hypoplastic Left Heart Syndrome? 

     

    Also, I would greatly appreciate any specific references you could provide to the two types of studies you mentioned:

     

    - "...several properly accomplished studies have demonstrated...

    RHMLucky777

    Read More

    Dear Dr. Weinrauch,

     

     

    What might be the mechanical effects of submersion (in 100 degree F water) on a patient with Hypoplastic Left Heart Syndrome? 

     

    Also, I would greatly appreciate any specific references you could provide to the two types of studies you mentioned:

     

    - "...several properly accomplished studies have demonstrated that a 10-minute hot-tub immersion in patients with treated hypertension is safe."

     

    and

     

    - "Recent scientific studies on the use of hot tubs in patients with congestive heart failure have demonstrated clinical benefits."

     

    Thank you very much

  • Sue
    Sue
    Apr. 24, 2008

    Thanks Doctor for sharing this with us.  I bet alot of people are happy to hear of these findings.

     

    All the best, sue (moderator)

     

    Smart lifestyle choices are helpful to those with heart concerns.  See our material on diet and exercise.

     

     

    • syra
      Oct. 08, 2010

      We can help manage our Diastolic Heart Failure and prolong our lives, by not smoking, restricting or eliminating altogether alcohol consumption, eating a diet low in salt and fat, and exercising. Doctors may prescribe medications, such as beta-blockers, ACE inhibitors and diuretics. to help improve heart function and treat resulting symptoms, such as swelling...

      RHMLucky777

      Read More

      We can help manage our Diastolic Heart Failure and prolong our lives, by not smoking, restricting or eliminating altogether alcohol consumption, eating a diet low in salt and fat, and exercising. Doctors may prescribe medications, such as beta-blockers, ACE inhibitors and diuretics. to help improve heart function and treat resulting symptoms, such as swelling and fluid retention. Surgery, including the insertion of a pacemaker or a transplant, may also be necessary. Life expectancy with CHF, as with other diseases and conditions, is most bleak when diagnosed as end stage.