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Blood Pressure Benefits of a Swim Spa

Lower blood pressure is one of the more obvious cardiovascular effects of hydrotherapy. But how does the process work? What are the benefits? And are there any risks? It begins with immersion in heated water.

The benefits of heated water

Typically, swim spas operate in the range of 95 to 104 degrees Fahrenheit (35C to 40C), which is the recommended therapeutic range for low-activity soaking. The warmth of the water raises the body’s skin and core temperatures about one degree, which doesn’t seem like much but the effect is dramatic. Known as "passive heating” because it happens without physical activity, it actually mimics the effect of mild aerobic exercise by increasing the heart rate. This result is helpful for those who find it difficult to exercise on dry land, such as people with obesity or mobility issues. In addition to a faster heart rate, passive heating increases the availability of nitric oxide, a molecule that dilates blood vessels. With less vascular resistance, cardiovascular load is reduced because the heart is able to pump blood more efficiently, resulting in lower blood pressure.

According to a 2008 study involving mice, warm water immersion also activates “heat shock proteins,” a group of molecules that protect cells from heat, cold and low blood sugar. A byproduct of this process blocks the inflammatory response, improving insulin function and protecting against obesity-induced glucose intolerance. Potentially, this may benefit people with type 2 diabetes and those who have reduced gene expression in heat shock protein HSP72.

The cardiovascular benefits of heat are comparable to sauna bathing. Middle-aged men should be particularly interested in these benefits. Research published in a 2015 issue of JAMA Internal Medicine evaluated the cardiovascular effects of sauna bathing on a group of 2,300 middle-aged men. Health benefits included “fewer deaths from heart attacks, strokes, various heart-related conditions, and other causes.” Compared to those who only participated once per week, those who did so two or three times a week experienced a 23% lower risk of fatal coronary heart disease episodes or cardiovascular disease. Those who participated four to seven times a week experienced a 48% lower risk.

The benefits of hydromassage 

Hydromassage, or jetted-water massage, is comparable to massage on dry land. But because it can be enjoyed at home, it is more convenient and less expensive than seeing a masseuse several hours a week. Evidently, women in particular stand to benefit.

For example, a study published in the International Journal of Preventive Medicine looked at the blood pressure benefits of massage on 25 pre-hypertensive women. (Pre-hypertension is an early warning sign of high blood pressure.) Each woman received a 10- to 15-minute massage, three times a week for 10 sessions. Their blood pressure was compared to a group of 25 different women who experienced the same relaxing environment, but without massage. Researchers found that the average “blood pressure in the massage group was significantly lower in comparison with the [non-massage] group.” After 72 hours the massage group still had “a significant difference” in lower blood pressure compared to the non-massage group.

What if you have hypertension?

Do you or a loved one have hypertension? Over the decades, conflicting information may have created confusion as to whether it is wise to make use of a spa when you have high blood pressure. Recent studies may help to clarify the subject, but only a healthcare provider can provide you with qualified medical advice.

According to a 2003 study, published by the Cardiovascular Risk Factor Reduction Unit at the University of Saskatchewan, researchers tackled the question: “Are hot tubs safe for people with treated hypertension?” Experts studied 21 hypertensive men and women (aged 46-76 years old) and measured their blood pressure before, during and after 10 minutes of immersion in a hot tub. A control group of 23 men and women (aged 19-83 years old) who did not have hypertension was also measured. What was the result? “Immersion in a hot tub for 10 minutes lowers blood pressure in subjects with treated hypertension, but no more than in [the non-hypertensive group].” In other words, those with hypertension reacted the same as those without it. Therefore, the experts concluded, “Spending 10 minutes in a hot tub should be safe for most treated hypertensive patients.”

Another study, published in 2013 in the journal Blood Pressure Monitoring, considered the same question in relation to heated-water exercise. Their study demonstrated that heated-water exercise lowered blood pressure in patients with “mild-to-moderate hypertension.” And afterward, “cardiovascular load was reduced significantly during the 24-hour daytime and nighttime period after the heated water-based exercise.” This led them to conclude: “These effects suggest that heated water-based exercise may have a potential as a new therapeutic approach to resistant hypertensive patients.”

However, a few scenarios are worthy of caution. Rapidly switching between hot and cold environments may raise your blood pressure. So if you have any concerns about high blood pressure, speak to a healthcare provider before engaging in these activities: 1) getting in or out of a swim spa in very cold or snowy conditions, which may expose you to rapid temperature shifts; 2) engaging in contrast water immersion (CWI) which requires you to switch repeatedly between hot water immersion and cold water immersion at specific time intervals.

You should apply the same caution if you have concerns about low blood pressure, or experience symptoms like dizziness, lightheadedness or fainting. If you take medications or supplements that may lower your blood pressure, be cautious of any activity that further reduces your blood pressure, or may lower it below safe levels.

The bottom line

By combining the benefits of heated-water immersion and hydromassage, hydrotherapy is a very effective method of lowering blood pressure. For the vast majority of people, it is just one of many potential benefits. If you’re ready to experience these benefits, contact your local ATV Dealer to get started.


  • The Conversation: “A Hot Bath has Benefits Similar to Exercise”
  • Netherlands Heart Journal: "Sauna Bathing: A Warm Heart Proves Beneficial”
  • Canadian Medical Association Journal: “Are hot tubs safe for people with treated hypertension?”
  • Blood Pressure Monitoring: “Effects of Short-term Heated Water-based Exercise Training on Systemic Blood Pressure in Patients with Resistant Hypertension: A Pilot Study”
  • Journal of Applied Physiology: “Passive Heat Therapy Improves Cutaneous Microvascular Function in Sedentary Humans Via Improved Nitric Oxide-dependent Dilation”
  • International Journal of Preventive Medicine: “Durability of Effect of Massage Therapy on Blood Pressure”

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