CLINICAL STUDY
Repeated thermal therapy improves impaired vascular endothelial function in patients with coronary risk factors
Masakazu Imamura, MD*,
Sadatoshi Biro, MD*,
Takashi Kihara, MD*,
Shiro Yoshifuku, MD*,
Kunitsugu Takasaki, MD*,
Yutaka Otsuji, MD, FACC*,
Shinichi Minagoe, MD*,
Yoshifumi Toyama, MD and
Chuwa Tei, MD, FACC
* First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Sakuragaoka, Kagoshima, Japan
Nanpuh Hospital, Kagoshima, Japan
Manuscript received January 5, 2001;
revised manuscript received May 18, 2001,
accepted June 11, 2001.
Reprint requests and correspondence: Dr. Chuwa Tei, First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
chuwatei{at}med5.kufm.kagoshima-u.ac.jp
OBJECTIVES
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.
BACKGROUND
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.
METHODS
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°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.
RESULTS
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%).
CONCLUSIONS
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.
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Abbreviations and Acronyms
| | BP | = blood pressure | | eNOS | = endothelial isoform of nitric oxide synthase | | NO | = nitric oxide | | NTG | = nitroglycerin | | TBARS | = thiobarbituric acid reactive substances | | %FMD | = percent flow-mediated dilation | | %NTG | = percent nitroglycerin-induced dilation |
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