Professor Deljanin Ilic said: "In the setting of cardiovascular risk factors and cardiovascular disease the endothelium loses its normal function.1 Since endothelium derived nitric oxide is necessary to maintain an adequate vascular response, correction of endothelial dysfunction has become a goal of therapy."
She added: "Exercise training has been shown to improve endothelial function and is the cornerstone of a multifaceted programme of cardiovascular rehabilitation. However, little is known about the role of music in cardiovascular rehabilitation or the effects of listening to favourite music on endothelial function."
The current study evaluated the effects of listening to favourite music on endothelial function through changes of circulating blood markers of endothelial function: the stable end products of nitric oxide (NOx), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and xanthine oxidase (XO) in 74 patients with stable CAD.
Patients were randomised to trained (T, n=33), music and trained (MT, n=31) and music (M, n=10) groups. Patients in the T and MT groups underwent 3 weeks of supervised aerobic exercise training at a residential centre. In addition to exercise training, patients in the MT group listened to their favourite music for 30 minutes every day.
Patients in the M group received usual community care and listened to their favourite music for 30 minutes every day. Markers were measured and an exercise test performed at baseline and 3 weeks.
After 3 weeks the value of NOx increased in groups T (from 33.0±13.0 to 42.8±11.0 µmol/l, p< 0.005) and MT (from 34.5±7.1 to 49.6±12.6 µmol/l, p<0.0005) (table 1). The increase in NOx was higher in the MT group than in the T and M groups (p=0.0246 and p<0.005) and in the T than in the M group (p<0.05).
XO significantly decreased in all 3 groups after 3 weeks (p<0.0005 for all groups), but at the end of the study XO was significantly lower in the MT than in the T and M groups (p<0.005 and p<0.0005) and in the T than in the M group (p<0.001). After 3 weeks exercise capacity had increased by 39% in MT, 29% in T and 19% in M compared to baseline values (table 2). ADMA and SDMA decreased in all 3 groups (most pronounced in MT) after 3 weeks but the findings were not significant.
Professor Deljanin Ilic said: "The combination of music and exercise training led to the most improvement in endothelial function. Improvements in endothelial function were associated with significant improvements in exercise capacity."
She added: "Listening to joyful music for 30 minutes has been associated with improved endothelial function, possibly by β-endorphin mediated activation of endothelium derived nitric oxide.2 The vascular health benefits of music may be due to endorphins or endorphin like compounds released from the brain when we hear music we like."
Professor Deljanin Ilic concluded: "Listening to favourite music alone and in addition to regular exercise training improves endothelial function and therefore may be an adjunct method in the rehabilitation of patients with CAD. There is no an 'ideal' music for everybody and patients should choose music which increases positive emotions and makes them happy or relaxed."
Notes to editor
1 Widlansky ME, Gokce N, Keaney JF, Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol. 2003;42:1149-1160.
2 Miller M, Mangano CC, Beach V, Kop WJ, Vogel RA. Divergent effects of joyful and anxiety-provoking music on endothelial vasoreactivity. Psychosom Med. 2010;72(4):354-356.
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