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1995 Medical Tribune News Service

People with high blood pressure may want to avoid taking up the French horn, according to a new report.

California doctors describe the case of a 47-year-old man with hypertension who was learning to play the French horn. Every time the man played notes higher than G on the musical scale, he became dizzy.

So the researchers from the University of California, San Diego hooked the budding musician up to a blood-pressure monitor, and measured his heartbeat-to-heartbeat pressure as he played a scale from middle C to high C, then back to middle C.  The man held each note for at least 15 seconds, then rested for 20 seconds before playing the next note.
The monitor showed that the man's blood pressure rose immediately after he began playing, rising further as the notes got higher and dropping as he returned to middle C.

"Horn playing was associated with an immediate and progressive increase in diastolic pressure, from 76 mmHg to 113 mmHg," Dr. Joel Dimsdale and Richard Nelesen wrote in a letter published Thursday in The New England Journal of Medicine.

Diastolic pressure - the pressure between heartbeats - of 90 or below is considered normal.

The higher the note, the higher the diastolic pressure, the California doctors said. "It is unclear whether in horn players [with normal blood pressure] such a crescendo of diastolic pressure would accompany the higher notes," they wrote.

The French horn is a coiled tube that if unwound, would measure about 12 feet long. The resistance caused by blowing against pursed lips through the long tubing causes a situation known as Valsalva's maneuver, an increase in pressure inside the chest cavity that can interfere with the blood supply to the heart, the researchers said.

Other situations that cause the Valsalva maneuver include when a person holds his breath and tightens his muscles while moving a heavy object.

While in healthy people the Valsalva maneuver generally is safe, the pressure it creates can be dangerous for people with heart or blood-vessel problems.

"We do not know whether such episodic blood-pressure elevations during horn playing have clinical relevance," the researchers wrote. "However, brass players' folklore suggests an increased incidence of [eye] hemorrhages, retinal detachments and cerebrovascular accidents."


This story is from Your Health Daily, an Internet web site operated by The New York Times Syndicate, and is used with permission. No publication, reuse or redistribution of this article is permitted.  This material is for informational use only and should not be considered health advice.

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