Blood pressure, pulse rate, and skin temperature during hot-water bathing in real-world settings among community-dwelling older adults: the HEIJO-KYO Study
- PMID: 38447972
- PMCID: PMC10937243
- DOI: 10.1265/ehpm.23-00320
Blood pressure, pulse rate, and skin temperature during hot-water bathing in real-world settings among community-dwelling older adults: the HEIJO-KYO Study
Abstract
Background: Home hot-tub bathing substantially increases drowning mortality rates among older adults in Japan. Previous laboratory studies on hemodynamic responses during hot-tub bathing have been inconsistent depending on the thermal conditions. Furthermore, real-world hemodynamic changes that occur during bathing remain poorly understood. This study investigated the association between individual thermal states and hemodynamic parameters during hot-tub bathing among community-dwelling older adults.
Methods: In this cross-sectional study conducted between January 2016 and April 2019, which involved 1,479 older adults (median [range] age, 68 [40-90] years), skin temperature on the abdominal surface was measured every minute. Ambulatory blood pressure and pulse rate were recorded at 15-min intervals for 24 h. Participants underwent simultaneous living room temperature measurements in their homes, and the time and methods of bathing were recorded. Associations between skin temperature and hemodynamic parameters during bathing and between the pre-bath living room temperature and in-bath maximum proximal skin temperature were evaluated using mixed-effects and linear regression models, respectively.
Results: A 1 °C increase in skin temperature was significantly associated with a 2.41 mmHg (95% confidence interval [CI]: 2.03-2.79) increase in systolic blood pressure and a 2.99 bpm (95% CI: 2.66-3.32) increase in pulse rate, after adjusting for potential confounders, including age, sex, body mass index, antihypertensive medication use, dyslipidemia, diabetes, and living room and outdoor temperatures. Significant interactions were not observed between sex and skin temperature in relation to systolic blood pressure and pulse rate (P = 0.088 and 0.490, respectively). One standard deviation lower living room temperature before bathing was significantly associated with a 0.41 °C (95% CI: 0.35-0.47) higher maximum skin temperature during bathing.
Conclusions: Our findings suggest that pre-bath cold exposure may increase the skin temperature during hot-tub bathing, possibly resulting in excessive hemodynamic changes. This provides a framework for future interventions that utilize pre-bath thermal conditions and bathing environments to prevent bath-related deaths.
Keywords: Blood pressure; Cardiovascular diseases; Consciousness; Drowning; Heart rate; Immersion; Syncope; Temperature; Water.
Conflict of interest statement
KS and KO received research grants from YKK AP Inc., Ushio Inc., Tokyo Electric Power Company, EnviroLife Research Institute Co., Ltd., Sekisui Chemical Co., Ltd., LIXIL Corp., KYOCERA Corp, ENDO Lighting Corp., and KANEKA Corp. The other authors report no conflicts of interest.
Figures
Similar articles
-
Effect of water bath temperature on physiological parameters and subjective sensation in older people.Geriatr Gerontol Int. 2017 Nov;17(11):2164-2170. doi: 10.1111/ggi.13053. Epub 2017 Apr 19. Geriatr Gerontol Int. 2017. PMID: 28421715
-
Association Between Passive Body Heating by Hot Water Bathing Before Bedtime and Depressive Symptoms Among Community-Dwelling Older Adults.Am J Geriatr Psychiatry. 2022 Feb;30(2):161-170. doi: 10.1016/j.jagp.2021.06.010. Epub 2021 Jun 24. Am J Geriatr Psychiatry. 2022. PMID: 34275727
-
Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults.J Clin Sleep Med. 2021 Jun 1;17(6):1257-1266. doi: 10.5664/jcsm.9180. J Clin Sleep Med. 2021. PMID: 33645499 Free PMC article.
-
A review of Japanese-style bathing: its demerits and merits.J Physiol Anthropol. 2022 Feb 15;41(1):5. doi: 10.1186/s40101-022-00278-0. J Physiol Anthropol. 2022. PMID: 35168673 Free PMC article. Review.
-
Unveiling Lethal Risks Lurking in Hot Tub Baths: A Review of Tragic Consequences.Cureus. 2024 Feb 14;16(2):e54198. doi: 10.7759/cureus.54198. eCollection 2024 Feb. Cureus. 2024. PMID: 38496149 Free PMC article. Review.
References
-
- Tai Y, Saeki K, Yamagami Y, Yoshimoto K, Kurumatani N, Nishio K, et al.. Association between timing of hot water bathing before bedtime and night-/sleep-time blood pressure and dipping in the elderly: a longitudinal analysis for repeated measurements in home settings. Chronobiol Int. 2019;36:1714–22. doi: 10.1080/07420528.2019.1675685. - DOI - PubMed
-
- Tokyo Gas, Urban Life Report. The state of modern bathing in 2020. https://www.toshiken.com/report/hot48.html#gsc.tab=0. Accessed Dec 16, 2023.
-
- Tai Y, Obayashi K, Yamagami Y, Yoshimoto K, Kurumatani N, Nishio K, et al.. Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults. J Clin Sleep Med. 2021;17:1257–66. doi: 10.5664/jcsm.9180. - DOI - PMC - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous