The sound of stress: Can noise spike your blood pressure?

In their remarkable work, investigators from Baltimore, Maryland, challenged the prevailing belief that public places are less conducive to accurately measuring blood pressure (BP), given the difficulties in implementing the standards recommended by guidelines in such settings.1 They hypothesized that BP measured in a loud public space would be higher than when measured in a quiet private space, and that using earplugs in a noisy public space (to simulate a quiet public environment) would alleviate this discrepancy.In this meticulously planned study, the investigators enrolled 108 participants from the Baltimore community through referrals, personalized mailing, and campaigning.Their mean age was 56 years; 84.3% were black, and 40.7% were women.Most had attended a chronic care clinic in the previous year, with the majority already on antihypertensive medications.The patients were randomized into 6 groups.In each, participants underwent BP measurements in a public loud setup, a public quiet setup, and a private loud setup in different sequences.Additionally, a fourth reading was recorded in a private, quiet setting for each of the 6 groups, alongside the three sets of readings for each group.Every participant underwent 4 sets of triplicate BP measurements, with the first three in random order, followed by the fourth always in a private, quiet office, which led to 6 groups.The averages of systolic (SBP) and diastolic blood pressure (DBP) readings in public loud, public quiet, and private quiet locations were compared for differences among all groups combined, as well as in subgroups based on age, baseline hypertension, and recent healthcare utilization, using independent t-tests.The results indicated that the mean SBP measured in a public, loud space was not statistically different from that recorded in a private, quiet setup.Likewise, SBP in a public space and a private, quiet office did not differ significantly.The authors concluded that public spaces can also serve as reasonable setups for conducting a hypertension screening program, as the differences in BP readings between a loud public space and a quiet private space were not significant in this study.