Ryan Milon1, Jeffery T. Wight2,,1, Thomas Waller1, Shaylee Befus1, Akhil Mandavalli1, Sofia Rohde1, Tatiana Lino1, George G.A Pujalte, FACSM1. 1Mayo Clinic, Jacksonville, FL. 2Jacksonville University, Jacksonville, FL.

BACKGROUND: White coat hypertension (WCH) refers to patients with high blood pressure (BP) in a clinical setting, but normal BP at home. This condition is common and problematic, as it prevents physicians from properly evaluating and treating elevated BP. Strategies have been developed to obtain valid BP measurements for WCH patients including 24-hour ambulatory BP monitoring and the automated office BP measurement. However, these strategies are time-consuming and impractical. Practical approaches are needed to rapidly obtain valid BP measures. In this pilot study, we explore a potential solution: virtual reality (VR) headsets. This intervention may be beneficial as calming scenes can be easily displayed to patients. PURPOSE: Have WCH patients complete a 5-minute VR intervention (calm beach scene) and determine if BP decreases significantly. METHODS: WCH patients (13 males, 13 females, age 55+) were recruited from a hospital database (at Mayo Clinic Florida). All the patients were previously diagnosed as WCH by their physician. Patients who agreed to participate arrived 15 minutes early for a previously scheduled routine appointment. First, the participant signed the informed consent. Then a baseline BP measurement was collected taken. (Welch Allyn Connex 6700 Vital Signs Monitor). Next, the patient wore the VR headset for 5 minutes Oculus Quest 2 with Skybox VR Video Player). The VR displayed a “calming beach scene" and BP was collected again (at 5-minutes). RESULTS: The systolic BP reduced significantly (p<0.01) from baseline (154.0±23.7) to the VR condition (147.4±22.1). For diastolic BP, there was no significant difference (p=0.12) between the baseline (85.3±24.4) and VR (83.6±14.2). On 5-point scale questions, 21 of 22 patients answered favorably when asked if the VR experience was “enjoyable” (4.45±0.78) and if they believed it could lower their blood pressure (4.0±0.93). Further, only 1 of 22 participants reported feeling “nervous” while wearing the VR device (1.54±0.88). CONCLUSION: The VR device appeared to quickly reduce systolic BP by a clinically relevant amount and the majority of WCH participants responded positively to the intervention. This approach appears to have the potential to improve clinical practice. Future studies should attempt to optimize this intervention; detailed studies are needed to better understand the optimal exposure time and scene.

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