Mayo Clinic Proceedings Home

Cardiovascular Responses in a Whirlpool Bath at 40°C Versus User-Controlled Water Temperatures


      To compare cardiovascular responses in a whirlpool bath at 40°C versus user-controlled water temperature (UCT).

      Material and Methods

      In an experimental study, six healthy men, 36 to 43 years of age, participated in two randomly assigned trials of whirlpool bath use for 25 minutes at 40°C and UCT. Water temperature, esophageal temperature (Tes), heart rate (HR), systolic blood pressure (SBP), and perceived comfort were monitored before immersion and at 5-minute intervals during immersion.


      Although the mean water temperature during the UCT trial was slightly below 40°C (39.4 ± 2.0°C), it varied considerably among subjects (from 36.5 ± 2.1°C to 42.5 ± 1.7°C). Peak Tes, HR, and SBP were not significantly different between the two trials, although the UCT trial had greater variability. No adverse effects were observed. Mild or moderate overheating was reported by four subjects in the 40°C trial and two subjects in the UCT trial, and mild chest pain, light-headedness, dyspnea, and nausea were reported by one subject during the UCT trial. A trend toward higher comfort ratings was noted in the UCT than in the 40°C trial, especially during the final 10 minutes of immersion.


      These data show that cardiovascular responses to whirlpool bathing for 25 minutes at 40°C are mild. In comparison with the 40°C trial, peak Tes HR, and SBP under UCT conditions were not, on the average, significantly higher, although more variability existed among the subjects.
      UCT (user-controlled water temperature)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brown V
        Spa Associated Hazards: An Update and Summary. US Consumer Product Safety Commission, Wash ington (DC)1981
        • Allison TG
        • Miller TD
        • Squires RW
        • Gau GT
        Cardiovascular responses to immersion in a hot tub in comparison with exercise in male subjects with coronary artery disease.
        Mayo Clin Proc. 1993; 68: 19-25
        • Allison TG
        • Reger WE
        Thermoregulatory, cardiovascular, and psychophysical response to alcohol in men in 40°C water.
        J Appl Physiol. 1992; 72: 2099-2107
        • Versteegh PMR
        • van den Hoogen RHWM
        • Zwaveling A
        Systemic hyperthermia by the immersion bath method.
        Neth J Surg. 1981; 33: 195-199
        • Falthfull NS
        • Relnhold HS
        • van den Berg AP
        • van Rhoon GC
        • van der Zee J
        • Wlke-Hooley JL
        Cardiovascular changes during whole body hyperthermia treatment of advanced malignancy.
        Eur J Appl Physiol. 1984; 53: 274-281
        • Rowell LB
        • Brengelmann GL
        • Blackmon JR
        • Murray JA
        Redistribution of blood flow during sustained high skin temperature in resting man.
        J Appl Physiol. 1970; 28: 415-420
        • Arborelius Jr, M
        • Balldln Ul
        • Lllja B
        • Lundgren CEG
        Hemodynamic changes in man during immersion with the head above water, aerospace.
        Med. 1972; 43: 592-598
        • Begin R
        • Epstein M
        • Sackner MA
        • Levinson R
        • Dougherty R
        • Duncan D
        Effects of water immersion to the neck on pulmonaiy circulation and tissue volume in man.
        J App I Physiol. 1976; 40: 293-299
        • Echt M
        • Lange L
        • Gauer OH
        Changes of peripheral venous tone and central transmural venous pressure during immersion in a thermoneutral bath.
        Pflugers Arch. 1974; 352: 211-217
        • US Department of Health and Human Services
        Suggested Health and Safety Guidelines for Public Spas and Hot Tubs. Centers for Disease Control, Atlanta1985 (Publication No. PHS 99-960)