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Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

Headline - Sauna Use Decreases Heart Attacks

Part of the job of any primary care doctor is staying up to date on the latest medical research. There are numerous medical journals each publishing a range of research topics every week. Article topics can be very specific, technical, and dare I say - boring. When an article comes across my desk that is not only useful but FUN that is a good day.

So it is with this article published in the British journal, BMC Medicine. The study came out last year but is certainly still applicable. Researchers looked at a cohort of 1,688 middle aged men and women in Finland and analyzed how often they used a sauna and the risk of dying from heart disease. What they found is that people who used a sauna more often were less likely to have a fatal heart attack. The amazing part of the study is that the effects were so significant. Using the sauna 2 or more times per week led to a 77% reduction in fatal heart attacks. That effect is far better than any drug on the market!

A real strength of the study was that it followed individuals for 15 year, which by medical study standards is quite a long time. Another key point of the study is that there were different “doses” of sauna exposure. To really show that sauna use is helpful you would like to see more use resulting in better outcomes - which this study does show. Finally the study did not have any conflicts of interest. It was funded by The Finnish Foundation for Cardiovascular Research. If it was funded by a sauna manufacturer I would be much more skeptical of the results.

A good scientist should always be skeptical of new information. Can we really trust this data? Overall I think this is a good study; however, there are a few areas I question. First, they only studied Finnish people. I wonder if this is broadly generalizable to the rest of the world? Could there be something special in Finnish genetics or body makeup that makes sauna especially healthy for them? Second, there was no placebo group. Who’s to say it wasn’t simply the relaxation in a social setting - not the sauna itself - that protected against heart attacks. Lastly, someone who has 6 hours per week to spend in a sauna likely has a pretty good life to begin with; eats good food, exercises, and is less stressed. The study did attempt to account for this by statistically tracking socioeconomic status (individual income), and physical activity levels. Even with those taken into account the protective effect of sauna were still present.

The real utility of this article (really any science for that matter) is if it can help people live better. We need to analyze new information in the context of ideas that we already hold to be true. Here are my take away points from this article:

  1. Self care activities aimed at relaxation, including activities like sauna, help us live longer and better lives

  2. Medication is not the only answer protecting people from disease

  3. There is evidence that sweating it out in a sauna 2 or more times per week could reduce the risk of heart attack by 77%

So whether its a hot cup of tea, snuggling up in your favorite blanket, or jumping into a hot sauna take some time to treat yourself this winter. The health benefits could be more than you know.

citation:

Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study. BMC Med. 2018 Nov 29;16(1):219.

Oren Gersten, MDsauna, self care, primary care, winter, dpc, heart disease