{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:17:20Z","timestamp":1792174640690,"version":"4.4.0"},"reference-count":59,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec><jats:title>Abstract<\/jats:title><jats:p>There is considerable overlap between the mechanisms underlying the health benefits of exercise training and heat therapy. However, it remains unclear whether combining heat therapy with exercise can enhance improvements in cardiovascular and metabolic health. The present study investigated whether post\u2010exercise hot water immersion (EX+HWI) could augment improvements in cardiorespiratory fitness, cardiovascular and metabolic health compared to post\u2010exercise thermoneutral water immersion (EX+TWI). Twenty\u2010four physically inactive middle\u2010aged adults (age: 58\u00a0\u00b1\u00a05\u00a0years; body mass index: 28\u00a0\u00b1\u00a03\u00a0kg\u00a0m<jats:sup>\u2013<\/jats:sup><jats:sup>2<\/jats:sup>; 13 females) were randomly allocated to 8 weeks of supervised EX+HWI (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) or EX+TWI (<jats:italic>n<\/jats:italic>\u00a0=\u00a012). Moderate\u2010intensity aerobic exercise (65\u201375% maximum heart rate) was performed for 30\u00a0min followed by 30\u00a0min of immersion at 40\u00b0C or 34\u00b0C, two to four times per week (total 24 sessions). Cardiorespiratory fitness, brachial\u00a0artery\u00a0flow\u2010mediated dilatation, aortic pulse wave velocity, blood pressure and circulating lipids, glucose and inflammatory markers were assessed pre\u2010 and post\u2010intervention. Between\u2010group differences showed that EX+HWI resulted in greater reductions in mean arterial pressure (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.029, \u03b7<jats:sup>2<\/jats:sup><jats:italic><jats:sub>p<\/jats:sub><\/jats:italic>\u00a0=\u00a00.207, mean difference: \u20134\u00a0mmHg) and an increase in brachial artery flow\u2010mediated dilatation (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.030, \u03b7<jats:sup>2<\/jats:sup><jats:italic><jats:sub>p<\/jats:sub><\/jats:italic>\u00a0=\u00a00.206, 2.33%). In addition, there were greater improvements in perceived physical health (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.036, \u03b7<jats:sup>2<\/jats:sup><jats:italic><jats:sub>p<\/jats:sub>\u00a0=\u00a0<\/jats:italic>0.211, 5\u00a0a.u.). No between\u2010group differences were observed for cardiorespiratory fitness, aortic stiffness, circulating glucose, lipids and inflammatory markers. Taken together, post\u2010exercise hot water immersion enhances blood pressure and brachial artery endothelial function, in the absence of improvements in cardiorespiratory fitness, circulating glucose, lipids and inflammatory markers.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp16871-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec><jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Hot water immersion replicates some of the physiological adaptations to exercise, but it is unclear whether post\u2010exercise hot water immersion can augment exercise\u2010derived improvements in cardiovascular health.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>This is the first study to assess whether 8\u00a0weeks of supervised exercise followed by hot water immersion can augment improvements in cardiovascular and metabolic health compared to post\u2010exercise thermoneutral water immersion in physically inactive middle\u2010aged adults.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>We demonstrate that 30\u00a0min of moderate\u2010intensity aerobic exercise, followed by 40\u00b0C water immersion, on average three times a week for 8\u00a0weeks, reduces diastolic and mean arterial blood pressure more than exercise followed by thermoneutral immersion at 34\u00b0C, and increases brachial artery flow\u2010mediated dilatation.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>These findings provide novel evidence that post\u2010exercise hot water immersion lowers diastolic blood pressure and mean arterial pressure, and improves brachial artery endothelial function, without further enhancing cardiorespiratory fitness, glucose, lipids or inflammation in physically inactive middle\u2010aged adults.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1113\/jp288873","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T13:23:50Z","timestamp":1753709030000},"page":"4515-4533","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Post\u2010exercise hot water immersion enhances haemodynamic and vascular benefits of exercise without further improving cardiorespiratory fitness, glucose, lipids or inflammation"],"prefix":"10.1113","volume":"603","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5405-4608","authenticated-orcid":false,"given":"Charles J.","family":"Steward","sequence":"first","affiliation":[{"name":"Centre for Physical Activity, Sport and Exercise Sciences Coventry University  Coventry UK"},{"name":"The David Greenfield Human Physiology Unit, School of\u00a0Life Sciences, Queen's Medical Centre University of\u00a0Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-1712","authenticated-orcid":false,"given":"Mathew","family":"Hill","sequence":"additional","affiliation":[{"name":"Centre for Physical Activity, Sport and Exercise Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2546-1618","authenticated-orcid":false,"given":"Campbell","family":"Menzies","sequence":"additional","affiliation":[{"name":"Centre for Physical Activity, Sport and Exercise Sciences Coventry University  Coventry UK"},{"name":"The David Greenfield Human Physiology Unit, School of\u00a0Life Sciences, Queen's Medical Centre University of\u00a0Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3924-3435","authenticated-orcid":false,"given":"Sophie L.","family":"Russell","sequence":"additional","affiliation":[{"name":"Centre for Physical Activity, Sport and Exercise Sciences Coventry University  Coventry UK"},{"name":"Centre for Nutrition, Exercise and Metabolism, Department for Health University of Bath  Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0632-2137","authenticated-orcid":false,"given":"C. 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