For millennia humans have historically turned to a variety of heat therapy strategies to address critical health issues. As new studies pour into reputable peer reviewed journals it seems that this research only confirms what our ancestors have known for thousands of years that dose appropriate exposure to heat may cure a litany of diseases. Whether you have entry to a Native American Sweat Lodge or a traditional Finnish sauna, the source of heat does not seem as important as the fact that you have regular access to some form of passive heat therapy.
The scientific journal Frontiers published a paper in 2025 that emphasizes the critical need for many individuals to turn to a variety of forms of heat therapy to overcome cardiovascular diseases, specifically peripheral artery disease (PAD). PAD affects over 230 million individuals globally and has risen by 45% since the year 2000. This disease affects those living in wealthier countries at greater rates than those living in less industrialized nations. (1)
The good news is that this research has harvested data from several decades of studies to demonstrate that heat therapy as seen in saunas can aid tremendously in the treatment of PAD as well as other cardiovascular diseases.
The American Heart Association recommends a four pillar approach to treating PAD, the fourth aspect (exercise) of this approach can become difficult for those with limb associated dysfunction (a common effect of PAD). While sauna use cannot replace other critical aspects of treating PAD, it is extremely useful as a replacement or adjunct to exercise particularly for those who have suffered damage to the limbs.
The benefits to cardiovascular health as a result of sauna use are undeniable. In fact it is for this reason that saunas are known to reduce all cause mortality. Find out what PAD is, and how saunas can help to specifically treat and possibly prevent the progression of this disease that affects hundreds of millions of people around the world.
What is Peripheral Arterial Disease (PAD)?
Perhaps the most debilitating cardiovascular disease is peripheral arterial disease or peripheral artery disease (PAD). This artery blocking disease limits blood flood to the lower limbs of the body. The lack of blood flow to these limbs can have devastating effects on mobility. Many millions of individuals world-wide are affected by this disease, but there are ways to both treat it as well as potentially prevent its development.
The Mayo Clinic’s publication ‘Peripheral Arterial Disease’ defines this condition succinctly here.
“Peripheral arterial disease (PAD) is a major circulatory problem characterized by diminished arterial blood flow that predominantly impacts the lower extremities.” (2)
The frightening consequences of this disease will likely cause anyone to want to take immediate action to prevent its development. Unfortunately for some it is too late and they may have already lost their use of the lower extremities. Even if this is the case, the beauty of a sauna is that being mobile is not necessary in order to benefit from the biological reactions to heat.
In 2025 a groundbreaking publication emerged in Frontiers journal entitled: ‘Sauna use as a novel management approach for cardiovascular health and peripheral arterial disease’ the authors of this publication write about the primary means of treating PAD, when they write this.
“The American Heart Association/American College of Cardiology (AHA/ACC) guidelines recommend that patients with PAD receive a comprehensive program of guideline-directed medical therapy based on four pillars: statin therapy to reduce hyperlipidemia, antiplatelet therapy, smoking cessation therapy/counseling, and supervised exercise therapy programs (SEPs)” (1)
While the researchers did not seek to find alternatives to pharmacological treatments, they did look for alternatives to exercise for those who were reluctant to exercise, or who simply could not. The authors write about the fourth pillar of treatment in the form of exercise in this way.
“…there is an ongoing need for a more viable alternative or adjunctive therapy to alleviate symptoms, improve function, and reduce cardiovascular and limb events especially in individuals who are unable to regularly exercise.” (2)
For anyone who has suffered the irreversible and devastating consequences of this disease and cannot exercise, or for those who are looking for a robust way to prevent the development of PAD, please continue reading to find out how saunas can help you.
How Can Sauna Use Help to Treat and Prevent Peripheral Arterial Disease?
- Heat Shock Protein Production
- NrF2
- Increased Blood Flow to the Lower Limbs Without Exercise
- Wound Healing of Sores Caused by PAD (Infrared Sauna Only)
The heat of a sauna operates by the principles of hormesis. Which is simply to say that a measured stress, in this case heat, is placed on the body for a finite period of time. In reaction to this stress the body responds with a plethora of biological transformations that eventually develop into protective mechanisms, including repairing cellular damage.
The authors of the paper ‘Sauna use as a novel management approach for cardiovascular health and peripheral arterial disease’ define heat therapy, or sauna when they write this.
“In recent decades, heat therapy (HT) has emerged not only as a tool for relaxation, but also as a novel treatment option for various health concerns. Traditionally, repeated HT can be obtained in the form of whole-body, also known as “sauna bathing,” which has been associated with numerous health benefits.”
For the purposes of treating or preventing PAD it does not appear as important what the heat source is, but rather, that it is an immersive style of heat therapy such as a traditional Finnish sauna, an infrared sauna, or perhaps a steam room.
The goal is to elicit four primary reactions in the body: Increase heat shock proteins (HSP), improve bio availability of brain derived neurotropic factors (NrF2), increase circulation, and if using infrared saunas, the possibility of improving wound healing of the sores that can form on the lower limbs in consequence of PAD.
Heat Shock Protein Production
In response to heat therapy the body begins to produce heat shock proteins (HSPs), these tiny, but mighty protein chaperones are numerous in their variety. The authors of the research write this about the increased production of HSPs.
“On a molecular level, heat stress activates a series of mechanisms that stimulate endogenous antioxidant, repair, and degradation processes. One such mechanism is the increased expression of heat shock proteins (HSPs), a highly conserved family of proteins present in all cells.” (1)
HSPs aid in many of the body’s functions and their presence is so beneficial that it is impossible to list them all in this article. To quote the authors of our paper of interest, here are just a few relevant ways that an increase in HSP presence can help with PAD.
“HSPs also play vital roles under normal conditions, contributing to immune function, cell signaling, cell-cycle regulation, and proteostasis. By repairing damaged proteins, HSPs prevent protein disorder and aggregation, a common feature in age-related diseases. Additionally, HSPs have been found to positively influence cardiovascular function by modulating nitric oxide pathways, and mitigating chronic oxidative stress and vascular inflammation.” (1)
Regardless of what type of sauna you chose, the heat stress will elicit an increase in heat shock protein production and inevitably improve many aspects of PAD. Furthermore, saunas help to induce the secretion of specific neurotropic factors, including NrF2.
NrF2: A Regulator of Cellular Antioxidant Response
An aspect of heat therapy, often ignored, is the release of the specific nuclear factor known as NrF2 (nuclear factor erythroid 2–related factor 2). This biochemical release helps to regulate inflammation and cytoprotection antioxidants. The authors describe the vast array of curative factors of NrF2 for PAD patients here.
“Another key molecular player in the heat stress response is nuclear factor erythroid 2–related factor 2 (Nrf2), a regulator of the cellular antioxidant response. Upon activation by heat stress, Nrf2 translocates from the cytoplasm to the nucleus, orchestrating the regulation of a vast network of genes involved in cytoprotective, antioxidant, and anti-inflammatory functions. Specifically, heat-activated Nrf2 has been shown to suppress pro-inflammatory molecules involved in CVD, such as E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1, through the upregulation of HSP heme oxygenase-1.” (1)
Either directly or indirectly, this result of heat therapy helps to free the arteries that become blocked for PAD patients. In addition to helping with inflammation and oxidation of the blood stream, sauna use is known to mimic exercise and improve cardiovascular function.
Improved Cardiovascular Function
Exposure to heat stress as seen in the sauna activates the cardiovascular network to help promote blood flow through the arteries. This is why exercise is recommended for patients of PAD. The authors double down on this fact as they express this.
“Supervised exercise is considered a cornerstone therapy for PAD, yet many patients face significant health-related barriers that complicate its broad implementation…adjunctive management strategies, in addition to or as alternatives to exercise, for management of cardiovascular diseases” (1)
Cardiovascular disease is the leading cause of death. By improving cardiovascular function it is possible to reduce ‘all-cause-mortality’ which is what is found in many studies surrounding sauna use. In cases of PAD, sauna use and its incredible benefit to cardiovascular health is no different. According to the authors of the paper seeking novel treatment of PAD
“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 short-term passive exposure to high temperatures. Such responses closely parallel the physiological adaptations observed during aerobic exercise…This review highlights the potential benefits, underlying mechanisms of action, challenges, and safety considerations associated with HT. We emphasize the importance of exploring HT as a viable option for patients with cardiovascular conditions, particularly those with PAD, who face barriers to traditional exercise regimens.”
Whether or not it is physically possible to exercise, the use of a sauna by PAD patients, or those looking to prevent its development is a key pillar either in addition to exercise or as an alternative.
Wound Healing
Due to the lack of circulation moving into the lower extremities of the body, PAD patients may develop sores on the bottom of their feet or elsewhere that seemingly do not heal. If these patients are able to use an infrared sauna then it is likely that wound healing may be improved.
“In the context of PAD, primarily associative data from studies utilizing Waon therapy have shown significant decreases in pain scores and increases in 6-minute walk distance, ankle-brachial index, and blood flow as assessed by laser doppler perfusion imaging.” (1)
Waon therapy is the use of an infrared sauna at lower temperatures and capitalizes on the healing power of infrared light. The rapid wound healing is likely a result of photobiomodulation, which is a type of phototherapy that relies on near infrared light, primarily to upregulate the function of the mitochondria. (4)
If wounds are present in PAD patients it is better to consider an infrared sauna over a traditional sauna. If these sores are not present both styles of saunas appear, at this time, to be equal as treatments.
What Style of Sauna Should You Use When Treating PAD: Finnish-Style Sauna and Waon Therapy (Infrared Sauna)
It appears that PAD patients respond well to all forms of heat therapy, and that one source of heat is not favored over another. This being said if wound healing is of critical concern then it is better to use an infrared sauna as seen in Waon therapy.
Here is how the authors of our esteemed article describe Waon therapy.
“In Japanese, the term “Waon” translates to “comfortable warmth that refreshes the mind and body”. This whole-body HT, as outlined in, consists of a two-step process: first, a 15-minute session of infrared heat exposure in a sauna heated to approximately 60°C, raising the core body temperature by about 1.0°C–1.2°C; second, participants lie supine outside the sauna while covered in warm blankets to maintain this temperature for an additional 30 min.” (1)
If wound healing is not an issue for you then any style of heat therapy will help to improve heat shock protein production, NrF2, and cardiovascular function, all of which play a critical role in improving the condition of PAD, or even preventing its expression.
A traditional Finnish sauna, a steam room, or a sweat lodge all serve as viable forms of heat therapy for PAD patients. Given the severity of PAD it is best to work in close association with your doctor before beginning a sauna protocol.
If you are looking for a substitute to exercise then you can rely on a sauna to activate many of the same biochemical responses to exercise, and even several more.
PAD is affecting over 200 million people worldwide, and there are many treatments, including sauna therapy that can help as a portion of its treatment. While sauna use is not a substitute for pharmacological treatment for PAD patients, the data does reveal that saunas can improve aspects of peripheral arterial disease in measurable and clinically significant ways.
Contraindications:
If you are living with PAD please work with your medical provider before beginning a sauna program. Furthermore, please ensure that you maintain proper hydration at all times, including fluids that contain electrolytes and other essential nutrients.
Sources Cited:
- https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1537194/full
- https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557
- https://app.biorender.com/citation/67c1daff74074817887a7bc1
- https://www.sciencedirect.com/science/article/pii/S0190962224001865