Formerly known as diastolic heart failure, HFpEF affects a growing number of Americans every year. Nearly half of all individuals with heart failure have HFpEF. Historically, there has been clinically significant evidence demonstrating that the use of a sauna on a regular basis improves the lives of those living with chronic heart failure. Until recently there have been no studies that specifically examined how sauna use affected the health of those living with HFpEF. With a new peer reviewed publication on this very subject released in March of 2026, much more is known about the subject.
Patients of HFpEF will often find exercise to be prohibitive for a variety of reasons. They may suffer from several negative downstream effects from a more sedentary lifestyle including abnormalities to the muscular skeletal structure, lowered immunity, and chronic fatigue. During the 10 week trial period, researchers found that the use of sauna for patients with HFpEF was so positively robust for cardiovascular health that the participants showed many of the same biological results as they would from a similar period of aerobic exercise. This means that the use of a sauna may be an effective means for HFpEF patients to benefit from the positive effects from exercise without actively moving their bodies.
It is difficult to live with heart failure of any kind, but it appears that the relatively simple activity of sauna bathing may promote health for these patients in unprecedented ways. Find out more about the details of this prominent and new research, including the methods used to measure the effectiveness of sauna bathing for HFpEF patients, and more conclusive results from the study.
Furthermore, given the primary contingency of sauna bathing, namely that it must be continued as a daily or twice weekly activity throughout a lifetime, find out how you can personally use a sauna to mimic the study to protect your heart, or to sauna safely if you do live with chronic heart failure.
If you have been diagnosed with HFpEF, then please consult with your physician before beginning a sauna program.
What is HFpEF?
- Definitions of terms
- Statistics
- Risk Factors
- Treatments
Roughly half of all people living with heart failure have HFpEF, formerly known as diastolic heart failure. The HF in this acronym stands for Heart Failure and the following pEF refers to preserved ejection fraction of the lower left ventricle. This condition is growing globally and about 3 million Americans are living with HFpEF, and about 30 million individuals worldwide. (1)
Since 50% of patients living with heart failure also have HFpEF, or diastolic heart failure, it is worth understanding what sets this particular condition apart from other forms of heart failure. It is very simply put that the left ventricle may spontaneously fill up with blood without the ability to release it, so in short this part of the heart may, without warning, experience flooding or extreme pressure. HFpEF is more aptly and precisely described by the Mayo Clinic’s authors of this paper entitled ‘Heart failure with preserved ejection fraction (HFpEF): More than diastolic dysfunction’ (2) when they write this.
“Heart failure with preserved ejection fraction (HFpEF), previously known as diastolic heart failure, is currently defined as a left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressures; HFpEF comprises at least 50% of all heart failure diagnoses.” (2)
The same article goes on to describe who this condition affects most commonly and how it is of increasing concern for global health.
“Nearly half of all patients with heart failure have a normal ejection fraction (EF). The prevalence of this syndrome, termed heart failure with preserved ejection fraction (HFpEF), continues to increase in the developed world, likely because of the increasing prevalence of common risk factors, including older age, female sex, hypertension, metabolic syndrome, renal dysfunction and obesity.” (2)
Primary risk factors for developing HFpEF include hypertension, older age, diabetes, obesity, and dyslipidemia. (1) While no one would want to experience diastolic heart failure, there are some treatment modalities available to improve the over quality of life as well as length of life for those individuals who have received this diagnosis.
According to a publication by the National Library of Medicine entitled ‘Heart Failure With Preserved Ejection Fraction (HFpEF)’ there are a variety of treatments available for patients living with HFpEF.
“…therapeutic interventions are available to reduce symptoms, improve functional status and quality of life, and reduce hospital admission rates.Clinical understanding of HFpEF continues to evolve, and clinical trials to improve outcomes for patients with HFpEF are ongoing.” (3)
Among the continuing research and clinical trials under way to improve the quality of life for individuals living with HFpEF is the study on sauna bathing as a treatment for these patients. It may seem counter intuitive to put someone with a very specific type of heart failure into a sauna, but research published in March of 2026 suggests that sauna bathing may be a promising treatment for those living with HFpEF. Find out more of the details from this study, and how it may benefit those living with diastolic heart failure.
The Study Details on HFpEE Patients Engaged in Sauna Bathing: Saunas Under The Microscope
Studies on the clinical use of saunas continue to evolve to become increasingly inclusive of a variety of acute and chronic conditions. Included in this is the study of sauna bathing on heart failure. There is significant clinical evidence to suggest that sauna bathing regularly does improve heart conditions as well as the quality of life for its patients. Until the year 2026 there has never been a study that specifically examined the effects of sauna use on patients living with HFpEF.
The researchers and authors of a study published by Oxford Academic in the European Journal of of Heart Failure entitled ‘Effects of sauna bathing on exercise capacity and muscle function in HFpEF (SAUNA-HFpEF): A mechanistic, prospective, translational, single-arm, and single-centre pilot study’ (4) are very excited about the promising potential use of saunas for individuals living with HFpEF.
The authors describe this novel study in general terms here.
“SAUNA-HFpEF is the first prospective mechanistic, translational pilot study investigating feasibility, safety, and efficacy of supervised sauna bathing in stable HFpEF outpatients.” (4)
Among many health concerns is the fact that those living with HF-pEF experience considerable fatigue and exercise intolerance which can exacerbate health concerns. Due to lack of mobility, skeletal and muscular abnormalities may occur. The researchers hoped that the use of a sauna would help to ameliorate some of these health concerns for patients living with HFpEF.
Aims and Objectives:
Due to the fact that previous studies on patients living with heart failure and engaged in sauna therapy were so effective, the researchers studying sauna bathing and HFpEF hoped that the results would be similarly positive.
“Intermittent hyperthermia, such as sauna bathing, may represent a practical alternative to exercise training. Moderate sauna exposure induces physiological responses comparable to moderate-intensity exercise.Previous studies have demonstrated safety and improvements in endothelial function, left ventricular function, and exercise capacity in patients with coronary heart disease and HFrEF. Patients with HFpEF are known to exhibit reduced exercise capacity, impaired skeletal muscle function, and elevated atrophy-related gene expression.We therefore hypothesized that regular sauna bathing could mitigate these alterations.” (4)
The researchers hoped that sauna bathing could be a treatment used to preserve mobility, the ability to exercise, and the integrity of the muscular-skeletal system.
“Fatigue and exercise intolerance are the predominant symptoms in this population..Skeletal muscle abnormalities are recognized as key peripheral contributors to exercise limitation in both HFrEF and HFpEF” (4)
It was particularly important for the researchers to resolve this issue for those living with HFpEF since treatment options to improve exercise ability are very limited for this demographic.
“Treatment options to improve exercise capacity in heart failure with preserved ejection fraction (HFpEF) are limited.” (4)
The researchers’ final stated hypothesis in engaging this research was stated by the authors here.
“We hypothesized that sauna bathing enhances exercise performance, skeletal muscle function, body composition, and quality of life (QoL) in HFpEF. However, benefits may decline after discontinuation.” (4)
What follows is a basic breakdown of the participants engaged in the research, as well as the style of saunas used and exactly how the saunas were used.
Research Methods:
- Traditional Finnish saunas
- 10 Weeks of twice weekly sauna use
- Temperature was set to 140 degrees Fahrenheit, or 60 degrees Celsius
- Sauna sessions lasted between 8 to 15 minutes progressively
In this study patients diagnosed with HFpEF voluntarily chose to participate in the study. They were all out-patients and were living stably with their diagnosis. A total of 18 participants all aged 50 years or older engaged in the 10 week long study. Traditional Finnish saunas were used for the study and the temperature of the sauna was set to a steady 140 degrees Fahrenheit.
“Participants completed 10 weeks of sauna sessions (60°C, twice weekly), with duration progressively increased from 8 to 15 min.” (4)
The participants of the study were monitored carefully before, during, and after the study using these methodologies.
“Blood pressure and heart rate were monitored three times per session. Assessments were performed at baseline, end-of-study (after 10 weeks intervention), and 3 months after sauna withdrawal (follow-up), including echocardiography, cardiopulmonary exercise testing, 6-min walk test (6MWT), quadriceps strength testing, QoL questionnaires [SF-36, Hospital Anxiety and Depression Scale (HADS), EQ-5D], laboratory testing, and body composition.” (4)
The conclusion from this study was very promising for HFpEF patients in many more areas of health than initially hoped for by the researchers.
Conclusions and Results
- Improved VO2 max
- Reduction in body fat
- Increased anaerobic threshold
- Lowered blood pressure
- Increase in heat shock protein 90
The researchers found that key elements of health were improved through the use of saunas for patients living with HFpEF, furthermore with the use of a subjective questionnaire the participants also reported an improved quality of life with a significant reduction in anxiety.
Overall the researchers found that sauna bathing was both safe, but moreover effective in improving the health of those living with HFpEF.
“Sauna bathing was safe, feasible, and improved exercise capacity, body composition, muscle function, and QoL in HFpEF. Benefits diminished after withdrawal.” (4)
The study did demonstrate that sauna use must continue on a regular basis in order to have positive effects on the body. This means that sauna bathing as a treatment for HFpEF must be ongoing as a lifestyle change for the benefits to continue.
Other relevant results for health included, but were not limited to what the authors write here.
“Clinically relevant improvements were observed in exercise capacity, including peak VO2, anaerobic threshold, 6-MWT distance, and quadriceps peak torque. These findings are particularly relevant in HFpEF, where exercise intolerance and skeletal muscle dysfunction are central features.” (4)
Additionally, saunas were shown to reduce blood pressure (BP) in clinically significant ways for those living with HFpEF:
“Sauna exposure induced an acute increase in heart rate and a reduction in blood pressure after each session, resembling physiological responses to endurance exercise.The observed BP reduction is consistent with heat-induced vasodilation,potentially supported by improvements in arterial stiffness.” (4)
Finally, the presence of heat shock protein 90 increased after sauna sessions to improve vasodilation.
“Heat shock protein 90 (HSP90), which promotes cutaneous vasodilatation via nitric oxide synthase activation” (4)
The multitude of health benefits derived from a simple 10 week course of sauna bathing treatment is undeniable. For those living with heart failure of any kind this heralds good news. So, how can these patients continue to benefit from sauna bathing outside of the clinical setting for research, and furthermore, how can the population at large who may not be living with chronic heart failure benefit from sauna bathing.
Sauna Bathing as a Medicinal Treatment Must be Ongoing- Both For Patients of HFpEF as Well as For the Population at Large
There is overwhelmingly positive evidence that points to the benefits of using a sauna therapeutically to improve cardiovascular function, lower blood pressure, improve body composition, and so much more. The only downside of this is that saunas must be used on a continuous basis to produce long term results. This is similar to exercise, quality sleep, and nutrition. There are some treatments that must be a question of a complete lifestyle adjustment, meaning a part of your daily or weekly habits, and sauna use falls squarely into this category.
Yes, patients living with HFpEF will benefit tremendously from regular sauna bathing, but there are some precautions to follow as the study examined here was the first of its kind. First, HFpEF conditions must be stable, and it is important to work hand in hand with a medical doctor to ensure that sauna use is safe for you specifically. Furthermore, it is important to have a sauna chaperone in case you need additional help. Also, the patients in the study examined above slowly built up their sauna tolerance, beginning with only 8 minutes in the sauna before extending to 15 minutes. The temperature of a Traditional Finnish sauna was set to only 140 degrees Fahrenheit, which is quite low for this style of sauna. This suggests that when using a sauna for heart failure conditions the temperature should not surpass this range. Please keep the temperature much lower than what is normally recommended for a traditional sauna. Above all else please consult with your doctor before beginning a sauna protocol if you have been diagnosed with HFpEF.
For everyone else who may not be living with chronic heart failure of any kind, the results from this study may be just enough to encourage you to begin your sauna protocol. Saunas are a safe and relatively accessible way to dramatically improve nearly all aspects of health, as long as you can commit to using a sauna regularly.
Finally, for anyone engaged in sauna treatments, it is critical to maintain high levels of hydration at all times. This means including plenty of fluid rich foods in your diet, consuming healthy drinking water, as well as fluids that include electrolytes and plenty of minerals such as magnesium.
Citations:
- https://mayoclinic.elsevierpure.com/en/publications/heart-failure-with-preserved-ejection-fraction-a-review/
- https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/heart-failure-with-preserved-ejection-fraction-hfpef-more-than-diastolic-dysfunction/mac-20430055
- https://www.ncbi.nlm.nih.gov/books/NBK599960/
- Effects of sauna bathing on exercise capacity and muscle function in HFpEF (SAUNA-HFpEF): A mechanistic, prospective, translational, single-arm, and single-centre pilot study https://academic.oup.com/eurjhf/advance-article/doi/10.1093/ejhf/xuag082/8524194
- https://academic.oup.com/eurjhf/advance-article-abstract/doi/10.1093/ejhf/xuag093/8544840