Music-listening exposes gender differences in blood pressure reaction

Music-listening can be delivered through digital health tools and has been found to lower blood pressure (BP) in the long-term [1, 2]. The pathophysiology and treatment of hypertension differs between men and women [3, 4], but the interaction of gender, hypertension and music-listening has not yet been studied.

This study compares BP response to music between men and women, with high and normal baseline blood pressure, to help develop precision digital music interventions for cardiovascular health.

127 participants (74 women) were recruited to listen to ≈ 40 minutes of music following a 5 minute baseline while continuous blood pressure (BP) was measured using a CNAP® Monitor. 116 (68W, 43.2 ± 15.7 years) participants had complete BP data, 38 (17W) had high baseline blood pressure (HbBP) and 78 (51W) had normal baseline blood pressure (NbbP). Gender differences within HbBP and NbBP groups were first tested using a Mann-Whitney U test. A Kruskal-Wallis parametric test followed by a posthoc Dunn's Test was used to test how gender and baseline-blood pressure interact (b-BP x Gender) to affect blood pressure response during music-listening. Results were considered significant for p < 0.001.

During baseline, gender does not significantly affect systolic or diastolic BP averages (HbBP systolic: p = 0.30; diastolic: p = 0.67; NbBP systolic: p = 0.58; diastolic: p = 0.49).

However, gender impacts average systolic and diastolic BP during music (Table 1). Men in both HbBP and NbBP groups had higher systolic BP during music than women: HbBP men vs women: (mean mmHg (95%CI): 153.63 (150.45-156.82) vs 140.62 (136.58-144.65)); p = 5.96e-08; NbBP men vs women: 127.51 (125.36-129.66) vs 119.80 (118.24-121.37); p = 5.85e-09. For NbBP participants, men had significantly higher diastolic BP than women during music (82.52 (81.03-84.02) vs 79.26 (78.18-80.34); p = 0.0009). However, diastolic BP did not significantly differ among H-bBP men and women during music-listening (p = 0.13).

Post-hoc tests identify significant differences between bBP x gender groups in systolic but not diastolic baseline-normalised response (Table 2). During music, both HbBP and NbBP men have significantly higher systolic delta BP than HbbP women (10.08 (7.05-13.12) and 13.56 (11.44-15.67) vs 0.95 (-2.35-4.25); p = 0.00045 and p = 4.15e-09 respectively). NbBP men have a significantly higher rise from baseline in systolic BP compared to NbBP women (13.56 (11.44-15.67) vs 6.81 (5.21-8.41); p = 5.38e-05). There were no significant differences within gender groups by baseline BP.

Music-listening uncovers higher BP responses in men that are not apparent at rest. Gender interacts with hypertension’s effect on systolic and diastolic response to music and should be considered as a factor in developing precision music interventions.