Int J Sports Med 2020; 41(12): 824-831
DOI: 10.1055/a-1186-1716
Physiology & Biochemistry

Acute Hemodynamic Responses to Combined Exercise and Sauna

Joonas Antero Rissanen
1   Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Keijo Häkkinen
1   Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Jari Antero Laukkanen
2   Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
3   Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Arja Häkkinen
2   Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
3   Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
› Author Affiliations
Funding: The present study was funded by Kuopio University Hospital (grant no: B1703) and The Finnish Sauna Society. The authors would like to thank their research assistants and all the volunteer participants who made this project possible.


This study investigated acute hemodynamic, plasma volume and immunological responses to four loading protocols: sauna only, and sauna after endurance, strength or combined endurance and strength exercise. Twenty-seven healthy, slightly prehypertensive men (age 32.7±6.9 years) were measured at PRE, MID (after exercise), POST, POST30min and POST24h. The measurements consisted systolic and diastolic blood pressure, heart rate, body temperature and concentrations of high-sensitive C-reactive protein, white blood cells and plasma volume measurements. Endurance+sauna showed significant decreases in systolic blood pressure at POST (–8.9 mmHg), POST30min (–11.0 mmHg) and POST24h (–4.6 mmHg). At POST30min, significant decreases were also observed in sauna (–4.3 mmHg) and combined+sauna (–7.5 mmHg). Diastolic blood pressure decreased significantly from -5.4 to –3.9 mmHg at POST in all loadings. Plasma volume decreased significantly at MID in all exercise loadings and at POST in endurance+sauna and strength+sauna. Plasma volume increased significantly (p < 0.01) in endurance+sauna and combined+sauna at POST24h. White blood cells increased following all exercise+sauna loadings at MID, POST and POST30min, whereas high sensitive C-reactive protein showed no changes at any measurement point. The combination of endurance exercise and sauna showed the greatest positive effects on blood pressure. Both loadings including endurance exercise increased plasma volume on the next day.

Publication History

Received: 10 December 2019

Accepted: 14 May 2020

Article published online:
29 June 2020

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  • References

  • 1 Kearney PM, Whelton M, Reynolds K. et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 15-21 365: 217-223
  • 2 Mills KT, Bundy JD, Kelly TN. et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation 2016; 134: 441-450
  • 3 Pescatello LS, Franklin BA, Fagard R. et al. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36: 533-553
  • 4 Pilch W, Szygula Z, Palka T. et al. Comparison of physiological reactions and physiological strain in healthy men under heat stress in dry and steam heat saunas. Biol Sport 2014; 31: 145-149
  • 5 Hedley AM, Climstein M, Hansen R. The effects of acute heat exposure on muscular strength, muscular endurance, and muscular power in the euhydrated athlete. J Strength Cond Res 2002; 16: 353-358
  • 6 Leppäluoto J, Arjamaa O, Vuolteenaho O. et al. Passive heat exposure leads to delayed increase in plasma levels of atrial natriuretic peptide in humans. J Appl Physiol (1985) 1985; 1991: 716-720
  • 7 Kukkonen-Harjula K, Oja P, Laustiola K. et al. Haemodynamic and hormonal responses to heat exposure in a Finnish sauna bath. Eur J Appl Physiol Occup Physiol 1989; 58: 543-550
  • 8 Kosunen KJ, Pakarinen AJ, Kuoppasalmi K. et al. Plasma renin activity, angiotensin II, and aldosterone during intense heat stress. J Appl Physiol 1976; 41: 323-327
  • 9 Cornelissen VA, Smart NA. Exercise training for blood pressure: A systematic review and meta-analysis. J Am Heart Assoc 2013; 2: e004473
  • 10 Stanley J, Halliday A, D'Auria S. et al. Effect of sauna-based heat acclimation on plasma volume and heart rate variability. Eur J Appl Physiol 2015; 115: 785-794
  • 11 Gayda M, Paillard F, Sosner P. et al. Effects of sauna alone and postexercise sauna baths on blood pressure and hemodynamic variables in patients with untreated hypertension. J Clin Hypertens (Greenwich) 2012; 14: 553-560
  • 12 Scoon GS, Hopkins WG, Mayhew S. et al. Effect of post-exercise sauna bathing on the endurance performance of competitive male runners. J Sci Med Sport 2007; 10: 259-262
  • 13 Leicht AS, Halliday A, Sinclair WH. et al. Heart rate variability responses to acute and repeated postexercise sauna in trained cyclists. Appl Physiol Nutr Metab 2018; 43: 704-710
  • 14 Laukkanen T, Kunutsor SK, Zaccardi F. et al. Acute effects of sauna bathing on cardiovascular function. J Hum Hypertens 2018; 32: 129-138
  • 15 Gryka D, Pilch W, Szarek M. et al. The effect of sauna bathing on lipid profile in young, physically active, male subjects. Int J Occup Med Environ Health 2014; 27: 608-618
  • 16 Pilch W, Pokora I, Szyguła Z. et al. Effect of a single finnish sauna session on white blood cell profile and cortisol levels in athletes and non-athletes. J Hum Kinet 2013; 39: 127-135
  • 17 Ohira Y, Girandola RN, Simpson DR. et al. Responses of leukocytes and other hematologic parameters to thermal dehydration. J Appl Physiol Respir Environ Exerc Physiol 1981; 50: 38-40
  • 18 Cipryan L, Tschakert G, Hofmann P. Acute and post-exercise physiological responses to high-intensity interval training in endurance and sprint athletes. J Sports Sci Med 2017; 16: 219-229
  • 19 Ihalainen JK, Vuorimaa T, Puurtinen R. et al. Effects of carbohydrate ingestion on acute leukocyte, cortisol, and interleukin-6 response in high-intensity long-distance running. J Strength Cond Res 2014; 28: 2786-2792
  • 20 Ihalainen J, Walker S, Paulsen G. et al. Acute leukocyte, cytokine and adipocytokine responses to maximal and hypertrophic resistance exercise bouts. Eur J Appl Physiol 2014; 114: 2607-2616
  • 21 Donde A, Wong H, Frelinger J. et al. Effects of exercise on systemic inflammatory, coagulatory, and cardiac autonomic parameters in an inhalational exposure study. J Occup Environ Med 2012; 54: 466-470
  • 22 Meyer T, Gabriel HH, Rätz M. et al. Anaerobic exercise induces moderate acute phase response. Med Sci Sports Exerc 2001; 33: 549-555
  • 23 Harriss DJ, MacSween A, Atkinson G. ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
  • 24 Rissanen JA, Häkkinen A, Laukkanen J. et al. Acute neuromuscular and hormonal responses to different exercise loadings followed by a sauna. J Strength Cond Res 2020; 34: 313-322
  • 25 Hietavala EM, Ihalainen JK, Frassetto LA. et al. Effects of 12-week low or moderate dietary acid intake on acid–base status and kidney function at rest and during submaximal cycling. Nutrients 2018; 10: E323
  • 26 Haugan B, Langerud AK, Kalvøy H. et al. Can we trust the new generation of infrared tympanic thermometers in clinical practice?. J Clin Nurs 2013; 22: 698-709
  • 27 Strauss MB, Davis RK, Rosenbaum JD. et al. “Water diuresis” produced during recumbency by the intravenous infusion of isotonic saline solution. J Clin Invest 1951; 30: 862-868
  • 28 Figueiredo T, Rhea MR, Peterson M. et al. Influence of number of sets on blood pressure and heart rate variability after a strength training session. J Strength Cond Res 2015; 29: 1556-1563
  • 29 Rezk CC, Marrache RC, Tinucci T. et al. Post-resistance exercise hypotension, hemodynamics, and heart rate variability: Influence of exercise intensity. Eur J Appl Physiol 2006; 98: 105-112
  • 30 Maehlum S, Grandmontagne M, Newsholme EA. et al. Magnitude and duration of excess postexercise oxygen consumption in healthy young subjects. Metabolism 1986; 35: 425-429
  • 31 Short KR, Sedlock DA. Excess postexercise oxygen consumption and recovery rate in trained and untrained subjects. J Appl Physiol (1985) 1997; 83: 153-159
  • 32 González-Alonso J, Crandall CG, Johnson JM. The cardiovascular challenge of exercising in the heat. J Physiol 2008; 586: 45-53
  • 33 Craig SK, Byrnes WC, Fleck SJ. Plasma volume during weight lifting. Int J Sports Med 2008; 29: 89-95
  • 34 Brown WM, Davison GW, McClean CM. et al. A systematic review of the acute effects of exercise on immune and inflammatory indices in untrained Adults. Sports Med Open 2015; 1: 35
  • 35 Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other Health Benefits of Sauna Bathing: A review of the evidence. Mayo Clin Proc 2018; 93: 1111-1121
  • 36 Peake JM, Neubauer O, Walsh NP. et al. Recovery of the immune system after exercise. J Appl Physiol (1985) 2017; 122: 1077-1087