Hot tub and Sauna Safety for Heart Conditions

This is a common question asked by people who have recently undergone a heart issue. It was always a tough one, as some people can and some people shouldn’t. There are a number of concerns for heart patients including elevated heart rates, dehydration, electrolyte depletion, blood pressure issues to be aware of. I have provided you with some education of the benefits and risk. If in doubt of course ask your health care practitioner.

 Vasodilatation –

Benefits: Both steam rooms and dry saunas cause the blood vessels in the skin to dilate, in part accounting for the warm glow appearance afterwards. The blood flow out of the heart increases by 2 or more times after a 10 to 15 minute steam room or sauna exposure.

Risks: However, the blood flow to the internal organs actually decreases, because so much blood is being directed to the skin instead. This can be a problem for those with coronary heart disease. If the heart has to decide where to pump the blood it sends it to the skin to cool the body, and for those with severe blockages the heart then cannot feed itself it’s own oxygenated blood, and then can give symptoms of angina.

People with hard-to-control hypertension (high blood pressure) may experience worsening blood pressure in response to heat exposure. In addition, many blood pressure medications interfere with the normal response of the body to heat exposure.

 Analgesia –
Benefits: Heat has long been recognized as beneficial for folks with fibromyalgia, arthritis and other painful conditions.

Risks: If heat exposure is extreme, excessively prolonged, or if the individual has underlying irritation of the skin, heat can cause the equivalent of a sunburn, or thermal burn. In addition, steam exposure may be a concern if you have had recent surgery (particularly if sutures are still in place) or if you have an open or infected wound. Do not go in a steam room or sauna if you have open wounds.

Diaphoresis (sweating)
Benefits:  The average person will sweat about a pint during a 15 minute session in a sauna, depending on the person’s acclimatization to heat exposure. This has theoretical benefits for cleansing skin pores and some people believe sweating helps clear toxins from the body. This is not well proven and in many instances, is simply not true. In general, people with documented toxicant accumulation in their bodies benefit from specific medical treatment directed at the specific toxicants, rather than sweating. In addition, many of the toxicants of concern these days, for example: pesticides and many metals, asbestos, are not cleared very well through the sweat.

Risks:  The effect of both wet and dry heat to increase fluid loss from the body can also be a problem, particularly if you are already somewhat dehydrated (e.g. after heavy exercise with inadequate fluid replacement or in response to the diuretic effects of caffeine, beverage alcohol, and medications (diuretics). Too much fluid loss can lead to electrolyte imbalance, heart arrhythmias, blood pressure changes, heart rate range changes, light headedness, and fainting.

Dehydration can be a problem in people who have blood vessel blockages to the brain and the heart  The body lacks enough water to fill he blood vessels. Low fluid volume means lower blood pressure. A dehydrated person feels weak and dizzy especially when standing.

Some individuals experience an increase in their migraine headaches in response to dehydration.
There are a number of other medications that can affect the body’s normal response to heat either by inhibiting sweating or by otherwise interfering with the normal physiology, for example, some medications used for psychiatric conditions like schizophrenia. Use of stimulant medications for conditions like ADD or excessive sleeping also increases the health risks from heat exposure.

Dehydration also is dangerous on the kidneys, they will decrease the output of urine and low blood pressure with dehydration can damage the kidneys.

 Calorie Burn:
Benefits: Although exposure to heat increases energy consumption and thereby increases calorie burn, for example, up to 300 to 400 Kcal during a 20 to 30 minute sauna bath, thus helping to promote weight loss, there are clearly more healthful alternatives available, i.e. EXERCISE .

Risks:  Individuals who have been cautioned to restrict exercise intensity by health care providers should be aware that the effects of heat are similar to those of exercise for increasing heart rate. Increasing energy consumption through increased work of the heart can be a concern for people with coronary heart disease, congestive heart failure, valvular heart disease or heart rhythm problems (arrhythmias).


1- Avoid beverage alcohol and excessive caffeine intake and medications that may impair sweating or increase the health risks from heat exposure.

2- Stay in no more than 15 to 20 minutes at a time.

3- Cool down gradually after use. Avoid going rapidly from a hot to a cold environment, e.g. sauna cold shower as this increases the physiologic stress on the body considerably.

4- Drink 2 to 4 glasses of cool water after each session.

5- Don’t take a sauna or steam bath if you are ill, and if you find yourself feeling unwell while in a steam room or sauna, head for the door.

6- Ask your health care provider for advice and recommendations, if you have any concerns about potential health risks from steam room or sauna use.

STEAM ROOMS AND SAUNAS, Doug Linz MD, Medical Director, TriHealth

 If you take a blood thinner (such as Plavix) or blood pressure meds, the heat of a hot tub can combine with the medications to cause you to become dizzy, nauseated or even faint.

When you go in a hot tub, the heated water causes your blood vessels to dilate. In turn, blood pressure drops. If it falls too low, you can pass out.

It may be okay for short periods.

If you are able to carry out moderate exercise without symptoms such as chest pain or shortness of breath, you should be able to tolerate a sauna or soak in the hot tub.

When you get into cold water blood vessels constrict. Any sudden change in temperature leads to a considerable increase in the heart’s workload so moving back and forth between cold water baths and saunas or hot tubs is not a good idea.

Check with your doctor or health clinic to be on the safe side.

18 thoughts on “Hot tub and Sauna Safety for Heart Conditions

  1. In some countries…(not USA) recommend sauna for people with kidney disease. Sometimes when the kidneys aren’t functioning 100% the sauna creates a way for people to get rid of toxins though the sweat, instead of depending on the kidneys only. Interesting.

    • Generally pacemakers themselves are not a contraindication to go in the tub. If in doubt give your doctor a call.

  2. I am on Plavix and have 7 stents in femoral arteries in both legs as well as 3 stents in iliac artery. The iliac has 3 as 1 became blocked after a year and had 2 more placed to go around the blocked one. I am celebrating my 26th anniversary and wife want to get a room with a jacuzzi or a room in a place with a heated pool. Can anyone tell me if I need to be concerned or if I would be safe in accommodating her wishes.I would kind of like to be around for #…any comments or suggestions would be greatly appreciated Thanks

    • Plavix and stents in the legs should not be a contra indication for hot tub use.As long as there are no open wounds. For heart patients the concern is more related to blood pooling and making you prone to passing out, this occurs with blood pressure medication mostly.

      Congratulation on your anniversary, go out there and have fun.

      Question for you though…do you walk daily…that is imperative for anyone with peripheral artery disease. It doesn’t matter how many you have to stop, just try for 60 minutes of accumulated walking each day.

    • Thank you for your congratulations and yes I am on my feet for at least 8 hours a day as I am the retail parts manager for a local auto parts store. I am also on blood pressure meds.. I am on Plavix, Diltiazem, Aspirin, Dexilant, and Alprazolam.

    • Ah on your feet not the am as walking…doen’t require the same blood flow requirements necessary to grow collateral vessels, and to increase the ability of the leg muscle to efficiently use and return blood….another discussion though….regarding the blood pressure med’s if in any doubt contact your MD or quicker go through the physician assistant or nurse care practitioner…your primary care would be the best one to address the question to.

    • Okay let me re phrase I am on ,my feet probably walk a few miles a day easily throughout the day and occasionally have to walk 8 miles home. Thank you so very much for you quick response to all of my questions. I have you bookmarked, in my favorites,and am extremely happy that I found this site.Thanks again and have a great day 🙂

  3. I hope you can help, advise me. I am taking medication for high blood pressure. I am taking a 2.5mg tablet of Cipla-Indapamide in the morning for water retention and 1/2 of a 5mg tablet of Amloc in the evening, and a 5mg of Urbanol a day for anxiety. I have been taking these tablets now for about 8 months. I decided this weekend, I wanted to get back into using my spa bath. The first session, I was in there for about an hour and after coming out, I found I had shortness of breath and it took me some time to recover. This morning, I again, went into the spa bath, but this time, I only went in there for about 15 minutes and I still had shortness of breath, (But, the recovery time was much quicker) But, I don’t understand why this is happening to me. Last year in May 2012 I had a fall, which resulted in torn ligament/tissue damage around the knee, my leg was very stiff for quiet some time and mobility in that leg, and bending of the knee was limited and I had to use crutches for sometime. Prior to this happening, my health was fairly good, I was doing an hours gym each day, without even getting out of breath. Today, 9 months my leg is much better, but not 100% My leg and movement is not as the same as the other one. Also, just to mention, on Saturday, I had a lot of dead skin coming of me, around the top of the chest area and the back of the neck and across the shoulders.

    • I wish I could be more helpful to you but you really need to see your physician. Shortness of breath can be a warning signs of something serious, and there are many different causes of shortness of breath. These symptoms should not be ignored. It would be best for you to contact your health care provider and get a check up and when you schedule make sure you inform them you are coming in due to symptoms of shortness of breath to promptly get an appointment.

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