Spa treatment by condition
Spa treatment for high blood pressure
Grade two and three hypertension is on the Czech indication list, and Marienbad treats it with what comes from the ground here: carbon dioxide baths from the local mineral water and dry gas baths in Mariengas, together with outdoor exercise and nutrition counselling. The cure supplements blood-pressure-lowering medication; it does not replace it.
What is treated here
- Grade two and three hypertension under ongoing medical treatment
- High blood pressure with accompanying overweight or lack of exercise
- High blood pressure with elevated blood lipids or disturbed glucose metabolism
- Declining physical stamina that helps sustain the high blood pressure
- The wish to change diet and exercise habits under medical supervision
How the cure works
Initial examination on arrival day
The spa physician measures your blood pressure, reviews your medication and reviews any findings you bring. For the circulatory disease group, the indication list requires certain initial examinations and nicotine abstinence. Bring current readings, ideally from your own measurements at home, and a complete list of your medication.
First week: accustoming the circulation to exertion
Treatment begins with carbon dioxide baths at around 34°C and short outdoor walks. Blood pressure is checked regularly, and the drinking cure is tailored individually — not every spring in town is suitable for high blood pressure.
Second week: increasing exertion
The walking distances become longer and steeper, and group exercise and exercise therapy in water are added. Nutrition counselling runs in parallel; where there is overweight, weight loss is the lever that acts on blood pressure.
Final examination and a plan for home
How your blood pressure has changed over the stay is evaluated and recorded in writing; you take the report home for your own doctor. Whether and how medication is adjusted is decided solely by them, not by the spa town.
Treatments used
- Carbon dioxide bath in mineral water
- A bath in the local mineral water at around 34°C; the carbon dioxide absorbed through the skin is the active agent, and the low temperature keeps the strain on the circulation small.
- Dry gas bath in Mariengas
- Application of the natural carbon dioxide from the Marien Spring in a sealed bag — without water and without the strain of heat, which is why it is often the first choice for cardiovascular diagnoses.
- Terrain cure and climate therapy
- Guided walking on graded paths in the spa forest, with gradually increasing exertion at an altitude of 630 metres.
- Group exercise for cardiovascular guests
- Guided sessions with endurance, mobility and breathing components, put together for guests with a similar diagnosis.
- Exercise therapy in the pool
- Exercises in warm water that spare the joints while still building endurance.
- Nutrition counselling
- Individual sessions on salt, weight and blood lipids, accompanied by the spa diet during the stay.
- Drinking cure on medical prescription
- Which spring and what amount is set by the physician. The Cross Spring is not suitable for high blood pressure because of its high sodium content.
How long, and when
Grade two to three hypertensive disease is position II/3 on the Czech indication list. For stays covered by Czech public health insurance, the initial stay provides for 28 days of comprehensive spa care or 21 days of contributory care; a repeat stay runs to 21 days of contributory care, in certain cases 14. Self-paying guests agree the length with the spa physician; the professional minimum is at least 10 treatments over at least 10 days. There is a reasoned consideration for timing the season: daytime blood pressure is higher in winter than in summer, mainly because of cold, and more cardiovascular events occur in the cold season — a stay in autumn therefore comes before that peak in strain.
What the studies show
A review of bathing in natural thermal mineral water for high blood pressure concluded that the baths — alone, as a supplement to medication, or combined with other measures — had no adverse effects and had a favourable influence on blood pressure in most of the included studies (Yuan et al., 2019, Int J Biometeorol; very heterogeneous interventions, methodologically weaker studies, no meta-analysis). A mini-review describes a blood-pressure-lowering effect for various forms of hydro- and balneotherapy as a supplement to treatment, and names heat, heart-rate regulation and baroreceptors as mechanisms; the authors call for further clinical studies (Moini Jazani et al., 2023; mini-review without systematic methodology). In a before-and-after study of 35 patients, 24-hour blood pressure fell after three weeks of balneotherapy with carbon dioxide baths and peloids in people with medium and high baseline values, while it did not change in those with low baseline values (Ekmekcioglu et al., 2000, Altern Ther Health Med; no control group). On safety, a randomised study is available: 15 baths at 38°C produced no unfavourable changes in metabolic and inflammatory markers in patients with high blood pressure and overweight, so balneotherapy is not contraindicated for these diagnoses (Oláh et al., 2011; laboratory values were observed, not clinical endpoints). None of these studies shows that a spa cure can replace blood-pressure-lowering medication.
When a spa cure is not an option
- Second- to third-degree AV block, heart failure at NYHA class IV and active endocarditis — the indication list excludes these for the whole group
- Untreated or poorly controlled high blood pressure without medical supervision
- Severe heart disease, and acute infectious disease
- Peat packs: they place a strong strain on the circulation and are prescribed for cardiovascular disease only after an individual medical decision
- The Cross Spring: its high sodium content makes it unsuitable for people with high blood pressure
Whether and to what extent a spa cure is appropriate for your high blood pressure is decided by the spa physician at the initial examination, based on your readings and findings. Your own doctor alone decides on your medication; do not change it without their agreement. This page provides information and does not replace medical advice.
Frequently asked questions
Does a spa cure lower blood pressure?
The available studies suggest that baths in mineral water can favourably influence blood pressure as a supplement to treatment. In a before-and-after study of 35 patients, 24-hour blood pressure fell after three weeks of balneotherapy in people with raised baseline values, while it remained unchanged at low values; this study had no control group. A review found a favourable effect without adverse effects in most of the included studies, but points out the weaker methodology. According to this data, the cure does not replace blood-pressure-lowering medication.
Is a spa cure for high blood pressure covered?
Grade two to three hypertensive disease is position II/3 of the Czech indication list: for people insured with a Czech health fund, the initial stay provides for 28 days of comprehensive spa care or 21 days of contributory care, and a repeat stay runs to 21 or 14 days of contributory care. Guests insured outside the Czech Republic should clarify cost coverage with their own insurer in advance.
Which spring may I drink from with high blood pressure?
That is set by the spa physician, as is the amount; never drink more than prescribed. One restriction is known: the Cross Spring contains a great deal of sodium and is not suitable for people with high blood pressure or for heart patients. The springs in town differ considerably in chemistry, which is why the drinking cure is always prescribed individually.
Are peat packs allowed with high blood pressure?
Only after an individual medical decision. The peat pack is a heat-intensive application at up to 40°C and therefore places a clear strain on the heart and circulation; caution is needed with cardiovascular disease and at an older age. Where a treatment with carbon dioxide makes sense, the dry gas bath is often chosen instead, since it involves no strain from heat.
Do I have to stop my blood pressure medication during the cure?
No. Do not change medication prescribed for you at home without your doctor's agreement. The spa physician monitors your blood pressure during the stay and records the course in the final report; whether that leads to an adjustment is decided by your own doctor at home.
Sources
Studies and official documents this article relies on. Our content does not replace medical advice.
- Czech indication list for spa treatment (Decree No. 2/2015 Coll.), Group II — position II/3 — Hypertensive disease, grade II to III: initial stay 28 days of comprehensive or 21 days of contributory care; repeat stay 21 days of contributory care (14 in certain cases).
- Decree No. 2/2015 Coll. on the professional criteria for spa medical rehabilitation care — Group II — Full text of the indication list for circulatory diseases, including contraindications (second- to third-degree AV block, NYHA IV, active endocarditis), required nicotine abstinence and initial examinations. Czech-language text.
- Yuan H et al. 2019, Int J Biometeorol — review of bathing in natural thermal mineral water for hypertension — Baths alone, as a supplement to medication, and combined with other measures had no adverse effects and had a favourable influence on blood pressure in most studies. Heterogeneous interventions, no meta-analysis.
- Moini Jazani A et al. 2023, Int J Biometeorol — mini-review of the effect of hydrotherapy, balneotherapy and spa therapy on blood pressure — Various forms can lower blood pressure as a supplementary treatment; the mechanisms named are heat, heart-rate regulation and baroreceptors. Mini-review without systematic methodology.
- Ekmekcioglu C et al. 2000, Altern Ther Health Med — before-and-after study, 35 patients, 24-hour blood pressure measurement — After 3 weeks of balneotherapy with CO₂ baths and peloids, 24-hour blood pressure fell at medium and high baseline values; unchanged at low values. No control group.
- Oláh M et al. 2011 — randomised study of balneotherapy in hypertension and obesity (15 baths, 38°C) — No unfavourable changes in metabolic and inflammatory parameters after 15 baths at 38°C; balneotherapy is not contraindicated for these diagnoses. Laboratory values were observed, not clinical endpoints.
- Narita K, Hoshide S, Kario K 2021, Hypertens Res — review of the seasonal variation of blood pressure — Daytime blood pressure is higher in winter than in summer, mainly because of cold; the winter rise is associated with more cardiovascular events. Does not concern spa treatment.
- Pagourelias ED et al. 2011, Int J Biometeorol — review of CO₂ balneotherapy in cardiovascular disease — Three main effects: a drop in body temperature, stronger skin blood flow, a feeling of warmth; the authors call for methodologically stronger studies.
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