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Head-out immersion in natural thermal mineral water for the management of hypertension: a review of randomized controlled trials

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Abstract

Hypertension is a major public health problem in the world, and the management of hypertension has always been a research of interest. Balneotherapy, with its recreational aspect, is more acceptable than medication intake and lifestyle change for the management of hypertension. The aim of this review was to summarize the current available data on the clinical effects of head-out immersion in natural thermal mineral water (HINTMW) as the most common method of balneotherapy used in the management of hypertension. We screened the PubMed, EMBASE, Cochrane Library, China Science and Technology Journal, China National Knowledge Infrastructure, WANFANG, and China Biology Medicine disc databases and selected 12 randomized controlled trials involving a total of 1122 participants. Among 12 trials, HINTMW was taken as the only intervention in only one study, HINTMW was taken in addition to basic antihypertensive drugs in three studies, and HINTMW was taken in combination with advice to follow nonpharmacological methods in one study involving participants who partly used antihypertensive drugs, while HINTMW combined with other interventions, such as natural convalescent factor therapy, psychotherapy, exercises, nutrition therapy, and integrated care, was taken in addition to basic antihypertensive drugs in the other 7 studies. Our results showed that natural thermal mineral water immersion alone or natural thermal mineral water immersion as an adjuvant therapy to medication or natural thermal mineral water immersion combined with other interventions had no adverse effects on hypertensive patients, and most even had positive effects. However, more high-quality evidences on therapeutic effectiveness of natural thermal mineral water immersion on hypertension are needed from additional randomized controlled trials with high methodological quality.

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References

  • Ablin JN, Häuser W, Buskila D (2013) Spa treatment (balneotherapy) for fibromyalgia—a qualitative-narrative review and a historical perspective. Evid Based Complement Alternat Med 2013(2):638050

    Google Scholar 

  • Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP (2013) Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ 346:f1378

    Article  Google Scholar 

  • Antonelli M, Donelli D (2018) Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review. Int J Biometeorol:1–2), 1-12

  • Blumenthal JA, Babyak MA, Hinderliter A et al (2010) Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med 170:126–135

    Article  Google Scholar 

  • Carlson DJ, Dieberg G, Hess NC, Millar PJ, Smart NA (2014) Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc 89:327–334

    Article  Google Scholar 

  • Carretero OA, Oparil S (2000) Essential hypertension: Part I: Definition and etiology. Circulation 101(3):329–335

    Article  CAS  Google Scholar 

  • Christensen P, Clemensen P, Andersen PK, Henneberg SW (2000) Thermodilution versus inert gas re-breathing for estimation of effective pulmonary blood flow. Crit Care Med 28(1):51–56

    Article  CAS  Google Scholar 

  • Christie JL, Sheldahl LM, Tristani FE, Wann LS, Sagar KB, Levandoski SG, Ptacin MJ, Sobocinski KA, Morris RD (1990) Cardiovascular regulation during head-out water immersion exercise. J.appl.physiol 69(2):657–664

    Article  CAS  Google Scholar 

  • Cornelissen VA, Smart NA (2013) Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2:e004473

    Article  Google Scholar 

  • Ercegrukavina T, Stefanovski M (2014) Effects of Sulphate-Sulphide Mineral Water “Mlječanica” in Patients with Hypertension. Materia Socio Medica 26(6): 364–365

  • Fang L, Hu DY, Wang JS et al (2014) Observation of curative effect of Xingcheng mineral spring bath adjuvant medication on essential hypertension. Chin J Phys Med Rehabilitation 36(1) (in Chinese)

  • Gabrielsen A, Sørensen VB, Pump B, Galatius S, Videbæk R, Bie P, Warberg J, Christensen NJ, Wroblewski H, Kastrup J, Norsk P (2000) Cardiovascular and neuroendocrine responses to water immersion in compensated heart failure. AJP Heart Circ Physiol 279(4):H1931–H1940

    Article  CAS  Google Scholar 

  • Hao WP, Feng YH, Cheng JF, Li Q, Chai GD (2013) Study on sulfuretted hydrogen mineral bath to treat hypertension and hyperhomocysteinemia. Chin J Convalescent Med 22(4):295–297 (in Chinese)

  • He JH (2009) Therapeutic effect of nitrendipine combined with mineral spring bath. Chin J Convalescent Med 18(2):116–117 (in Chinese)

  • He FJ, Li J, MacGregor GA (2013) Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ 346:f1325

    Article  Google Scholar 

  • Hu PC, Wang RR, Shang ZH et al (2000) Floating therapy in treatment of patients with primary hypertension. Chin Ment Health J 14(6):414–416 (in Chinese)

  • Hu DY, Fang L, He D, Wang JS, Li GM, Shao DM et al (2013) Effect of Xingcheng mineral spring bath combined with levamlodipine benzenesulfonate on essential hypertension. Chin J Convalescent Med 22(8):682–683 (in Chinese)

  • Inder JD, Carlson DJ, Dieberg G, McFarlane JR, Hess NCL, Smart NA (2016) Isometric exercise training for blood pressure management: a systematic review and meta-analysis to optimize benefit. Hypertens Res 39:88–94

    Article  Google Scholar 

  • Su K (2015) Effects of spring immersiom on blood glucose and blood pressure in type 2 diabetic patients combined with hypertension. The 9th Beijing International Forum on Rehabilitation (in Chinese)

  • Kuliński W (2015) Hydrobalneological methods in modern medical treatment. Med Stud 1:1–5

    Article  Google Scholar 

  • Lewington S, Clarke R, Qizilbash N et al (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360:1903–1913

    Article  Google Scholar 

  • Li Y, Jin J (2014) Effect of natural convalescent factors on blood pressure in patients with hypertension in Kunming hot spring area. ChinJ Convalescent Med 23(2):120–121 (in Chinese)

    Google Scholar 

  • Li D, Zhang W, Men HY et al (2013) Specialized convalescent measures--Taijiquan combined with mineral spring bath for rehabilitation of hypertensive convalescents. Chin J Convalescent Medicine 22(4):321–322 (in Chinese)

  • Liu MJ, Hu DY (2009) Effect of exercises combined with mineral bath on blood pressure and blood fat in patients with primary hypertension. Chin J Convalescent Med 18(9):774–776 (in Chinese)

  • Liu HZ, Zhang W, Liu HH (2017) Effect of Xingcheng hot spring bath on blood pressure control and improvement of clinical symptoms in middle-aged hypertensive patients. Chinese Journal of Convalescent Medicine 26(4) (in Chinese)

  • Luo HY (2017) Nursing effect observation of comprehensive nursing applied to radon spring hydrotherapy combined with drug treatment for hypertension. Journal of Clinic Nursing’s Practicality 2(40) (in Chinese)

  • Manzur F, Rico A, Romero JD, Rodriguez-Martinez CE (2018) Efficacy and safety of valsartan or chlorthalidone vs. combined valsartan and chlorthalidone in patients with mild to moderate hypertension: the VACLOR study. Clin Med Insights Cardiol 12:1179546818796482. https://doi.org/10.1177/1179546818796482

    Article  Google Scholar 

  • Miller T (2015) Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386: 2287–2323

  • Naumann J, Bureau N, Schmidt S, Sadaghiani C, Huber R (2015) A single center three-arm parallel-group, randomized controlled study to evaluate antihypertensive effects of frequent immersion in thermoneutral water. Int J Cardiol 188:73–75

    Article  Google Scholar 

  • Naumann J, Sadaghiani C, Bureau N, Schmidt S, Huber R (2016) Outcomes from a three-arm randomized controlled trial of frequent immersion in thermoneutral water on cardiovascular risk factors. BMC Complement Altern Med 16(1):250

    Article  Google Scholar 

  • Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM (2003) Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 42:878–884

    Article  CAS  Google Scholar 

  • Nishimura M, Onodera S (2000) Effects of supine floating on heart rate, blood pressure and cardiac autonomic nervous system activity. J Gravit Physiol A J Int Soc Gravit Physiology 7(2):P171

    CAS  Google Scholar 

  • Peng GX (1994) Observation on curative effect of mineral spring bath combined with compound hypotensive tablets in treating 43 cases of hypertension. J Convalescence and Rehabilitation 1:27–28 (in Chinese)

  • Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S, White IR, Caulfield MJ, Deanfield JE, Smeeth L, Williams B, Hingorani A, Hemingway H (2014) Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet 383:1899–1911

    Article  Google Scholar 

  • Resch KL, Just U (1994) Possibilities and limits of CO2 balneotherapy. Wiener medizinische Wochenschrift 144(3):45–50

  • Roerecke M, Kaczorowski J, Tobe SW, Gmel G, Hasan OSM, Rehm J (2017) The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis. Lancet Public Health 2:e108–e120

    Article  Google Scholar 

  • Rühle PF, Klein G, Rung T et al (2018) Impact of radon and combinatory radon/carbon dioxide spa on pain and hypertension: results from the explorative RAD-ON01 study. Mod Rheumatol 29(1):1–22

    Google Scholar 

  • Sik Park K, Kyu Choi J, Saeng Park Y (1999) Cardiovascular regulation during water immersion. APPL HUM SCI J Physiol Anthropol 18(6):233–241

    Article  Google Scholar 

  • Smith D (1998) Cardiac effects of water immersion in healthy volunteers. Echocardiography 15:35–42

    Article  Google Scholar 

  • Stadeager C, Johansen LB, Warberg J, Christensen NJ, Foldager N, Bie P, Norsk P (1992) Circulation, kidney function, and volume-regulating hormones during prolonged water immersion in humans. J Appl Physiol 73(2):530–538

    Article  CAS  Google Scholar 

  • Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith Jr SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams Sr KA, Williamson JD, Wright Jr JT (2017) ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol pii: S0735-1097(17)41519-1, https://doi.org/10.1016/j.jacc.2017.11.006, 71, e127, e248

  • Yamaoka K, Mitsunobu F, Hanamoto K et al (2004) Biochemical comparison between radon effects and thermal effects on humans in radon hot spring therapy. J Radiat Res 45(1):83–88

    Article  CAS  Google Scholar 

  • Yang LY (1997) Observation on curative effect of radon spring bath on hypertension. Chin J Convalescent Med (1):79–80 (in Chinese)

  • Zhang ZA (2016) Observation of curative effect of comprehensive physiotherapy on patients with essential hypertension. Women’s Health Res 13:80、82 (in Chinese)

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Authors and Affiliations

  1. School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing, 400016, China

    Dan Yuan, Zhao-xia Yu & Yu Chen

  2. People’s Hospital of Nanan District, Chongqing, China

    Wen Wang

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  1. Dan Yuan
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  2. Zhao-xia Yu
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  3. Wen Wang
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  4. Yu Chen
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Correspondence to Yu Chen.

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Yuan, D., Yu, Zx., Wang, W. et al. Head-out immersion in natural thermal mineral water for the management of hypertension: a review of randomized controlled trials. Int J Biometeorol 63, 1707–1718 (2019). https://doi.org/10.1007/s00484-019-01780-4

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  • DOI: https://doi.org/10.1007/s00484-019-01780-4

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