MCW Cardiovascular Medicine Singing and Cardiovascular Health Research
What if you could improve your heart health just by singing?
Jacquelyn P. Kulinski, MD, associate professor of medicine and cardiologist in the MCW Division of Cardiovascular Medicine conducted a research study to evaluate whether singing could improve cardiovascular health.
The aim of the study was to explore if singing can serve as a complementary strategy to lower the risk of cardiovascular disease for individuals who may have difficulty exercising or accessing various forms of cardiovascular therapy.
Among Medicare fee-for-service beneficiaries aged ≥65, only 24% of those eligible for traditional cardiac rehabilitation participated in at least one session. One reason for lack of participation in cardiac rehabilitation among older adults is physical impairment, such as chronic arthritis or diabetic neuropathy, that limit participation in exercise. Singing is an aerobic form of exercise that improves the efficiency of the body’s cardiovascular system with little to no reliance on skeletal muscle. Unlike traditional physical exercise, the impact of singing on cardiovascular health and its potential as a form of cardiac rehabilitation has not been extensively studied.
Important Facts About Cardiovascular Disease (CVD)
Why you should care about CVD
- About 48.6% of all U.S. adults have some form of cardiovascular disease
- Heart disease, the most common form of CVD, is the leading cause of death in the United States, with about 695,000 people dying from the disease in 2021
- In the United States, someone has a heart attack every 40 seconds
- In 2021, there were 12,789 deaths caused by coronary heart disease in Wisconsin – this was the leading cause of death
The American Heart Association's "Life's Essential 8"
About 80% of CVD is preventable, largely through the maintenance or achievement of ideal cardiovascular health. The American Heart Association has defined ideal cardiovascular health based on eight health behaviors and metrics that people can improve through lifestyle changes:
- Eat better
- Be more active
- Quit tobacco
- Get healthy sleep
- Manage weight
- Control cholesterol
- Manage blood sugar
- Manage blood pressure
The Singing Heart Pilot Study
The singing heart pilot study aimed to investigate the effect of singing on biomarkers of cardiovascular health.
Important definitions
Peripheral arterial tonometry (PAT): A non-invasive measure of vascular function by measuring pulse volume changes of arteries in fingertips.
Heart rate variability (HRV): A non-invasive measure of vascular function by measuring the variability between R-R intervals (specific measurements in an ECG test) in back-to-back heartbeats. The HRV measure is a result of a complex interaction between respiratory activity and nervous system-cardiovascular control. Typically, healthy individuals have more heart rate variability.
Study design and details
Sixty (60) individuals participated in a 14-minute video coached singing lesson, singing the Star-Spangled Banner, and throughout this activity various measurements were taken to analyze the cardiovascular biomarkers described above.
Study results and conclusions
Our team has been the first to demonstrate that just 14 minutes of solo singing improves vascular function acutely, regardless of singing expertise (or lack thereof).
Changes were more favorable in subjects with baseline endothelial dysfunction (i.e. those with established coronary artery disease and/or advanced age with CVD risk factors). Interestingly, there was no relationship between level of enjoyment and changes in vascular function; however, a relationship was seen in level of enjoyment and improvement in heart rate variability. Changes in heart rate variability observed in this study are similar to those seen in light-intensity exercise. In this context, singing could be a promising non-pharmacologic intervention to lower CVD risk.
For more detailed information on the study design, methods, and results:
View the published study: Acute effects of singing on cardiovascular biomarkers
Study Resources & References
Singing Heart Pilot Study Summary (PDF)
A presentation summary of the main findings from the Singing Heart Pilot Study.
Singing Heart Pilot Study Recording
A recording of a medical student explaining the Singing Heart Pilot Study via a poster presentation.