High blood pressure inhibits cardiovascular responsiveness to expressive classical music.

Music lowers hypertensive patients' blood pressure (BP) in the long-term, but the dynamics of BP during music-listening are not well understood. This study aims to determine: (1) whether individuals with high and normal BP respond to music differently; and, (2) whether music's loudness or tempo drives these differences. Music with computer-altered tempo and loudness is rendered on a reproducing piano to 40 middle-aged participants, 20 with baseline BP above 140/90 mmHg (H-bBP) and 20 below (N-bBP) but above 90/60 mmHg, paired by playlist. Continuous BP was recorded whilst they listened to playlists of 9 tempo- and loudness-transposed versions of 8 distinct pieces of Western classical music (40 min) after a 5-minute baseline silence. Both participant groups' mean systolic and diastolic BP rose significantly higher than baseline during music listening, with normotensives' mean systolic and diastolic BP rising significantly more than hypertensives'. Both groups' BP variability (indexed by range and standard deviation of continuous BP measurements) reduced during faster tempi, but not during increased loudness. BP variability is significantly higher for both groups during the slowest pieces, which maintain the originally performed tempi. These findings suggest that music's long-term benefit, like exercise, may come from its power to temporarily physiologically activate listeners.