title: [Sulphureous mud-bath therapy and changes in blood pressure: observational investigation].
abstract: OBJECTIVE
  The chronic arthropathies currently appear to be a major cause of disability with a negative impact on quality of life and health care spending. The mud-bath therapy is a spa treatment that induces benefic effects in chronic rheumatic diseases. It has long been debated on the assumption that the mud-bath spa therapy could have adverse cardiovascular effects which often induce caution and even a contraindication to the use of this treatment in chronic arthropathies associated with cardiovascular alterations such as hypertension. The aim of this observational study was to investigate, in arthrorheumatic subjects, the effects of sulphureous mud-bath cycle on blood pressure and the possible appearance of adverse drug reaction.
  
  
  METHODS
  169 patients, with age range 42-86 years, suffering by chronic arthropathies were treated with sulphureous mud-bath therapy for 2 weeks. According to the arterial pressure values, measured before the spa treatment, the patients considered were divided in three groups: with normal blood pressure (NOR group); with high blood pressure, after, the latter group was divided in IPET (patients in treatment with antihypertensive drugs) and IPENT (patients not in antihypertensive therapy). The arterial pressure values, maximum and minimum, expressed in mmHg, were detected in the first (T1) - sixth (T6) and twelfth (T12) day of spa treatment. The media arterial pressure values collected before and after T1, before and after T6, before and after T12 , before T1 and after T12 were compared. The data, presented as mean±SD, were compared with the paired Student t test. A p value ≤0.05 was considered significant.
  
  
  RESULTS
  The comparison between the mean values detected in pre and post T1, pre and post T6, pre and post T12 have showed that sulphureous mud-bath therapy induced a significant (p<0.05) reduction of arterial blood pressure values in patients suffering of chronic arthropathies with high blood pressure in antihypertensive therapy or not (IPET and IPENT groups); while in patients with normal blood pressure (NOR group) were observed modest reduction at the limit of statistical significance. Similarly, the comparison between the data detected at the end of sulphureous mud-bath therapy (post-T12) vs baseline (pre-T1) have demonstrated: in IPET and IPENT groups a significant (p<0,01) decrease of arterial blood pressure values; in NOR group very small decrease, this reduction is significant (p<0.05) only for maximum arterial pressure value. Were not observed adverse drug reaction.
  
  
  CONCLUSIONS
  The results of our study, in according with the few data in the literature, evidenced that is possible include the sulphureous mud-bath therapy in interdisciplinary therapeutic p rotocol of patients suffering of chronic arthropathies and arterial hypertension.
authors.affiliation: Dipartimento di Medicina e Chirurgia-Università degli Studi di Salerno, Italia - Assoc. non profit F.I.R.S.Thermae - Formazione Interdisciplinare, Ricerche e Scienze Termali - inserita in Anagrafe Nazionale di Ricerche del MIUR.
authors.forename: M
authors.initials: M
authors.lastname: Costantino
authors.forename: M B
authors.initials: MB
authors.lastname: Marongiu
authors.affiliation: Dipartimento di Medicina e Chirurgia-Università degli Studi di Salerno, Italia.
authors.forename: G
authors.initials: G
authors.lastname: Russomanno
authors.affiliation: Dipartimento di Medicina e Chirurgia-Università degli Studi di Salerno, Italia.
authors.forename: V
authors.initials: V
authors.lastname: Conti
authors.affiliation: Dipartimento di Medicina e Chirurgia-Università degli Studi di Salerno, Italia.
authors.forename: V
authors.initials: V
authors.lastname: Manzo
authors.affiliation: Dipartimento di Medicina e Chirurgia-Università degli Studi di Salerno, Italia - Assoc. non profit F.I.R.S.Thermae - Formazione Interdisciplinare, Ricerche e Scienze Termali - inserita in Anagrafe Nazionale di Ricerche del MIUR.
authors.forename: A
authors.initials: A
authors.lastname: Filippelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009094:Mud Therapy / Q000379:methods*; D012216:Rheumatic Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013457:Sulfur Compounds / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013457:Sulfur Compounds
keywords: Chronic arthropathies; Hypertension; Mud-bath therapy; Sulphureous mineral water