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Kunutsor SK, Jae SY, Laukkanen JA. Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY. J Cardiopulm Rehabil Prev. 2022;42(1):59-63doi: 10.1097/HCR.0000000000000598.
Kunutsor, S. K., Jae, S. Y., & Laukkanen, J. A. (2022). Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY. Journal of cardiopulmonary rehabilitation and prevention, 42(1), 59-63. https://doi.org/10.1097/HCR.0000000000000598
Kunutsor, Setor K, et al. "Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY." Journal of cardiopulmonary rehabilitation and prevention vol. 42,1 (2022): 59-63. doi: https://doi.org/10.1097/HCR.0000000000000598
Kunutsor SK, Jae SY, Laukkanen JA. Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY. J Cardiopulm Rehabil Prev. 2022 Jan 01;42(1):59-63. doi: 10.1097/HCR.0000000000000598. PMID: 33797457.
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J Cardiopulm Rehabil Prev. 2022 Jan 01;42(1):59-63. doi: 10.1097/HCR.0000000000000598.

Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY.

Journal of cardiopulmonary rehabilitation and prevention

Setor K Kunutsor, Sae Young Jae, Jari A Laukkanen

Affiliations

  1. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, England (Dr Kunutsor); Department of Sport Science, University of Seoul, Seoul, South Korea (Dr Jae); and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland, and Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland, and Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland (Dr Laukkanen).

PMID: 33797457 DOI: 10.1097/HCR.0000000000000598

Abstract

PURPOSE: Inflammatory pathways are involved in the pathogenesis of pneumonia. Frequent sauna sessions may reduce the risk of respiratory tract infections including pneumonia independent of inflammation. We aimed to evaluate the independent and joint associations of high-sensitivity C-reactive protein (hsCRP) and frequency of sauna bathing (FSB) with risk of pneumonia in a prospective cohort study.

METHODS: Serum hsCRP as an inflammatory marker was measured using an immunometric assay and FSB was assessed by self-reported sauna bathing habits at baseline in 2264 men aged 42-61 yr. Serum hsCRP was categorized as normal and high (≤3 and >3 mg/L, respectively) and FSB as low and high (defined as ≤1 and 2-7 sessions/wk, respectively). Multivariable-adjusted HRs (CIs) were calculated for incident pneumonia.

RESULTS: A total of 528 cases of pneumonia occurred during a median follow-up of 26.6 yr. Comparing high versus normal hsCRP, the multivariable-adjusted risk for pneumonia was HR = 1.30 (95% CI, 1.04-1.62). The corresponding risk was HR = 0.79 (95% CI, 0.66-0.95) comparing high versus low FSB. Compared with men with normal hsCRP and low FSB, high hsCRP and low FSB was associated with an increased risk of pneumonia in multivariable analysis (HR = 1.67: 95% CI, 1.21-2.29), with no evidence of an association for high hsCRP and high FSB and pneumonia (HR = 0.94: 95% CI, 0.69-1.29).

CONCLUSIONS: In a general middle-aged to older male Caucasian population, frequent sauna baths attenuated the increased risk of pneumonia due to inflammation.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

The authors declare no conflicts of interest.

References

  1. Cilloniz C, Martin-Loeches I, Garcia-Vidal C, San Jose A, Torres A. Microbial etiology of pneumonia: epidemiology, diagnosis and resistance patterns. Int J Mol Sci. 2016;17(12):2120. - PubMed
  2. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67(1):71–79. - PubMed
  3. Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax. 2013;68(11):1057–1065. - PubMed
  4. Franklin BA, Brubaker PH, Harber MP, Lavie CJ, Myers J, Kaminsky LA. The Journal of Cardiopulmonary Rehabilitation and Prevention at 40 years and its role in promoting lifestyle medicine for prevention of cardiovascular diseases: part 1. J Cardiopulm Rehab Prev. 2020;40(3):131–137. - PubMed
  5. Franklin BA, Myers J, Kokkinos P. Importance of lifestyle modification on cardiovascular risk reduction: counseling strategies to maximize patient outcomes. J Cardiopulm Rehab Prev. 2020;40(3):138–143. - PubMed
  6. Franklin BA, Brubaker P, Harber MP, Lavie CJ, Myers J, Kaminsky LA. The Journal of Cardiopulmonary Rehabilitation and Prevention at 40 yr and Its role in promoting preventive cardiology: part 2. J Cardiopulm Rehab Prev. 2020;40(4):209–214. - PubMed
  7. Emerging Risk Factors Collaboration; Kaptoge S, Di Angelantonio E, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375(9709):132–140. - PubMed
  8. Wu J, Jin YU, Li H, et al. Evaluation and significance of C-reactive protein in the clinical diagnosis of severe pneumonia. Exp Ther Med. 2015;10(1):175–180. - PubMed
  9. Jae SY, Heffernan KS, Kurl S, et al. Cardiorespiratory fitness, inflammation, and the incident risk of pneumonia [published online ahead of print February 4, 2021] J Cardiopulm Rehabil Prev. doi: 10.1097/HCR.0000000000000581. - PubMed
  10. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other health benefits of sauna bathing: a review of the evidence. Mayo Clin Proc. 2018;93(8):1111–1121. - PubMed
  11. Kunutsor SK, Laukkanen T, Laukkanen JA. Frequent sauna bathing may reduce the risk of pneumonia in middle-aged Caucasian men: The KIHD prospective cohort study. Respir Med. 2017;132:161–163. - PubMed
  12. Kunutsor SK, Laukkanen T, Laukkanen JA. Sauna bathing reduces the risk of respiratory diseases: a long-term prospective cohort study. Eur J Epidemiol. 2017;32(12):1107–1111. - PubMed
  13. Ernst E, Pecho E, Wirz P, Saradeth T. Regular sauna bathing and the incidence of common colds. Ann Med. 1990;22(4):225–227. - PubMed
  14. Kunutsor SK, Hakkinen A, Zaccardi F, et al. Short-term effects of Finnish sauna bathing on blood-based markers of cardiovascular function in non-naive sauna users. Heart Vessels. 2018;33(12):1515–1524. - PubMed
  15. Laukkanen T, Kunutsor SK, Zaccardi F, et al. Acute effects of sauna bathing on cardiovascular function. J Hum Hypertens. 2018;32(2):129–138. - PubMed
  16. Lee E, Laukkanen T, Kunutsor SK, et al. Sauna exposure leads to improved arterial compliance: findings from a non-randomised experimental study. Eur J Prev Cardiol. 2018;25(2):130–138. - PubMed
  17. Vuori I. Sauna bather's circulation. Ann Clin Res. 1988;20(4):249–256. - PubMed
  18. Kunutsor SK, Khan H, Laukkanen T, Laukkanen JA. Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study. Ann Med. 2018;50(2):139–146. - PubMed
  19. Laukkanen J, Laukkanen T, Khan H, Babar M, Kunutsor SK. Combined effect of sauna bathing and cardiorespiratory fitness on the risk of sudden cardiac deaths in Caucasian men: a long-term prospective cohort study. Prog Cardiovasc Dis. 2018;60(6):635–641. - PubMed
  20. Kunutsor SK, Laukkanen JA. High fitness levels, frequent sauna bathing and risk of pneumonia in a cohort study: are there potential implications for COVID-19 [published online ahead of print January 10, 2021]? Eur J Clin Invest. doi:10.1111/eci.13490. - PubMed
  21. Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015;175(4):542–548. - PubMed
  22. Kunutsor SK, Khan H, Nyyssonen K, Laukkanen JA. Lipoprotein(a) and risk of sudden cardiac death in middle-aged Finnish men: a new prospective cohort study. Int J Cardiol. 2016;220:718–725. - PubMed
  23. Laukkanen T, Kunutsor S, Kauhanen J, Laukkanen JA. Sauna bathing is inversely associated with dementia and Alzheimer's disease in middle-aged Finnish men. Age Ageing. 2017;46(2):245–249. - PubMed
  24. Kunutsor SK, Whitehouse MR, Blom AW, Laukkanen JA. Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study. Eur J Epidemiol. 2017;32(7):593–603. - PubMed
  25. Kunutsor SK, Sameul S, Blom AW, Khunti K, JA L. Serum C-reactive protein increases the risk of venous thromboembolism: a prospective study and meta-analysis of published prospective evidence. Eur J Epidemiol. 2017;32(8):657–667. - PubMed
  26. Kunutsor SK, Khan H, Zaccardi F, Laukkanen T, Willeit P, Laukkanen JA. Sauna bathing reduces the risk of stroke in Finnish men and women: a prospective cohort study. Neurology. 2018;90(22):e1937–e1944. - PubMed
  27. Kunutsor SK, Makikallio TH, Khan H, Laukkanen T, Kauhanen J, Laukkanen JA. Sauna bathing reduces the risk of venous thromboembolism: a prospective cohort study. Eur J Epidemiol. 2019;34(10):983–986. - PubMed
  28. Kunutsor SK, Laukkanen T, Laukkanen JA. Cardiorespiratory fitness and future risk of pneumonia: a long-term prospective cohort study. Ann Epidemiol. 2017;27(9):603–605. - PubMed
  29. Kunutsor SK, Laukkanen T, Laukkanen JA. Cardiorespiratory fitness is associated with reduced risk of respiratory diseases in middle-aged Caucasian men: a long-term prospective cohort study. Lung. 2017;195(5):607–611. - PubMed
  30. Groenwold RH, Klungel OH, Grobbee DE, Hoes AW. Selection of confounding variables should not be based on observed associations with exposure. Eur J Epidemiol. 2011;26(8):589–593. - PubMed
  31. Centers for Disease Control and Prevention; American Heart Association, Pearson TA, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511. - PubMed
  32. Yende S, Tuomanen EI, Wunderink R, et al. Preinfection systemic inflammatory markers and risk of hospitalization due to pneumonia. Am J Respir Crit Care Med. 2005;172(11):1440–1446. - PubMed
  33. Paiva MB, Botoni FA, Teixeira AL Jr, et al. The behavior and diagnostic utility of procalcitonin and five other inflammatory molecules in critically ill patients with respiratory distress and suspected 2009 influenza a H1N1 infection. Clinics (Sao Paulo). 2012;67(4):327–334. - PubMed
  34. Medeiros IL, Terra RM, Choi EM, Pego-Fernandes PM, Jatene FB. Evaluation of serial C-reactive protein measurements after surgical treatment of pleural empyema. Clinics (Sao Paulo). 2012;67(3):243–247. - PubMed
  35. van Vugt SF, Broekhuizen BD, Lammens C, et al. Use of serum C reactive protein and procalcitonin concentrations in addition to symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough: diagnostic study. BMJ. 2013;346:f2450. - PubMed
  36. Boyd AR, Orihuela CJ. Dysregulated inflammation as a risk factor for pneumonia in the elderly. Aging Dis. 2011;2(6):487–500. - PubMed
  37. Laitinen LA, Lindqvist A, Heino M. Lungs and ventilation in sauna. Ann Clin Res. 1988;20(4):244–248. - PubMed
  38. Hasan J, Karvonen MJ, Piironen P. Special review. I. Physiological effects of extreme heat as studied in the Finnish “sauna” bath. Am J Phys Med. 1966;45(6):296–314. - PubMed
  39. Cohen M. Turning up the heat on COVID-19: heat as a therapeutic intervention. F1000Res. 2020;9:292. - PubMed
  40. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–1207. - PubMed
  41. Kunutsor SK, Laukkanen JA. Cardiovascular complications in COVID-19: a systematic review and meta-analysis. J Infect. 2020;81(2):e139–e141. - PubMed
  42. Kunutsor SK, Laukkanen JA. Hepatic manifestations and complications of COVID-19: a systematic review and meta-analysis. J Infect. 2020;81(3):e72–e74. - PubMed
  43. Kunutsor SK, Laukkanen JA. Renal complications in COVID-19: a systematic review and meta-analysis. Ann Med. 2020;52(7):345–353. - PubMed
  44. Martinez-Rojas MA, Vega-Vega O, Bobadilla NA. Is the kidney a target of SARS-CoV-2? Am J Physiol Renal Physiol. 2020;318(6):F1454–F1462. - PubMed
  45. Chin AWH, Chu JTS, Perera MRA, et al. Stability of SARS-CoV-2 in different environmental conditions. Lancet Microbe. 2020;1(1):e10. - PubMed
  46. Kunutsor SK, Lavie CJ, Laukkanen JA. Finnish sauna and COVID-19. Infez Med. 2021;29(1):160–162. - PubMed
  47. Laukkanen JA, Makikallio TH, Khan H, Laukkanen T, Kauhanen J, Kunutsor SK. Finnish sauna bathing does not increase or decrease the risk of cancer in men: a prospective cohort study. Eur J Cancer. 2019;121:184–191. - PubMed

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