Acute vascular effects of carbonated warm water lower leg immersion in healthy young adults

Endothelial dysfunction is associated with increased cardiovascular mortality and morbidity; however, this dysfunction may be ameliorated by several therapies. For example, it has been reported that heat‐induced increases in blood flow and shear stress enhance endothelium‐mediated vasodilator function. Under these backgrounds, we expect that carbon dioxide (CO 2)‐rich water‐induced increase in skin blood flow improves endothelium‐mediated vasodilation with less heat stress. To test our hypothesis, we measured flow‐mediated dilation (FMD) before and after acute immersion of the lower legs and feet in mild warm (38°C) normal or CO 2‐rich tap water (1000 ppm) for 20 min in 12 subjects. Acute immersion of the lower legs and feet in mild warm CO 2‐rich water increased FMD (P < 0.01) despite the lack of change in this parameter upon mild warm normal water immersion. In addition, FMD was positively correlated with change in skin blood flow regardless of conditions (P < 0.01), indicating that an increase in skin blood flow improves endothelial‐mediated vasodilator function. Importantly, the temperature of normal tap water must reach approximately 43°C to achieve the same skin blood flow level as that obtained during mild warm CO 2‐rich water immersion (38°C). These findings suggest that CO 2‐rich water‐induced large increases in skin blood flow may improve endothelial‐mediated vasodilator function while causing less heat stress