The Use of Virtual Reality and Music Therapy for Hypertensive Urgency

Ankara City Hospital

Status: Completed

Conditions: Hypertensive Urgency; Primary Hypertension

Treatments: Device: Virtual Reality Exposure; Drug: Captopril 25Mg Tab; Behavioral: Classic Music Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07272486

E2-24-7802 (Other Identifier)

Details and patient eligibility

About

This study aims to evaluate whether virtual reality (VR) and classical music therapy, when added to standard antihypertensive treatment, can improve blood pressure control and reduce anxiety in patients presenting to the emergency department with hypertensive urgency. Patients with primary hypertension and no signs of end-organ damage will be randomly assigned to receive either standard treatment alone or standard treatment combined with VR and classical music. Blood pressure will be monitored at multiple time points over a 240-minute period, and anxiety will be assessed using the State Anxiety Inventory (STAI-I). The study seeks to determine if these non-pharmacological interventions can enhance the effectiveness of routine management of hypertensive urgency.

Full description

Hypertensive urgency is characterized by severely elevated blood pressure without evidence of acute target-organ damage. Standard management typically involves the gradual reduction of blood pressure using oral antihypertensive agents such as captopril. Emotional stress and anxiety can contribute to elevated sympathetic activity, potentially worsening blood pressure control. Virtual reality (VR) environments and classical music therapy have been shown in prior studies to reduce stress, improve patient comfort, and modulate physiological responses.

In this randomized controlled study, patients with primary hypertension who present to the emergency department with hypertensive urgency will be assigned to one of two groups: standard pharmacological treatment alone or standard treatment combined with VR exposure and classical music therapy. The intervention will be delivered in a quiet and dimly lit room, and blood pressure will be measured at predefined intervals over 240 minutes. Anxiety levels will be assessed at baseline and at the end of the monitoring period using the State Anxiety Inventory (STAI-I).

This study aims to determine whether VR and classical music can enhance routine management by improving blood pressure reduction and decreasing anxiety levels during acute hypertensive episodes. Findings may support the incorporation of non-pharmacological strategies into the emergency management of hypertensive urgency.

Enrollment: 130 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 years or older
• Clinical diagnosis of primary hypertension
• Presentation to the emergency department with hypertensive urgency
• Absence of any signs of acute end-organ damage
• Ability to understand the study and provide informed consent
• Able to cooperate with serial blood pressure measurements

Exclusion criteria

• Age younger than 18 years
• Diagnosis of secondary hypertension
• Any medication intolerance or known hypersensitivity to captopril or nitrate therapy
• Current severe psychiatric disorder or cognitive impairment interfering with participation
• Contraindications to using virtual reality (history of severe vertigo, epilepsy, motion sickness, etc.)
• Hemodynamic instability requiring immediate high-intensity medical intervention
• Pregnancy or breastfeeding
• Inability or unwillingness to provide informed consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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130 participants in 2 patient groups

Standard Pharmacological Treatment

Active Comparator group

Description:

Participants in this arm will receive standard oral antihypertensive treatment consisting of 25 mg captopril. Additional doses (25 mg at 30 minutes and 25 mg at 60 minutes, total 75 mg) will be administered if MAP reduction of ≥25% is not achieved. Rescue therapy with IV nitrate (0.1 mg/kg/min) will be used if blood pressure remains uncontrolled after 90 minutes, following routine emergency department protocol. No VR or music therapy is administered in this arm.

Treatment:

Drug: Captopril 25Mg Tab

Standard Treatment + VR and Classical Music Therapy

Experimental group

Description:

Participants in this arm will receive standard oral antihypertensive treatment (25 mg captopril; additional doses at 30 and 60 minutes if needed) combined with virtual reality exposure and classical music therapy. Patients will view a calming VR environment of their choice for approximately 20 minutes while listening to a selected classical music piece. VR and music therapy are administered concurrently in a quiet and dimly lit room. Rescue therapy with IV nitrate will be used according to the same emergency department protocol as the control group.

Treatment:

Behavioral: Classic Music Therapy

Drug: Captopril 25Mg Tab

Device: Virtual Reality Exposure