Article

Do Far-infrared Saunas Have Cardiovascular Benefits in People with Type 2 Diabetes?

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Abstract

Objective: Far-infrared saunas are beneficial for the treatment of congestive heart failure, hypertension and obesity. As such, they may have a beneficial effect on cardiovascular (CV) health in those with type 2 diabetes. Our objective is to examine whether or not there are quantitative CV benefits from infrared sauna use. Methods: The intervention consisted of 20-minute, thriceweekly infrared sauna sessions, over a period of 3 months. The following CV risk factors were measured: weight, height, waist circumference, blood pressure (BPtru), glycated hemoglobin (A1C), fasting blood glucose and cholesterol profile. Baseline study parameters were measured within one week prior to commencing sauna sessions. Post-intervention measurements were collected between 1 and 3 days after the last sauna session. Results: Systolic blood pressure decreased by 6.4 mm Hg (124±12 vs. 118±15 mm Hg, 95% CI 0.01-12.71 p=0.05), and there was a trend toward decreased waist circumference (115.0±13.4 vs. 112.7±11.9 cm, 95% CI 0.4-5.1 p=0.10). All other measurements did not change significantly. There were no adverse events. Study completion rate was 75%. Conclusion: Our results suggest that infrared sauna use may be beneficial for lowering blood pressure and waist circumference. Subject adherence to infrared sauna use is greater than adherence to other lifestyle interventions. The combination of favourable compliance/adherence, as well as effectiveness in improving blood pressure and possibly waist circumference, makes infrared sauna therapy an attractive lifestyle option.

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... The results of our systematic search and selection detailed on a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flowchart can be seen in Figure 1. The systematic search yielded 5 [24][25][26][27][28] eligible articles for the qualitative and quantitative analysis, including the data of 193 patients. ...
... Three out of the five included [24][25][26] articles reported on other laboratory parameters and the changes in the body weight, blood pressure, and heart rate, pre-, and post-intervention. We summarized these parameters in Table 2. Based on the paper of Koc¸ak et al. [26] we can observe that HOMA-IR, leptin-, visfatin, and cortisol levels showed a slight decrease after the intervention, while the insulin, CRP, adiponectin levels and ESR increased compared to pre-intervention measures. ...
... We summarized these parameters in Table 2. Based on the paper of Koc¸ak et al. [26] we can observe that HOMA-IR, leptin-, visfatin, and cortisol levels showed a slight decrease after the intervention, while the insulin, CRP, adiponectin levels and ESR increased compared to pre-intervention measures. Beever et al. [24] reported a decreased systolic blood pressure and heart rate. Two articles [24,25] measured changes in body weight in the follow-up period; the mean body weight showed a mild decrease in one of the studies [25] but increased in the other one [24] compared pre-and postinterventions weight and BMI. ...
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(1) To evaluate the evidence relating to the effectiveness of methods to prevent and treat obesity, and (2) to provide recommendations for the prevention and treatment of obesity in adults aged 18 to 65 years and for the measurement of the body mass index (BMI) as part of a periodic health examination. In adults with obesity (BMI greater than 27) management options include weight reduction, prevention of further weight gain or no intervention. The long-term (more than 2 years) effectiveness of (a) methods to prevent obesity and (b) methods to treat obesity. MEDLINE was searched for articles published from 1966 to April 1998 that related to the prevention and treatment of obesity; additional articles were identified from the bibliographies of review articles and the listings of Current Contents. Selection criteria were used to limit the analysis to prospective studies with at least 2 years' follow-up. BENEFITS, HARM AND COSTS: Health benefits of weight reduction were evaluated in terms of alleviation of symptoms, improved management of obesity-related diseases and a reduction in major clinical outcomes. The health risk of weight-reduction methods were briefly evaluated in terms of increased mortality and morbidity. The recommendations of this report reflect the commitment of the Canadian Task Force on Preventive Health Care to provide a structured, evidence-based appraisal of whether a manoeuvre should be part of a periodic health examination. (1) Prevention: There is insufficient evidence to recommend in favour of or against community-based obesity prevention programs; however, because of considerable health risks associated with obesity and the limited long-term effectiveness of weight-reduction methods, the prevention of obesity should be a high priority for health care providers (grade C recommendation). (2) Treatment: (a) For obese adults without obesity-related diseases, there is insufficient evidence to recommend in favour of or against weight-reduction therapy because of a lack of evidence supporting the long-term effectiveness of weight-reduction methods (grade C recommendation); (b) for obese adults with obesity-related diseases (e.g., diabetes mellitus, hypertension), weight reduction is recommended because it can alleviate symptoms and reduce drug therapy requirements, at least in the short term (grade B recommendation). (3) Detection: (a) for people without obesity-related diseases, there is insufficient evidence to recommend the inclusion or exclusion of BMI measurement as part of a periodic health examination, and therefore BMI measurement is left to the discretion of individual health care providers (grade C recommendation); (b) for people with obesity-related diseases, BMI measurement is recommended because weight reduction should be considered with a BMI of more than 27 (grade B recommendation). The findings of this analysis were reviewed through an iterative process by the members of the Canadian Task Force on Preventive Health Care. The Canadian Task Force on Preventive Health Care is funded through a partnership between the Provincial and Territorial Ministries of Health and Health Canada.
Article
We sought to determine whether sauna therapy, a thermal vasodilation therapy, improves endothelial function in patients with coronary risk factors such as hypercholesterolemia, hypertension, diabetes mellitus and smoking. Exposure to heat is widely used as a traditional therapy in many different cultures. We have recently found that repeated sauna therapy improves endothelial and cardiac function in patients with chronic heart failure. Twenty-five men with at least one coronary risk factor (risk group: 38 +/- 7 years) and 10 healthy men without coronary risk factors (control group: 35 +/- 8 years) were enrolled. Patients in the risk group were treated with a 60 degrees C far infrared-ray dry sauna bath for 15 min and then kept in a bed covered with blankets for 30 min once a day for two weeks. To assess endothelial function, brachial artery diameter was measured at rest, during reactive hyperemia (flow-mediated endothelium-dependent dilation [%FMD]), again at rest and after sublingual nitroglycerin administration (endothelium-independent vasodilation [%NTG]) using high-resolution ultrasound. The %FMD was significantly impaired in the risk group compared with the control group (4.0 +/- 1.7% vs. 8.2 +/- 2.7%, p < 0.0001), while %NTG was similar (18.7 +/- 4.2% vs. 20.4 +/- 5.1%). Two weeks of sauna therapy significantly improved %FMD in the risk group (4.0 +/- 1.7% to 5.8 +/- 1.3%, p < 0.001). In contrast, %NTG did not change after two weeks of sauna therapy (18.7 +/- 4.2% to 18.1 +/- 4.1%). Repeated sauna treatment improves impaired vascular endothelial function in the setting of coronary risk factors, suggesting a therapeutic role for sauna treatment in patients with risk factors for atherosclerosis.
Article
The purpose of this study was to determine the mechanism by which 60 degrees C sauna treatment improves cardiac function in patients with chronic heart failure (CHF). We have previously reported that repeated 60 degrees C sauna treatment improves hemodynamic data and clinical symptoms in patients with CHF. We hypothesized that the sauna restores endothelial function and then improves cardiac function. Twenty patients (62 plus minus 15 years) in New York Heart Association (NYHA) functional class II or III CHF were treated in a dry sauna at 60 degrees C for 15 min and then kept on bed rest with a blanket for 30 min, daily for two weeks. Ten patients with CHF, matched for age, gender and NYHA functional class, were placed on a bed in a temperature-controlled (24 degrees C) room for 45 min as the nontreated group. Using high-resolution ultrasound, we measured the diameter of the brachial artery at rest and during reactive hyperemia (percent flow-mediated dilation, %FMD: endothelium-dependent dilation), as well as after sublingual administration of nitroglycerin (%NTG: endothelium-independent dilation). Cardiac function was evaluated by measuring the concentrations of plasma brain natriuretic peptide (BNP). Clinical symptoms were improved in 17 of 20 patients after two weeks of sauna therapy. The %FMD after two-week sauna treatment significantly increased from the baseline value, whereas the %NTG-induced dilation did not. Concentrations of BNP after the two-week sauna treatment decreased significantly. In addition, there was a significant correlation between the change in %FMD and the percent improvement in BNP concentrations in the sauna-treated group. In contrast, none of the variables changed at the two-week interval in the nontreated group. Repeated sauna treatment improves vascular endothelial function, resulting in an improvement in cardiac function and clinical symptoms.
Article
Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetic people have cardiovascular disease (CVD) risk factors comparable to those of nondiabetics who have had a myocardial infarction or stroke. Physiologic changes in diabetic hypertensive people include endothelial dysfunction, altered platelet activity, and microalbuminuria, all of which may increase coronary heart disease risk. Hyperglycemia and dyslipidemia have been shown to effect physiologic changes in the vasculature; therefore, establishing normoglycemia, reducing cholesterol levels, and controlling blood pressure are the primary and initial goals in the management of diabetic hypertensive patients. The atherosclerotic risk is greatest in poorly controlled patients, possibly because of associated hypercholesterolemia and hypertriglyceridemia. Aggressive management of risk factors such as hypertension, dyslipidemia, and platelet dysfunction in diabetics has been shown to reduce morbidity and mortality in prospective randomized controlled clinical trials. In this article we review the impact of diabetes mellitus on cardiovascular morbidity and mortality.
Article
This article describes the American College of Physicians' guidelines for managing hypertension in patients with type 2 diabetes mellitus. It answers the following questions: 1) What are the benefits of tight blood pressure control in type 2 diabetes? 2) What are appropriate target levels of systolic blood pressure and diastolic blood pressure for patients with type 2 diabetes? and 3) Are certain antihypertensive agents more effective in patients with diabetes?
Article
Several classes of drugs are used to treat hypertension but how they affect cardiovascular morbidity and mortality in high-risk patients is still under investigation. Recent outcome trials have examined the benefits associated with different levels of blood pressure control or have compared several of the 'newer' classes of antihypertensive drugs, such as angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers, with 'older' drug classes, such as diuretics and beta-blockers. Other trials have compared antihypertensive drugs with placebo. We performed a meta-regression analysis of 30 clinical trials that included a total of 149,407 patients. We based our analysis on summary statistics reported in the literature, and showed that blood pressure gradients accounted for most, if not all, of the differences in outcome in patients with hypertension or at high cardiovascular risk. We also conducted a study in older patients with isolated systolic hypertension and showed that antihypertensive drug treatment starting with the dihydropyridine calcium channel blocker, nitrendipine, reduced the risk of stroke and all cardiovascular complications. In addition, nitrendipine-based blood pressure-lowering therapy decreased the incidence of dementia. In diabetic patients, nitrendipine reduced the risk of proteinuria, decreased total mortality, and markedly improved cardiovascular prognosis. Taken together, these findings emphasize the desirability of tight blood pressure control.
Article
Congenital cardiovascular malformations (CCM) cause substantial neonatal morbidity and mortality. Known risk factors for CCM explain only 10–20% of all cases. Few studies have examined mothers’ physical exposures during pregnancy and the risk of CCM in their offspring. This study examined the association between exposures to extreme temperatures, prolonged standing, and heavy lifting during early pregnancy and risk of CCM in offspring. Using a case-control study design, 502 cases and 1066 controls were drawn from the population of all liveborn infants born between January 1988 and June 1991 to mothers living in 14 counties in New York State. Cases were identified from a population-based registry of congenital malformations. Controls were randomly selected from birth certificate records. Interviews were conducted by telephone, using a structured questionnaire. Exposure estimates were based on women's self-reports of conditions in the residence and workplace. Eighty-three per cent of the mothers were white, and 66% were between 25 and 34 years old. After adjusting all results for known risk factors and confounding variables, we found no significant increased risk of CCM in subjects whose mothers reported being exposed during early pregnancy to extreme heat (OR = 1.13, 95% CI 0.59, 2.19), nor to extreme cold (OR = 1.19, 95% CI 0.66, 2.15). Mothers who reported ever using a hot tub, hot bath, or sauna during early pregnancy had no increased risk of CCM in their offspring (OR = 0.88, 95% CI 0.65, 1.18). Performing heavy lifting during early pregnancy did not increase the risk of CCM in offspring (OR = 0.80, 95% CI 0.57, 1.11). Prolonged standing during early pregnancy was not associated with an increased risk of CCM in children (OR = 1.03, 95% CI 0.82, 1.28). Thus if these maternal exposures have an adverse effect, it is unlikely to involve CCMs.
Article
Seasonal variations influence blood pressure (BP) in healthy persons. Its effects on BP in renal replacement therapy, especially after renal transplantation (RTX), have not been proven clearly. We studied 80 stable RTX and 82 hemodialysis (HD) patients for 4 years. Systolic and diastolic BP, body weight (BW), cholesterol (Chol), triglyceride (TG), fasting blood sugar (FBS), blood urea nitrogen (BUN), and creatinine (Cr) were measured monthly. Their relationship with environmental temperature and humidity changes were assessed by Pearson tests and Fourier analysis. Ambient temperature and humidity were between 2.5 degrees C to 25.4 degrees C and 68% to 31% in the winters versus summers, respectively. The mean systolic BP in HD patients was 144 +/- 18 mm Hg and 140 +/- 15 mm Hg during the winter and summer, respectively (P =.004). For the RTX recipients, it was 133 +/- 12 mm Hg in winter and 128 +/- 19 mm Hg in summer (P <.001). The decrement in diastolic BP in warmer seasons was even more significant than that in systolic BP in both HD and RTX groups. Also, BW in summer was significantly lower than winter among HD (61.1 +/- 10 kg vs 63.2 +/- 9 kg; P <.001) and RTX (64.4 +/- 8 kg vs 65.6 +/- 8.4; P <.001) groups. Serum Chol, TG, and FBS did not change significantly during summer and winter in the both groups. Among RTX recipients, BUN level was greater in summer than winter seasons (24.2 +/- 15 vs 39.4 +/- 20 mg/dL; P =.01), but serum Cr did not differ. The degree of humidity did not correlate with BP, BW, or the above biochemical markers. We conclude that BP and BW are decreased in warmer seasons in both HD and RTX patients. The changes are not accompanied by changes in biochemical markers except for BUN in RTX patients.
Article
The physiologic effect of the sauna in human beings has been studied extensively, but only recently have there been studies to suggest sauna can be an effective therapeutic modality for patients with cardiovascular disease, especially for those with congestive heart failure. The data reported to date have been promising, but definitive studies are not possible because sauna treatment would be difficult to evaluate in a double-blind, placebo-controlled study.
Article
This paper describes the successful treatment of two patients with chronic fatigue syndrome (CFS) using repeated thermal therapy. Two patients with CFS underwent treatment with prednisolone (PSL), with no satisfactory effect. They were subjected to thermal therapy that consisted of a far-infrared ray dry sauna at 60 degrees C and postsauna warming. The therapy was performed once a day, for a total of 35 sessions. After discharge, these subjects continued the therapy once or twice a week on an outpatient basis for 1 year. Symptoms such as fatigue, pain, sleep disturbance, and low-grade fever were dramatically improved after 15 to 25 sessions of thermal therapy. Although PSL administration was discontinued, the subjects showed no relapse or exacerbation of symptoms during the first year after discharge. The patients became socially rehabilitated 6 months after discharge. These results suggest that repeated thermal therapy might be a promising method for the treatment of CFS.
Article
It has been reported that local thermal therapy with a hot pack or paraffin relieves pain. We hypothesized that systemic warming may decrease pain and improve the outcomes in patients with chronic pain. The purpose of this study was to clarify the effects of systemic thermal therapy in patients with chronic pain. Group A (n = 24) patients with chronic pain were treated by a multidisciplinary treatment including cognitive behavioral therapy, rehabilitation, and exercise therapy, whereas group B (n = 22) patients were treated by a combination of multidisciplinary treatment and repeated thermal therapy. A far-infrared ray dry sauna therapy and post-sauna warming were performed once a day for 4 weeks during hospitalization. We investigated the improvements in subjective symptoms, the number of pain behavior after treatment and outcomes 2 years after discharge. The visual analog pain score, number of pain behavior, self-rating depression scale, and anger score significantly decreased after treatment in both groups. After treatment, the number of pain behavior was slightly smaller (p = 0.07) and anger score was significantly lower in group B than those in group A (p = 0.05). Two years after treatment, 17 patients (77%) in group B returned to work compared with 12 patients (50%) in group A (p < 0.05). These results suggest that a combination of multidisciplinary treatment and repeated thermal therapy may be a promising method for treatment of chronic pain.
Article
We sought to determine the safety and efficacy of repeated 60 degrees C sauna bathing in patients with chronic systolic congestive heart failure (CHF). 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). 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.
Article
Lifestyle modification, although often neglected, is an important strategy to prevent and treat hypertension and reduce antihypertensive drug burden.1,2 On a population-wide basis, even a modest reduction in blood pressure of 3 mm Hg may reduce the rate of death due to stroke by 8% and coronary artery disease by 5%.1 Here we provide a summary of the expected reductions in blood pressure that may be achieved with various lifestyle interventions (Table 1). Table 1 Rajdeep Padwal General Internal Medicine University of Alberta Edmonton, Alta. Norman Campbell Department of Medicine University of Calgary Calgary, Alta. Rhian M. Touyz Department of Nephrology University of Ottawa Ottawa, Ont. For the Canadian Hypertension Education Program
Article
Lifestyle modification should be the primary therapeutic intervention in individuals with the dysmetabolic syndrome, given the fact that obesity, unhealthy diet, and physical inactivity are primary underlying risk factors for its development. Most individuals with the dysmetabolic syndrome need to lose weight through dietary changes and increases in physical activity. Modest weight losses may significantly improve all aspects of the syndrome. Because individuals differ in their lifestyles, tailoring interventions to meet the specific needs of each person will maximize the chances of success. Assessment of the individual with the dysmetabolic syndrome involves quantification of obesity, diets and dietary patterns, physical activity, emotional problems, and motivation. To help individuals make lifestyle changes, a number of behavior modification strategies have shown good efficacy. These strategies include a tailored problem-solving intervention, involving goal-setting, self-monitoring, stimulus control, cognitive restructuring, stress management, relapse prevention, social support, and contracting. The frequency of self-monitoring is an especially important strategy for continued success. Research studies have clearly demonstrated the power of lifestyle modification for long-term behavioral change. Lifestyle modification appears effective in delaying or preventing the development of the dysmetabolic syndrome.
Article
1 but the number of things we have to manage can make caring for patients with diabe- tes a challenge. To try to improve the quality and consistency of my care, I have made several changes in my practice.
Article
The objective of this report is to combine the data from an earlier adult study with the data from a paediatric study in order to determine the overall accuracy of the BpTRU (BPM-100 model) as compared to the recognized standard, auscultatory mercury sphygmomanometer. The individual blood pressure points recorded for both adult and paediatric studies were compared directly to its corresponding observer reference measurements from data collected and stored from the two separate studies. There were 255 sets of readings in the adult study and 162 sets from the paediatric study, which were combined to make 417 pairs of blood pressure readings for this study. The overall observer standard reference mean for the 417 measurements was calculated and the difference between this and the overall mean BPM-100 was calculated with SD and ranges. Measurements within 5, 10 and 15 mmHg agreement were expressed as percentages. A total of 121 subjects were included for this study (85 from the adult study and 36 from the paediatric study). From these, 417 paired measurements were recorded. The mean difference between the BpTRU and the reference standard systolic blood pressure (BP) was 0.47+/-5.40 mmHg with 89.2% measurements within 5 mmHg, 96.4% within 10 mmHg and 99.3% within 15 mmHg. The mean difference between the BpTRU and reference diastolic BP was -2.12+/-5.93 mmHg with 81.1% within 5 mmHg, 92.1% within 10 mmHg and 97.6% within 15 mmHg. The BpTRU has been shown to be an accurate non-invasive blood pressure monitoring device in the general population over a wide range of ages (3-83 years). This combined study meets all requirements of the Association of Advancement of Medical Instrumentation and achieved a grade 'A' in the BHS protocol.
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