Acute effects of Finnish sauna and cold-water immersion on haemodynamic variables and autonomic nervous system activity in patients with heart failure

Eur J Prev Cardiol. 2016 Apr;23(6):593-601. doi: 10.1177/2047487315594506. Epub 2015 Jul 7.


Background: The haemodynamic response to Finnish sauna and subsequent cold-water immersion in heart failure patients is unknown.

Methods: Haemodynamic response to two consecutive Finnish sauna (80℃) exposures, followed by a final head-out cold-water immersion (12℃) was measured in 37 male participants: chronic heart failure (n = 12, 61.8 ± 9.2 years), coronary artery disease (n = 13, 61.2 ± 10.6 years) and control subjects (n = 12, 60.9 ± 8.9 years). Cardiac output was measured non-invasively with an inert gas rebreathing method prior to and immediately after the first sauna exposure and after cold-water immersion, respectively. Blood pressure was measured before, twice during and after sauna. The autonomic nervous system was assessed by power spectral analysis of heart rate variability. Total power, low-frequency and high-frequency components were evaluated. The low frequency/high frequency ratio was used as a marker of sympathovagal balance. Sauna and cold-water immersion were well tolerated by all subjects.

Results: Cardiac output and heart rate significantly increased in all groups after sauna and cold-water immersion (p < 0.05), except for coronary artery disease patients after sauna exposure. Systolic blood pressure during sauna decreased significantly in all groups with a nadir after 6 min (all p < 0.05). Cold-water immersion significantly increased systolic blood pressure in all groups (p < 0.05). No change in the low/high frequency ratio was found in chronic heart failure patients. In coronary artery disease patients and controls a prolonged increase in low frequency/high frequency ratio was observed after the first sauna exposure.

Conclusions: Acute exposure to Finnish sauna and cold-water immersion causes haemodynamic alterations in chronic heart failure patients similarly to control subjects and in particular did not provoke an excessive increase in adrenergic activity or complex arrhythmias.

Keywords: Heat exposure; cardiac output; cold-water immersion; heart failure; sympathetic nervous system activity.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Blood Pressure
  • Cardiac Output
  • Chronic Disease
  • Cold Temperature* / adverse effects
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Heart / innervation*
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Rate
  • Hemodynamics*
  • Humans
  • Immersion* / adverse effects
  • Male
  • Middle Aged
  • Steam Bath* / adverse effects
  • Switzerland
  • Sympathetic Nervous System / physiopathology*
  • Time Factors
  • Treatment Outcome
  • Water* / adverse effects


  • Water