Gazing at a flowing river while listening to classical music could lower the blood pressure of people in the emergency room. Luckily, as these landscapes and live orchestras are hard to come by in hospitals, virtual reality and playlists do the job.
Dangerously high blood pressure, known as hypertensive urgency, is common among people in intensive-care settings. Medication can prevent it from causing damage to the eyes, heart and brain. However, relaxation approaches, such as looking at aquarium scenes and listening to classical music, have also shown promise.
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Now, Safa Dönmez at the University of Health Sciences in Ankara, Turkey, and his colleagues have combined these two approaches to relaxation. The team recruited 130 adults who arrived in an emergency department with hypertensive urgency. These patients are often anxious, which can make their bodies release stress hormones that tighten blood vessels and further hike up blood pressure, says Dönmez.
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The researchers gave all the participants standard medication to reduce blood pressure. Half also viewed a scene of the Columbia River in Canada flowing through a forest via a VR headset while listening to a soothing playlist of classical music from the likes of Debussy, Bach and Mozart. “Overall, the aim was to create a calm, natural and relaxing environment,” says Dönmez.
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Before treatment, the participants’ arterial pressure was about 130 to 138 mmHg, on average. Fifteen minutes after the intervention, it had dropped by about 12mmHG among those who only took medication, compared with about 16 mmHg for those also having the VR and music experience. The results were presented at the European Emergency Medicine Congress in Paris, France.
Verónica Saldaña-Ortiz at the European University in Madrid, Spain, says that seeing such results so quickly is clinically significant. “In an emergency department, even a relatively simple non-pharmacological intervention that helps patients feel calmer during the initial phase of care could be clinically valuable,” she says.
After 30 minutes, the difference had shrunk, and by 60 minutes, the blood pressure readings of the two groups were about the same.
The intervention’s initial positive effect on blood pressure may be related to its impact on anxiety, says Dönmez. Anxiety fell by a greater amount in the VR/music group, according to ratings using a questionnaire called the State Anxiety Inventory.
“The results are consistent with a growing body of work that shows that even virtual nature can help reduce stress, including reductions in blood pressure, in stressful situations,” says Mathew White at the University of Exeter, UK. “Extending this approach to an emergency room setting seems like a wonderful idea, and hopefully results can be replicated and more widely implemented if confirmed.”
The VR and classical music were delivered together, so we cannot determine whether the benefit came from the music, the virtual environment or both, says Saldaña-Ortiz. Dönmez says the team is planning to do larger studies with longer follow-up periods to disentangle this and see whether patients choosing their own music makes a difference.