Hydrotherapy as a Complementary Approach in Hypertension Management: A Narrative Review

Abstract

Background: Hypertension remains a leading global risk factor for cardiovascular disease. Complementary non-pharmacological therapies that reduce blood pressure (BP) and improve vascular function are of growing interest. Hydrotherapy including warm or hot-water immersion, aquatic exercise, foot soaks, balneotherapy and local cold applications (e.g., ice massage) is widely used in clinical and traditional settings but its role in hypertension management is not yet standardized. Objective: To summarize the changes in systolic and diastolic blood pressure through available clinical evidences in hypertensive patients using hydrotherapy modalities such as warm-water immersion, cold water therapies, ice massage, steam and sauna bath. Methods: A literature search was conducted using terms like "hydrotherapy," "hypertension,"  and "blood pressure", "complimentary" in PubMed, Scopus, Google Scholar, and ScienceDirect to find publications published between 1985 and 2025. Excluded were research involving animals or unrelated topics, and included were peer-reviewed English-language human studies that examined how hydrotherapy affected circulatory or autonomic processes. Key findings were summarized by screening and narratively analyzing pertinent papers. Only publicly available data were used, thus ethical approval was not necessary. Conclusions: Hydrotherapy shows promise as an adjunctive strategy for managing hypertension by enhancing vascular function and autonomic balance through endothelial and thermoregulatory mechanisms. Further research is needed to standardize protocols and confirm long-term efficacy.