Virtual Reality Reduces Office Blood Pressure and Anxiety in Patients Undergoing Ambulatory Blood Pressure Monitoring: Enhanced Response among Those With a Pronounced White Coat Response.
Baker L, Karthik R, et al. • Journal of clinical hypertension (Greenwich, Conn.) • 2026
A brief VR relaxation intervention was associated with significant reductions in office blood pressure and anxiety, particularly among participants with a pronounced white coat response, supporting its potential as an adjunct for improving office blood pressure assessment in hypertension clinics.
Key Findings
Results
Virtual reality relaxation significantly reduced systolic office blood pressure across the full study cohort.
Systolic OBP decreased by 6.1 mmHg (95% CI, -7.6 to -4.6; p < 0.001) following VR exposure
Diastolic OBP decreased by 1.4 mmHg (p = 0.002) following VR exposure
Study included 78 participants with mean age 62 ± 15 years; 47% female
Prospective, single-arm, pre-post study design conducted in a tertiary hypertension clinic
Participants completed paired OBP measurements before and after a brief immersive VR relaxation experience
Results
Participants with a pronounced white coat response experienced the greatest systolic blood pressure reduction following VR exposure.
Pronounced white coat response was prespecified as an office-to-daytime ambulatory systolic BP difference ≥15 mmHg
This subgroup experienced a systolic BP reduction of -12.2 mmHg (p < 0.001)
The between-group difference in response was statistically significant (p = 0.005)
Other subgroups experienced smaller or nonsignificant changes in systolic BP
ABPM results were used to classify predefined blood pressure subgroups
Results
Following VR exposure, nearly one-third of participants were reclassified to a lower office blood pressure category.
32.1% of participants were reclassified to a lower OBP category after VR intervention
This reclassification has potential implications for diagnostic accuracy and overtreatment concerns
The study setting was a tertiary hypertension clinic among adults undergoing ambulatory blood pressure monitoring
Results
Anxiety scores decreased significantly following VR exposure and no adverse effects were reported.
Validated anxiety assessments were administered before and after VR exposure
Anxiety scores decreased significantly following the VR relaxation experience
No adverse effects were reported among the 78 participants
The VR intervention was described as a 'brief immersive VR relaxation experience'
Background
The study was conducted to evaluate whether VR-based relaxation could mitigate the white coat response among patients undergoing ambulatory blood pressure monitoring.
Office blood pressure may be transiently elevated during clinical encounters because of situational anxiety and stress-related physiologic arousal, contributing to diagnostic uncertainty and potential overtreatment
Prior to this study, VR effects on OBP and its role in mitigating the white coat response among ABPM patients had not been evaluated
VR-based relaxation had previously been shown to reduce stress-related physiologic responses in other contexts
When people visit a doctor's office, their blood pressure can temporarily spike due to nervousness or anxiety — a phenomenon known as the 'white coat effect.' This can lead to misdiagnosis of high blood pressure and unnecessary treatment. This study tested whether having patients use a virtual reality (VR) headset for a brief relaxation experience before having their blood pressure measured could reduce this effect. Seventy-eight adults who were already having their blood pressure monitored over 24 hours (ambulatory blood pressure monitoring) participated, and their blood pressure and anxiety were measured before and after the VR session.
This research suggests that a short VR relaxation session was associated with meaningful reductions in office blood pressure — an average drop of about 6 mmHg in systolic (top number) blood pressure across all participants. People who had the most pronounced white coat effect — meaning their office readings were at least 15 mmHg higher than their daytime readings at home — saw the biggest benefit, with an average drop of about 12 mmHg. Additionally, about one in three participants were reclassified into a lower blood pressure category after the VR session, and anxiety levels also fell significantly. No harmful side effects were reported.
This research suggests that VR relaxation could be a practical, low-risk tool to help doctors get more accurate blood pressure readings in clinical settings, potentially reducing the risk of over-diagnosing or over-treating high blood pressure. The effect appeared especially strong in patients most prone to anxiety-driven blood pressure spikes in medical settings. Future research with controlled designs would be needed to confirm these findings and determine how VR might best be incorporated into routine clinical care.
Baker L, Karthik R, Munlapudi V, Balog J, Mao M, Trautman C, et al.. (2026). Virtual Reality Reduces Office Blood Pressure and Anxiety in Patients Undergoing Ambulatory Blood Pressure Monitoring: Enhanced Response among Those With a Pronounced White Coat Response.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70360