Sauna Use as a Novel Management Approach for Cardiovascular Health and Peripheral Arterial Disease

Sergio Sastriques-Dunlop ¹ Santiago Elizondo Benedetto ² Mohamed Adel Zayed ^2*

• ¹ Eastern Virginia Medical School, Norfolk, Virginia, United States
• ² Washington University in St. Louis, St. Louis, Missouri, United States

Heat therapy (HT), particularly in the form of whole-body sauna bathing, has emerged as a promising intervention for the management of cardiovascular disease (CVD). Passive HT can induce both local and systemic physiological responses, primarily through repeated thermal stress consisting of shortterm passive exposure to high temperatures. Such responses closely parallel the physiological adaptations observed during aerobic exercise. Peripheral arterial disease (PAD) poses significant health challenges, impacting millions of individuals worldwide. Supervised exercise is considered a cornerstone therapy for PAD, yet many patients face significant health-related barriers that complicate its implementation. Recent studies have explored the potential role of HT to alleviate PAD symptoms, improve functional capacity, and reduce cardiovascular and limb events. This review offers a comprehensive analysis of the literature exploring the therapeutic implications of various HT practices beyond sauna. We evaluate the potential use of these practices as adjunctive management strategies, in addition to or as alternatives to exercise, for cardiovascular diseases, particularly in patients with PAD. Furthermore, we highlight the potential benefits, underlying mechanisms of action, challenges, and safety considerations associated with these therapies.