A pair of studies last month at the American Society of Hypertension (ASH) 2012 Scientific Sessions highlight the influence of music and relaxation therapy on blood-pressure levels.
In one study, investigators observed that listening to Mozart in the doctor’s office can lower blood-pressure levels, while a mindfulness-based stress-reduction program failed to lower blood-pressure levels in a group of healthy patients with stage 1 hypertension.
In the first study, Dr. Giuseppe Crippa with Ospedale Guglielmo de Saliceto, Piacenza, Italy, measured blood-pressure levels using an automated office blood-pressure device (BpTRU BPM-100, Quick Medical) while the patient sat in a chair listening to classical, rock or no music at all. The investigators found that rock music (specifically “Bicycle Race” by the classic rock band Queen) increased blood pressure, while a Mozart adagio lowered blood pressure.
“Many physicians use music in the office to make the patient more comfortable, but what we’re showing here is that blood pressure can be altered by the type of music played in the office,” Crippa told heartwire.
Blood pressure was measured during three consecutive periods in 40 patients with mild to moderate hypertension. After listening to silence for eight minutes, the average systolic and diastolic blood pressure was 144.6 and 87.4 mm Hg, respectively. In the same patients, the average systolic and diastolic blood pressure declined while listening to Mozart, down to 138.1 and 83.9 mm Hg, respectively, while systolic blood pressure increased to 147.8 when listening to Queen, and diastolic blood pressure remained similar to that observed during silence.
Stress Reduction for Blood Pressure Management
In the HARMONY stress-reduction study, lead author Kimberly Blom of the University of Toronto, Ontario, along with senior investigator Dr. Sheldon Tobe of Sunnybrook Health Sciences Center, Toronto, Ontario, included 101 male and female patients with baseline 24-hour ambulatory blood pressure levels >135.85 mm Hg.
The stress-management program is currently funded by the Ontario provincial government for depression, anxiety and pain, and it has been shown to provide benefits in patients with eating disorders as well as those with psoriasis. It is an eight-week program that includes a two-and-a-half-hour session once weekly as well as a daylong retreat near the end of the program. Patients are taught yoga, stress-reduction techniques and guided imagery with the intention of bringing mindfulness to their daily activities.
“There were some data in the literature suggesting that stress reduction could lower blood pressure, and our study was based on that,” Blom told heartwire. “Overall, the changes from starting the program to finishing the program, when you compare the blood-pressure levels of those who just finished the intervention with those who are to enter the program, there was a consistent drop in blood pressure, but it just wasn’t statistically significant.”
The researchers observed 24-hour ambulatory reductions in systolic blood pressure ranging from 1.3 mm Hg to 2.0 mm Hg, as well as reductions in diastolic blood pressure ranging from 0.6 mm Hg to 1.3 mm Hg. They also observed reductions in awake and nighttime systolic and diastolic blood pressure, but as noted, the reductions did not reach statistical significance.
Given the lack of benefit with the stress-management program, Blom said that nearly all of the previous studies that have shown a benefit in terms of blood-pressure reduction included patients taking antihypertensive medications. “I would think that if you have patients enrolled in a stress-reduction program for their blood pressure they might be more likely to take their blood-pressure medications,” said Blom. “So it’s possible, and I’m speculating, that these patients might have done better in those trials because they were adhering to their medications.”
In addition, Blom said that the power analysis of the trial was based on studies that included medicated and unmedicated hypertensive patients, whereas their trial included only patients not currently taking antihypertensive medications. “To find an effect, we’d have had to recruit thousands of people. So two things have come out this: One, we need to repeat the study with more patients to find out if the results are true, and second, we think the program might be an effective adjuvant therapy for patients already on medication.”
By Michael O’Riordan