Repeated thermal therapy improves impaired vascular endothelial function in patients with coronary risk factors

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\textless0.0001), 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\textless0.001). 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. © 2001 by the American College of Cardiology.