Predictors of improvement in cardiovascular biomarkers with singing.

Although regular physical exercise lowers the risk of coronary heart disease in both primary and secondary prevention populations, physical exercise may be difficult for some individuals, prompting the need for alternative therapies. This study is a sub-analysis of a previously completed clinical trial that aimed to assess the effect of singing on cardiac biomarkers. The previous trial included 60 patients recruited from a cardiology clinic (mean age 61 ± 13 years; 68 % women) with measurements of vascular endothelial function and heart rate variability (HRV), and the results showed that 14 min of singing improves endothelial function acutely, similar to a short bout of physical exercise. The present sub-analysis examined whether predictive variables (prior singing experience, gender, age, enjoyment level, effort, smoking history) impacted changes in outcome measures. No significant change was seen in endothelial function or HRV based on exposure variables except for smoking status. Past smoking (compared to never smoking) predicted improvement in vascular endothelial function after singing. Abnormal baseline endothelial function was a predictor of acute improvement in endothelial function. These findings suggest that singing may have beneficial effects on vascular endothelial function, especially in patients with abnormal baseline endothelial function, regardless of singing experience.