Background: Non-pharmacologic management has been underutilized as an initial treatment for asymptomatic mildly elevated blood pressures (BP) among Emergency Room(ER) patients. The patients and the hospital are thus forced to spend for anti -hypertensive medications. Some studies have shown that music therapy and slow breathing exercises led to BP reductions among others. Hence, its potential to control BP and lessen the need for anti- hypertensive medications for mild-moderate hypertensive patients seen at the ER setting is worthwhile exploring.

Objective: To determine whether music or slow-breathing exercises will be effective as initial management in lowering mildly elevated blood pressure and reducing anxiety among Emergency Room patients.

Methods: This was an open label, randomized, controlled trial among one hundred eleven (111) patients with mildly to moderately elevated blood pressure measurements seen at the ER setting was done. Thirty seven (37) participants each were randomly allocated to receive the music intervention, the slow breathing exercise intervention or no intervention. The following outcome measures: systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), pain scores, anxiety levels, heart rate (HR) and respiratory rate (RR) were recorded at baseline and ten minutes post intervention and subsequent differences in these values were compared.

Results: One hundred seven subjects completed the trial. Each group had 37 participants. Baseline sociodemographic, clinical profile and clinical parameters measured were similar across the three groups. A multiple comparison procedure, the Scheffes, was used to test for differences among groups. There was a significant difference in the mean decrease in SBP among the three groups with the greatest decrease noted in the music group at 12.51 mmHg compared with the decrease in the slow breathing exercise group at 8.22 mmHg and that of the no intervention group at 5.43 mmHg. (ANOVA: p value of 0.015). A significant difference in the mean decrease in MAP among the three groups was also obtained, with the greatest decrease again found in the music group at 8.87 mmHg compared with those of the slow breathing exercise group at 5.91 mmHg and the no intervention group at 4.22 mmHg (ANOVA: p value of 0.027). With regards to the mean decrease in RR, a significant difference was also noted among the 3 groups with the greatest decrease found in the slow breathing group at 1.19 cycles/minute compared with that of the music group at 0.94 cycle/minute and an increase in the mean RR in the no intervention group at 0.08 cycles per minute (ANOVA: p value of 0.028). The three groups were different in effecting a change in the intensity of pain (Kruskall-Wallis Test: p value of 0.04) but not in the change in the anxiety level (Kruskall Wallis Test: p value of 0.088). Although decreasing trends were noted in the changes in DBP and HR, the differences among groups were not statistically significant (ANOVA: p values of 0.133 and 0.855, respectively).

Conclusion: Music therapy and slow breathing exercises are effective and safe modalities that can be used in reducing blood pressure and respiratory rate, respectively among patients with mild to moderately elevated blood pressure measurements.

The Filipino Family Physician, 2003 41 ( 1 ) pages 1-13