Heart Project

Prof. Dr. Predrag Mitrović, Cardiologist: Music therapy to a Healthy Heart

Life in the city can be grim, and the swiftness by which it inevitably absorbs us relates not only to the number and type of chores and contacts during the day but also dictates our diet habits, daily routes, and routines as well as all the conditions in which we will linger during the day and year.

We have become aware of air pollution (in Serbia and Belgrade) thanks to numerous initiatives by groups of citizens and experts ready to point out the harmful components of air in urban areas, but when we talk about pollution, we usually don’t think of exposure to city noise and it really affects our physical and mental health and well-being.

With the cardiologist, Professor Dr. Predrag Mitrović, who has been studying music therapy for more than two decades as one of the methods of preventing heart diseases, we talked about what Belgrade, as a pilot city in two European projects dealing with public health, offers us and what health-derogating factors are the residents exposed to. Through the HEART and euPOLIS projects, Belgrade is a demonstration site for testing the impact of blue and green urban environments on physical and mental health.

Doctor Mitrović explains how, along with other pollutants, noise affects the health of the heart and how each of us can help by diligently choosing the music tracks we should indulge in every day.

Along with several published novels, the magazine “Muzika Klasika” and the music festival of the same name that he organizes every year, Mitrović recently published a new music album “48 minutes on Kosančićev Venac” which on the one hand, has great artistic value and on the other has therapeutic properties, specifically on heart health.


– Dealing with the study of how music can have a therapeutic effect on patients with cardiovascular diseases, I came to many insights and regularities about how music can be used exactly in “certain doses” to positively affect the condition of sick people. Setting new standards, i.e. laws in the application of music in the treatment of cardiovascular patients, which I like to call “quantitative music therapy”, I came to a practical understanding of how music can be adjusted to musical genre, tempo, tonality and the use of certain instruments, so that really it affects our health as if we took medicine, i.e. in such a way that we cannot oppose its effect. This type of music therapy is significantly methodologically different from the established standards of the application of music in the treatment of psychiatric patients, which has been known since Pythagoras’ time – Mitrović begins the conversation.

As he says, by applying the standards of “quantitative music therapy” to the creation of compositions from the album “48 minutes on Kosančićev Venac” he came to the standard of “healthy music”, music that can positively affect the vital parameters of our organism, such as blood pressure values and number heartbeats per minute, even when we are healthy. The album belongs to the musical genre known as “smooth jazz”, which is proven in research as one of the musical genres that are most often used in patients’ treatment.

– The album contains 11 songs that were inspired by places and objects on Kosančićev Venac, my favorite part of the city where I spent the most time since childhood. In the compositions, motifs of the past and the present of my emotions and feelings towards this place are intertwined. Ivan Kosančić (a legendary Serbian knight) himself, the “Dragon of Radan”, a fighter with two swords, has been my idol since childhood. So, while writing the compositions for this album, I combined both scientific knowledge and musical skills and created something I like to call healthy music. What’s more specific about this album is that in all the compositions, you can hear the beat of my heart, which is part of the rhythm, adjusted according to the rules of quantitative music therapy, that the speed of the music’s rhythm must not be opposed to the rhythm of our heart – reveals Predrag.

Some twenty years ago, knowing how we tend to take for granted that music has positive and healing properties for our mental and emotional state, he embarked on a mission to research and prove that music directly affects the health of our heart too. As he says, each of us instinctively feels and knows that the music we listen to does something good to us, especially when it is the music we normally like, but there is also a “trick”: we like something today, but the very next day we experience it as irritating or boring, bothering us!?

– Have you asked yourself why? Did you perhaps measure your blood pressure or heart rate? You probably didn’t. Your ear certainly doesn’t accept the same music you like when your blood pressure is normal and when it’s higher. Music is not the same when you have diabetes because your blood vessels’s structure has changed. Such thoughts made me observe how music is applied in a specific way, as “quantitative music therapy” affects your organism. Why “quantitative music therapy”? Because you are prescribed exactly certain compositions, with precisely specified “mathematical” values that correspond to the condition of your organism. Thus, as I have already emphasized, something completely different from the method used in psychiatry and other areas of medicine – reveals the cardiologist.

And what exactly defines a composition as healing, apart from our subjective feelings and affection?

According to Mitrović’s insights, if we define the application of music in healing in this way: musical genre, then tempo (speed of songs) and tonality (major or minor), these are the three basic characteristics of songs that can determine whether they are a cure or not.

-Of course, this must be determined for each person individually. The selected music is listened to at least twice a day for 12 minutes but can be longer. It’s like a dose of medicine for you. When you take pills, you take them once or twice a day. You can do something while listening to music, but that work must not distract you from the music you are listening to. The results are such that patients who listen to music prescribed in this way, compared to the group of patients who did not listen to music, have a significant decrease in blood pressure, a significant decrease in heart rate, much less often have angina pectoris, the occurrence of repeated heart attacks, and less often die. Therefore, the importance of the application of music is invaluable, especially in the prevention of the occurrence of cardiovascular diseases – says Mitrović.

Just how susceptible we are to even micro-influences, and what kind of symbiosis we are in with our environment, is evidenced by the fact that our body inevitably reacts hemodynamically and mechanically, as well as that our psyche is directly related to what we see, feel, and hear.

– If our environment is such that it pleases us, that is, it awakens positive feelings in us, regardless of whether these are momentary feelings or memories, through our psyche we will only have a positive effect on our organism, and therefore on our health. It is a well-known fact that everything “goes from the head“. The beat of my heart, which is present in all the compositions, was recorded by ultrasound, but the speed of the heart in the songs was recorded during a walk along the Kosančićev Venac range and by evoking memories, but also by the current feelings that certain places evoked in me during the walk. One of the compositions is called “Saborna crkva”. The music created is related to this holy place and inspired by the church itself, but also by the hours spent sitting on the fence of the church with my girlfriend during elementary and part of high school. All the songs are a combination of personal emotions, emotions caused by the historical importance of this place, and memories that are perhaps the most important. Many of the secrets of my life are connected to Kosančićev Venac, and that is why I visited it looking for inspiration and with every right – expecting inspiration because as much as this place gave me, I gave a part of myself to it. Every city in which you have spent part of your life can be and is your inspiration, whether positive or negative. But the parts, the microenvironmental whereabouts are much more important because they are always a more detailed section of your life than the city itself or the macroenvironment – explains the author of the healing music album.


Just as every one of us probably has our own places of inspiration in the cities we live in, our musical preferences are equally diverse. Although there are genres that are more recognized as “healing” in this case the therapy is adapted to the listener-patient.

– As I said, everyone has their own music to which they respond positively. There are twelve genres of music and some listen to several genres, some just one, but if they like it, that’s enough. It is a misconception that folk music, or as I like to say national music, cannot positively affect our hearts. Some patients respond positively even to “kolo” (traditional Serbian circle dance, part of the UNESCO heritage, a.n), which is expected to speed up the heart’s work. Sometimes patients react to musical genres that they have never listened to before, they don’t even know exist. It is usually artistic music and followed by the already-mentioned “smooth jazz”. So, just listen to the music you like – says Mitrović.

In recent years, Belgrade has been included among the most polluted cities in the world in the categories of air, water, and excessive noise contamination. All this affects the quality of public health, and decades of practice at the Emergency Room of the Clinical Center of Serbia in the cardiology department undoubtedly proved to Mitrović that most patients who come to his table are from the most polluted, mostly central city districts.

In the catheterization room at the Clinical Center of Serbia

– Air and water pollution, the presence of soot, and noise are all parameters that affect our health in different ways, and in already sick people they worsen the degree of the disease. Why is it so? In our body, everything is connected. Air pollution causes a decrease in the quality of inhaled air, that is, it decreases the concentration of oxygen, which is necessary for the functioning of all parts of one’s body, from the cell to the brain. This accelerates the heart rate because our body tries to increase the flow of oxygen by accelerating blood flow, which is harmful to our cardiovascular system. Noise causes excitement, anxiety, secretion of adrenalin, and acceleration of the sympathetic nerve pathway, thus also affecting the increase in blood pressure and the increase in heart rate. The intake of harmful substances through water burdens our organs, as well as those that “purify” the ingested liquid such as the liver and kidneys, as well as those organs that expect electrolytes brought in by water. Therefore, it is expected and proven that the largest number of patients with new diseases or exacerbation of existing diseases come from the most polluted parts of the city. This is most often the center of the city, as well as those zones, that is, hubs through which the largest number of motor vehicles and population pass. As individuals, it is difficult to change anything in the conditions of the city. Practically, our individual contribution can be to not destroy the existing flora and fauna in any part of the city environment and that is why, Mitrović believes, it is very valuable if we occasionally, as individuals or even better in organized groups, dedicate ourselves to restoration and restoration, first of all flora to cities, wherever possible in the city – in old places where it was destroyed and even better, in new locations.

Well, that makes us wonder if there are places in Belgrade or Serbia that are planned carefully enough to actually have a positive effect on our health…?

– It is difficult to single out individual examples. Research has shown that every place on our planet, every area, every city, every street, and every terrace that has at least a certain amount of plants – is a place where the degree of illness is reduced. Let’s give an example of New Zealand, as a green oasis with nature that suits the human organism. We may not be able to afford New Zealand, but we can have a window full of flowers and herbs or a terrace if we have one. If not, let’s go to the nearest park at least once a day for half an hour… – finally recommends cardiologist Predrag Mitrović.

The heart hears even when we are tone-def

– It is often thought that people who are tone-deaf do not respond to music. Having no talent for music means only that you are not able to correctly reproduce certain melodic lines, but your body reacts positively to music just like people who have it, even sometimes much more sensitively than them. It is interesting to know that the largest number of world music hits were recorded to match the rate of our heartbeats. Many world music stars, such as Stevie Wonder, Elton John, and Michael Jackson, first set the rhythm according to the work of the heart, and then did the extension of the songs. Then, the tenor saxophone and the harp are the two instruments that are most pleasing to our body. Musical instruments that are made of natural materials (wood and tin) are much more pleasant to our bodies than synthetic instruments. That’s why art music can be applied to almost all people, even if they don’t listen to it. These are just some interesting facts related to music and our health. And as for the song selection, everyone has their own music. That’s the music they like. If we want to achieve the maximum effect of music in treatment, it is important that these are not musical hits and that they are instrumental compositions, if possible. If not, you should choose songs that are in a language that the patient does not know. Then the voice is treated as an instrument – reveals Mitrović.

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