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Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study.

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cam.issuedOnline2018-11-29
dc.contributor.authorLaukkanen, Tanjaniina
dc.contributor.authorKunutsor, Setor K
dc.contributor.authorKhan, Hassan
dc.contributor.authorWilleit, Peter
dc.contributor.authorZaccardi, Francesco
dc.contributor.authorLaukkanen, Jari A
dc.contributor.orcidLaukkanen, Jari A [0000-0002-3738-1586]
dc.date.accessioned2018-11-29T07:02:36Z
dc.date.available2018-11-29T07:02:36Z
dc.date.issued2018-11-29
dc.date.updated2018-11-29T07:02:34Z
dc.description.abstractBACKGROUND: Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. METHODS: Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53-74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with CVD mortality. RESULTS: A total of 181 fatal CVD events occurred during a median follow-up of 15.0 years (interquartile range, 14.1-15.9). The risk of CVD mortality decreased linearly with increasing sauna sessions per week with no threshold effect. In age- and sex-adjusted analysis, compared with participants who had one sauna bathing session per week, HRs (95% CIs) for CVD mortality were 0.71 (0.52 to 0.98) and 0.30 (0.14 to 0.64) for participants with two to three and four to seven sauna sessions per week, respectively. After adjustment for established CVD risk factors, potential confounders including physical activity, socioeconomic status, and incident coronary heart disease, the corresponding HRs (95% CIs) were 0.75 (0.52 to 1.08) and 0.23 (0.08 to 0.65), respectively. The duration of sauna use (minutes per week) was inversely associated with CVD mortality in a continuous manner. Addition of information on sauna bathing frequency to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change (0.0091; P = 0.010), difference in - 2 log likelihood (P = 0.019), and categorical net reclassification improvement (4.14%; P = 0.004). CONCLUSIONS: Higher frequency and duration of sauna bathing are each strongly, inversely, and independently associated with fatal CVD events in middle-aged to elderly males and females. The frequency of sauna bathing improves the prediction of the long-term risk for CVD mortality.
dc.identifier.citationBMC Medicine. 2018 Nov 29;16(1):219
dc.identifier.doi10.17863/CAM.33375
dc.identifier.eissn1741-7015
dc.identifier.issn1741-7015
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286059
dc.language.isoeng
dc.language.rfc3066en
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1186/s12916-018-1198-0
dc.rights.holderThe Author(s).
dc.subjectCardiovascular disease
dc.subjectGender
dc.subjectPrevention
dc.subjectRisk prediction
dc.subjectSauna bathing
dc.subjectAged
dc.subjectCardiovascular Diseases
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProportional Hazards Models
dc.subjectProspective Studies
dc.subjectRisk Factors
dc.subjectRisk Reduction Behavior
dc.subjectSteam Bath
dc.titleSauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study.
dc.typeJournal Article
dcterms.dateAccepted2018-10-26
prism.publicationNameBMC Med
rioxxterms.versionofrecord10.1186/s12916-018-1198-0

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