Study Investigates Use of Virtual Reality to Manage Hypertensive Urgency in Emergency Departments

In a randomized controlled trial involving 130 adult patients with hypertensive urgency—characterized by significantly elevated blood pressure without acute organ damage—researchers explored whether virtual reality (VR) could help decrease anxiety and lower blood pressure. The findings were shared at the European Emergency Medicine Congress.

Reducing blood pressure efficiently is crucial for patient safety and resource management in busy emergency departments. Dr. Safa Dönmez, an associate professor of emergency medicine at the University of Health Sciences in Ankara, Turkey, noted this study may be the first to combine VR with classical music as a method to assist patients experiencing high blood pressure.

Typically, patients arriving with blood pressure readings at or above 180 mmHg systolic or 110 mmHg diastolic often require medication. Dönmez observed that many patients exhibit anxiety, which can exacerbate their condition by triggering stress hormones that constrict blood vessels. Considering the often chaotic environment of emergency departments, he posited that fostering a calmer atmosphere could facilitate quicker blood pressure reduction.

In the trial, participants were divided into an intervention group (65 patients) receiving VR therapy and a control group (65 patients) only receiving standard medication. While the control group had no ancillary interventions, the VR group donned headsets that immersed them in calming natural settings complemented by a curated playlist of classical music, including works from composers like Bach and Mozart.

Blood pressure readings were taken at intervals of 15, 30, 60, 90, and 120 minutes. The mean arterial pressure (MAP), a crucial indicator of blood pressure, was initially around 130–138 mmHg for participants. The researchers used the State Anxiety Inventory (STAI) to assess anxiety levels, noting significant differences in traits and state anxiety between the two groups.

Despite initial differences in blood pressure at the outset, the study reported that the VR group experienced a greater reduction in MAP after 15 and 30 minutes, suggesting the VR intervention might offer benefits in the crucial early phase of treatment. Specifically, the VR group saw a MAP decrease from 132 mmHg to 116 mmHg at 15 minutes, compared to a drop from 138 mmHg to 126 mmHg in the control group.

Dr. Kadir Yenal, an emergency medicine specialist, emphasized the statistical significance of these findings. By the end of the observation, both groups exhibited similar anxiety levels, although the VR group started with greater anxiety, highlighting their notable improvement.

Dönmez concluded that the initial results, while promising, indicate a need for further examinations in larger cohorts. He classified VR as a non-pharmacological, patient-centered approach that could particularly benefit anxious patients, suggesting that a brief escape into a virtual peaceful environment might be a valuable addition to emergency care.

Despite the study's single-center design and limitations such as differing baseline blood pressures between groups, it raises intriguing questions about the potential for VR to enhance patient care in emergency settings. Dr. Felix Lorang, head of the emergency department at Klinikum Lippe in Germany, remarked on the need for additional research but acknowledged that this method might yield significant advantages in anxiety reduction and blood pressure control during early treatment phases. Future studies will explore the distinct effects of VR and classical music, along with the impact of patients selecting their own music.