Blood Pressure Drugs Work Best with Musical Accompaniment

Listening to music heightens the beneficial effects of blood pressure–lowering drugs, according to the results of a study by scientists in Brazil and the U.K. The team, coordinated by Vitor Engrácia Valenti, Ph.D., a professor in the Speech Language Pathology Department of UNESP Marília’s School of Philosophy & Sciences (FFC) in Brazil, found that hypertension patients who listened to music immediately after taking their regular blood pressure medications experienced greater reductions in heart rate and blood pressure than control patients who didn’t listen to music.

“We observed that music improved heart rate and enhanced the effect of antihypertensives for about an hour after they were administered,” Dr. Valenti states. The researchers, including academic teams in Brazil and at Oxford Brookes University (U.K.), report on the studies in Scientific Reports, in a paper entitled “Musical Auditory Stimulus Acutely Influences Heart Rate Dynamic Responses to Medication in Subjects with Well-Controlled Hypertension.”

The concept that making lifestyle changes can represent a “primary preventive” of hypertension has gained increasing attention, the authors write, and music therapy as a complementary approach is being investigated in the context of both cardiovascular physiology and antihypertension treatment. “Music therapy has been investigated as a possible contributor to the treatment of hypertension,” the researchers write.

However, studies reviewing existing data on the effects of music therapy on blood pressure in hypertensive patients have reported conflicting conclusions. “Previous research showed music therapy having a significant positive effect on blood pressure in hypertensive patients,” Valenti notes. “But it wasn’t clear if music could influence the effects of medication on heart rate variability and on systolic and diastolic blood pressure.” Yet, as the researchers note, “This information might assist clinicians in improving new pharmacological interventions for hypertension.”

Over recent years, the UNESP Marília teams studies on the effects of music on the heart under conditions of stress showed that classical music tends to lower heart rate. “We’ve observed classical music activating the parasympathetic nervous system and reducing sympathetic activity,” Dr. Valenti continues. The parasympathetic part of the autonomic nervous system slows the heart rate, lowers blood pressure, and stabilizes blood sugar and adrenaline levels when the body is at rest.

For their latest studies, the team directly measured the acute effects of music on heart rate variability (HRV) and blood pressure in 37 patients with well-controlled hypertension. Patients taking a range of blood pressure–lowering drugs were included in the study, and all of the participants had been taking their antihypertensive drugs for between six months and a year.

Heart rate and blood pressure measurements were taken for each patient on two random days, at least two days apart. On one day, the patients took their regular oral antihypertensive therapy and then listened to instrumental music through headphones for 60 minutes, always at the same volume. On the second measurement day, the same protocol was undertaken, but no music was played through the headphones.

Heart rate variability was measured at 20, 40, and 60 minutes after the drugs were taken, and differences between heart rates at different times were calculated. The results showed that heart rate was reduced by a significantly greater amount 60 minutes after medication when the patients listened to music than it was when they didn’t have music played through their headphones. “Of chief importance, we detected that music acutely intensified the effect of antihypertensive medication on HRV,” they state. Blood pressure reductions were also more pronounced during the 60 minutes after medication when the subjects listened to music.

Although the period of medication response exhibited by the study participants was dependent on the type of treatment and its configuration, “In most cases the effects begin to appear around 15 to 20 minutes after administration and approaches the optimum therapeutically around 60 minutes later,” the authors write.

“Based on our results, anti-hypertensive medication presented more intense effects on HR when associated with music, even taking into account that resting HR was reduced during the music protocol, thus reinforcing the influence of music on parasympathetic responses induced by such medications,” the researchers conclude. They acknowledge that the reported studies included a specific group of well-controlled hypertensive patients, and suggest that further research should be carried out to see if complementary approaches to lowering blood pressure, such as music therapy, can reduce reliance on drug therapy. They also note that the repeated music sequences used in the study might have become familiar to patients and so elicited a calming effect.

“We strongly encourage additional investigation under different pathological conditions to perform further experiments to detect whether music has a significant influence on pharmacologic action,” the team concludes. “It has recently been suggested that treatment of hypertension should be based on life-style behaviors including physical activity and/or giving up smoking. In this context, complementary therapies applied to assist hypertensive treatment may further decrease dependence on pharmacological intervention.”