The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure.

The short version

This study asked whether older adults with chronic heart failure (CHF) — a serious condition where the heart struggles to pump blood effectively — might benefit from a short forest retreat. Thirty-six CHF patients aged 65 to 80 from Hangzhou, China, were split into two groups: most went on a 4-day trip to a forest park, while a smaller group stayed in an urban area, under otherwise matched conditions (food, activity, lodging). Both groups walked outdoors twice a day for about 90 minutes at a gentle, unhurried pace — safe enough that a nurse and doctor accompanied the walks — and avoided smoking, alcohol, and caffeine throughout the trip. Blood was drawn before and after to check heart-failure markers, blood vessel and hormone factors related to heart disease, inflammation, and antioxidant status, and everyone completed a standard mood questionnaire (POMS) before and after. After the forest trip, participants had a significantly lower level of BNP, a key blood marker doctors use to gauge heart-failure severity, compared with both their own starting level and the city group — whose BNP didn't change. The forest group also had lower endothelin-1 (a blood-vessel-constricting hormone linked to heart disease) and lower interleukin-6 (an inflammation marker) than the city group, along with signs of less oxidative cell damage. Mood improved significantly in the forest group too — less tension, depression, anger, and confusion — while the city group's mood stayed about the same. The forest site's air was dramatically cleaner: about 30 times more of the negative ions associated with fresher air, and a small fraction of the fine-particle pollution found in the city. These early results suggest that even a short, four-day forest trip may offer measurable benefits in people living with heart failure — studied as a complement to regular medical care, not a replacement for it. The study was small (33 people finished it) and short, tested in only one season, and can't fully separate the effect of the forest itself from other differences like travel, group size, or simply a change of routine. Larger, longer trials are needed before forest bathing becomes a standard recommendation for heart failure patients.

Key findings

• In elderly patients with chronic heart failure (CHF), a 4-day forest bathing trip significantly lowered BNP — a key blood marker of heart-failure severity — compared with both their own starting levels and a comparison group who stayed in the city.
• The forest group also showed lower endothelin-1 (a blood-vessel-constricting hormone linked to heart disease) and lower interleukin-6 (an inflammation marker), along with signs of reduced oxidative stress, versus the urban group.
• Mood improved significantly in the forest group across four measures — less tension, depression, anger, and confusion — while the urban group showed no significant mood change.
• The forest site had dramatically cleaner air than the city (about 30 times more negative air ions and a small fraction of the fine-particle pollution), which the researchers suggest may partly explain the physiological benefits.
• This was a small, short (4-day) study with only 33 completers, tested in one summer season, so while the findings are promising for CHF as a complementary approach, they are not yet grounds to replace standard heart-failure treatment, and larger, longer trials are needed.

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