The Use of Virtual Reality and Music Therapy for Hypertensive Urgency

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 120 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 early percentage change in mean arterial pressure and decreasing anxiety levels during acute hypertensive episodes. Findings may support the incorporation of non-pharmacological strategies into the emergency management of hypertensive urgency.

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