Setor K.Kunutsor, Clinical Academic, University of Bristol
TanjaniinaLaukkanen, Researcher, University of Eastern Finland
Jari A.Laukkanen, Cardiologist, Universities of Jyväskylä and Eastern Finland
Published May 24, 2018
We thank Yu et al. for their comment on our article discussing the correlation between sauna bathing and reduction of stroke risk. [1] Yu et al. infer that participants in our study were very likely to have major cervical or intracranial vessel stenosis based on average age. This assertion was based on two studies which reported the prevalence of asymptomatic carotid and intracranial stenosis in the general population to range from 0% to 5.7%. [2, 3] The figures were higher for men aged 80 years and above, and in Asian, Hispanic, and African-American populations. It is unlikely these findings are applicable to our population, which comprised of apparently healthy Caucasians aged 53 to 74 years without a known history of stroke at baseline. Furthermore, of the 197 men who took very frequent baths, only 8 suffered a stroke. Indeed, we agree that intracranial vasculature status is an important factor to take into account; however, we had no such imaging data available. As with epidemiologic observational studies, there is always a possibility of residual confounding. This bias was minimized by taking into account a comprehensive panel of confounders and conducting several sensitivity analyses. Our results are robust and consistent with previous research data, [4] and the compelling body of evidence on the beneficial physiologic changes associated with sauna bathing. [5]
1. Kunutsor S K, Khan H, Zaccardi F, et al. Sauna bathing reduces the risk of stroke in Finnish men and women: A prospective cohort study. Neurology Epub 2018 May 2.
2. De Weerd M, Greving J P, Hedblad B, et al. Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis. Stroke 2010;41:1294-1297.
3. Suri MF, Johnston SC. Epidemiology of intracranial stenosis. J Neuroimaging 2009;19 Suppl 1:11S-16S.
4. Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med 2015;175:542-548.
5. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other health benefits of sauna bathing: A review of evidence. Mayo Clin Proc (in-press 2018).
We thank Yu et al. for their comment on our article discussing the correlation between sauna bathing and reduction of stroke risk. [1] Yu et al. infer that participants in our study were very likely to have major cervical or intracranial vessel stenosis based on average age. This assertion was based on two studies which reported the prevalence of asymptomatic carotid and intracranial stenosis in the general population to range from 0% to 5.7%. [2, 3] The figures were higher for men aged 80 years and above, and in Asian, Hispanic, and African-American populations. It is unlikely these findings are applicable to our population, which comprised of apparently healthy Caucasians aged 53 to 74 years without a known history of stroke at baseline. Furthermore, of the 197 men who took very frequent baths, only 8 suffered a stroke. Indeed, we agree that intracranial vasculature status is an important factor to take into account; however, we had no such imaging data available. As with epidemiologic observational studies, there is always a possibility of residual confounding. This bias was minimized by taking into account a comprehensive panel of confounders and conducting several sensitivity analyses. Our results are robust and consistent with previous research data, [4] and the compelling body of evidence on the beneficial physiologic changes associated with sauna bathing. [5]
1. Kunutsor S K, Khan H, Zaccardi F, et al. Sauna bathing reduces the risk of stroke in Finnish men and women: A prospective cohort study. Neurology Epub 2018 May 2.
2. De Weerd M, Greving J P, Hedblad B, et al. Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis. Stroke 2010;41:1294-1297.
3. Suri MF, Johnston SC. Epidemiology of intracranial stenosis. J Neuroimaging 2009;19 Suppl 1:11S-16S.
4. Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med 2015;175:542-548.
5. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other health benefits of sauna bathing: A review of evidence. Mayo Clin Proc (in-press 2018).
For disclosures, please contact the editorial office at journal@neurology.org.