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BMC Medicine
Published in: BMC Medicine 1/2018

Open Access 01-12-2018 | Research article

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

Authors: Tanjaniina Laukkanen, Setor K. Kunutsor, Hassan Khan, Peter Willeit, Francesco Zaccardi, Jari A. Laukkanen

Published in: BMC Medicine | Issue 1/2018

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Abstract

Background

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.
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Metadata
Title
Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study
Authors
Tanjaniina Laukkanen
Setor K. Kunutsor
Hassan Khan
Peter Willeit
Francesco Zaccardi
Jari A. Laukkanen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2018
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-018-1198-0

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