Abstract P181: Musical Improvisation In Labile Hypertension

Abstract

Background: Patients with labile hypertension experience transient but substantial increases in blood pressure, usually surrounding episodes of emotional distress and anxiety. Inability to express negative emotions may also play a substantial role. Most psychological interventions are aimed at blunting the stress response to anxiety or distress (i.e. mindfulness techniques). We hypothesize that musical improvisation therapy may blunt emotional response but may also decrease brain activity associated with negative thinking and emotions. Materials/methods: We surveyed 20 individuals with labile hypertension. Subjects completed a pre- and post-intervention and also had their blood pressure checked pre- and post-intervention. The intervention involved subjects actively engaging in a roughly one hour-long interactive musical improvisation simulation delivered via electronic media. Results: Nine out of 20 participants had a positive responsive to the exercise (SBP drop > 10mmHg). Fifty-eight percent of all subjects and 63% of positive responders felt the exercise made them feel less self-conscious and self-critical. Sixty-seven percent of all subjects who endorsed struggling with mindfulness felt that this exercise would help them practice mindfulness more regularly. Discussion: One of the most difficult judgments to make is whether a patient’s office hypertension is due to isolated “white coat spike” or whether the elevated readings represent a potentially physically damaging recurring hyperadrenergic response to life stressors. Most efforts of combating labile hypertension, such as yoga and relaxation techniques, aim at blunting the stress response, but results are variable. Yet, labile hypertension may well additionally be linked to inhibition of the expression of negative emotions. The neural complexes involved in musical improvisation appear to not only increase pleasure but also decrease activity in brain structures associated with negative thoughts and emotions. Conclusion: Our data supports the conclusion that musical improvising has the potential to both blunt emotional distress (i.e. through mindfulness) and decrease negative thoughts and emotions. Both pathways can potentially lessen the impact of labile hypertension.