Key take-aways
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New research shows that blood pressure, like heart rate and breathing, synchronises more to predictable phrase structures in music, which may improve the body’s baroreflex sensitivity, i.e. its ability to regulate blood pressure.
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92 participants had their blood pressure continuously monitored while listening to nine out of 30 piano music tracks. The piece of music that had the most predictable phrase structures, and the biggest impact on blood pressure, was the English pianist Harold Bauer’s performance of Franz Liszt’s transcription of Franz Schubert’s Serenade.
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The researchers say this finding could pave the way to create personalised music-based non-pharmacological cardiovascular therapies in the future.
Madrid , Spain – 28 August: A new study has found that blood pressure synchronises to predictable phrase structures in music. Blood pressure was more affected by loudness than tempo and was more strongly influenced by phrase structures that were more predictable.
The researchers say the research finding could help to inform personalised music based cardiovascular therapies for those with high blood pressure in the future.
Musicians modulate the tempo and loudness of music in understandable ways to mark phrases and phrase boundaries, which contributes to the patterns we hear. Some music has more predictable phrase structures, which can add to the enjoyment of listeners.
Study lead Professor Elaine Chew is a pianist by training and is also a Professor of Engineering at King’s College London in the UK. She explained, “Like language, music has patterns and phrases which form expressive structures, and this is often what strikes a chord with listeners. This research tells us that more predictable music phrase structures have a bigger impact in regulating the cardiovascular system.”
“This study follows our previous research that showed that respiration and heart rate is also influenced by phase structures, [1][2][3]” she continued. Stronger synchronisation was observed for predictable phrases, which are more regular, of duration similar to slow-paced breathing, and in longer tracks therefore having more phrase instances.
92 participants had their blood pressure continuously monitored listening to nine out of 30 piano music tracks. A Bayesian algorithm [4], also by Chew’s team, enabled a computer to automatically detect music tempo and loudness phrase arc boundaries. Performers denote phrases with arc-like changes in expressive music features that drive listener’s responses. Sixty women and 32 men took part with a mean age of 42 years old.
The 30 tracks used in the research were original recordings of legendary performances by master pianists, and the researchers altered their expressivity in systematic ways to observe the effect on cardiovascular variables. The music was played back to participants on a reproducing piano for consistency, and to come as close to a live performance as possible in a controlled experimental setting.
In 25 out of 30 tracks, blood pressure entrained more to loudness than tempo. Increased predictability of the phrase structures in the music allowed the listener to anticipate phrase changes and was found to lead to higher blood pressure-music synchronisation, which may strengthen the body’s ability to regulate blood pressure [5].
From the playlist, the recording that had the most predictable phrase structures, and the
biggest impact on blood pressure, was the English pianist Harold Bauer’s performance of Franz Liszt’s transcription of Franz Schubert’s Serenade.
The study used classical piano music because it was possible to vary the music and simulate a ‘live’ experience in a research setting. However, the researchers argue that the methods and strategies used are transferrable to any music with phrase indications.
“Throughout time and across cultures, humans have moved and grooved to music. There are likely to be biological and social advantages to being able to coordinate our actions to an external rhythm, such as people on a boat synchronising their rowing.” Professor Chew added.
“To coordinate our actions in this way, we need to be able to anticipate the beginnings and ends of rhythm cycles. It is this anticipation that likely influences our cardiorespiratory cycles. It feels good to synchronise to musical structures – research has found that music uses the same reward system as food, sex and drugs,” she continued.
The researchers measured ‘entrainment’, which is the synchronisation of physiological rhythms with external stimuli. This can be quantified using Earth Mover’s Distance (EMD) to produce a similarity measure between music and physiology. The participant’s blood pressure waveform was incorporated into the music’s beat time.
Blood pressure measurements for each track were shuffled with their responses to other tracks to understand their statistical significance. This helped to determine whether the blood pressure response was influenced by the music they were hearing, rather than being a random variation in the individual’s physiology.
The researchers note that music is increasingly being recognised as a potential non-pharmacological intervention to regulate the cardiovascular system.
“This research raises the intriguing possibility that we could design music therapies to elicit specific biological responses in the future. This could be tailored specifically to individuals, bringing us closer to music as precision medicine. In the longer term, one day we may be able to use music to prevent heart disease or slow, arrest, or reverse its progression.” Professor Chew concluded.
ENDS
Notes to editor
This press release accompanies an abstract at ESC Congress 2025.
It does not necessarily reflect the opinion of the European Society of Cardiology.
Funding: European Research Council as part of the COSMOS (Computational Shaping and Modeling of Musical Structures) project
Disclosures: Ms. Cotic reports doctoral research support from the Engineering and Physical Sciences Research Council (EPSRC) of UK Research and Innovation (UKRI). Prof. Chew, Dr. Pope, and Dr. Soliński report research support from the European Research Council (ERC, 788960). Prof. Chew and Prof. Lambiase also received support from the ERC (957532) for this research.
Prof Chew served as an advisor/consultant and/or received honoraria outside of this research for academic/research programme reviews for Georgia Institute of Technology, Institut de Recherch et Coordination Acoustique / Musique, Massachusetts Institute of Technology, Nanyang Technological University; grant reviews for the ERC, Harvard Radcliffe Institute for Advanced Study, National Science Foundation; and speaker/performer for a Biotronik event.
Prof Lambiase receives research support outside of the present study from the National Institute for Health and Care Research (NIHR) and British Heart Foundation (BHF).
References and notes
[1] Cotic, N, V Pope, M Soliński, PD Lambiase, E Chew (2025). Dynamics of Autonomic
Entrainment to Music: Effect of Loudness and Tempo Phrase Structures on RR Intervals and
Respiration. In Proceedings of the 47th Annual International Conference of the IEEE
Engineering in Medicine and Biology Society (EMBC), 14-17 Jul 2025, Copenhagen, DK.
kclpure.kcl.ac.uk/ws/portalfiles/portal/343854162/NC-EMBC25.pdf
[2] Cotic, N, V Pope, M Soliński, P Lambiase, E Chew (2024). A Computational Method for
Empirically Validating Synchronisation Between Musical Phrase Arcs and Autonomic
Variables. In Proceedings of Computing in Cardiology (CinC), 8-11 Sep 2024, Karlsruhe, DE.
www.cinc.org/archives/2024/pdf/CinC2024-380.pdf
[3] Cotic, N, V Pope, M Soliński, P Lambiase, E Chew (2024). Computationally Validating
Synchronisation Between Musical Phrase Arcs and Autonomic Variables. In Online
Proceedings of International Conference of the Society for Music Information Retrieval
(ISMIR), 11-15 Nov 2024, San Francisco, US. ismir2024program.ismir.net/lbd_467.html
[4] Guichaoua, C, P Lascabettes, E Chew (2024). End-to-end Bayesian segmentation and similarity assessment of performed music tempo and dynamics with no score information. Special issue on Explaining music with AI: Advancing the scientific understanding of music through computation, Music and Science, 7: 16 pages. doi.org/10.1177/20592043241233411
[5] Gitler A, Bar Yosef Y, Kotzer U, Levine AD. Harnessing noninvasive vagal neuromodulation: HRV biofeedback and SSP for cardiovascular and autonomic regulation (Review). Med Int (Lond). 2025 Apr 29;5(4):37. doi.org/10.3892/mi.2025.236
The abstract «Cardiovascular synchronisation to music : blood pressure entrainment to expressive musical structures » will be presented at the session Digital innovations in clinical practice which takes place on 31 August from 08:15 to 09:45 am CEST at Digital Health Stage (Digital Health Area)
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