Science1 publisher2 min readPublished
VR river footage and classical music deepened emergency patients' early blood pressure drop by 4 mmHg
Safa Donmez's Ankara team found a VR river scene plus classical music added about 4 mmHg to the drug-driven blood pressure drop in 130 emergency patients. By 60 minutes the groups matched, so hospitals would be adopting a faster first quarter-hour of care.
The Scientist · Science desk
What happened
- Safa Donmez's team at the University of Health Sciences in Ankara recruited 130 adults who arrived at an emergency department with hypertensive urgency.
- All received standard blood pressure medication, and half also watched a VR scene of Canada's Columbia River while hearing Debussy, Bach and Mozart.
- Fifteen minutes in, pressure had fallen about 16 mmHg in the VR and music group against about 12 mmHg with medication alone.
- The difference had shrunk by 30 minutes, and by 60 minutes the two groups' readings were about the same.
- The results were presented at the European Emergency Medicine Congress in Paris.
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Why it matters
- cost A department adopting the package would pay for headsets and staff time to get a pressure benefit that, on these readings, is gone within an hour of treatment.
- constraint Hospitals hoping to use a playlist alone, the version that needs no headset, get no support from this study for music working by itself.
- constraint The reported comparison runs to 60 minutes, so it cannot show the add-on reduces the eye, heart or brain damage that treating hypertensive urgency aims to prevent.
The extra effect at 15 minutes was about 4 mmHg [2]. That is a drop roughly a third larger than medication produced on its own [3]. Starting pressures averaged about 130 to 138 mmHg [3], so the two groups fell by roughly 9 and 12 percent [4]. Each arm had about 65 patients [1].
The medication-only group caught up within the hour [5]. So the add-on changed how fast pressure fell, and the 60-minute reading ended up where the drugs put it in both groups. I think that is a modest result: an earlier fall in pressure, seen in one emergency department. Veronica Saldana-Ortiz at the European University in Madrid said that results arriving this quickly are clinically significant [10]. "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 said [17].
Donmez suggests the early effect may be related to anxiety [9]. Patients who arrive with hypertensive urgency are often anxious, he said, and anxiety can make the body release stress hormones that tighten blood vessels and push pressure higher [8]. Scores on the State Anxiety Inventory fell further in the VR and music group [6]. The thing this doesn't tell you is whether the calmer mood produced the lower pressure. Both changed in the same arm over the same minutes. Testing that route would take a comparison group calmed by some other means.
The comparison arm received medication and nothing else [2]. Donmez described the add-on as one experience. "Overall, the aim was to create a calm, natural and relaxing environment," he said [16]. The 4 mmHg therefore covers the river footage, the music and any effect of simply being fitted with a headset [2]. Saldana-Ortiz said that because the two were delivered together, there is no way to tell whether the benefit came from the music, the virtual environment or both [11]. The report does not say how patients were assigned to the two arms or what the equipment cost.
Mathew White at the University of Exeter said the result fits earlier research. "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," he said [12]. He also said: "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." [13]
What to watch
- Donmez's planned larger studies with longer follow-up, designed to separate the music from the virtual scene and to test whether patients choosing their own music matters.
- Whether a full written paper follows the Paris congress presentation, letting outside groups check the complete data.