Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis

Yin Wu; Blair T Johnson; Shiqi Chen; Yiyang Chen; Jill Livingston; Linda S Pescatello

doi:10.1016/j.jshs.2020.03.007

Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis

J Sport Health Sci. 2021 Mar;10(2):211-221. doi: 10.1016/j.jshs.2020.03.007. Epub 2020 May 1.

Authors

Yin Wu¹, Blair T Johnson², Shiqi Chen³, Yiyang Chen⁴, Jill Livingston⁵, Linda S Pescatello⁶

Affiliations

¹ Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA. Electronic address: yin.2.wu@uconn.edu.
² Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA; Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
³ Department of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA.
⁴ School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
⁵ Homer Babbidge Library, University of Connecticut, Storrs, CT 06269, USA.
⁶ Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA.

Abstract

Background: Professional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy.

Methods: Tai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions.

Results: Participants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (-11.3 mmHg, 95%CI: -14.6 to -8.0; d₊ = -0.75) and DBP (-4.8 mmHg, 95%CI: -6.4 to -3.1; d₊ = -0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg).

Conclusion: Our results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%.

Keywords: Blood pressure; Complementary medicine; Exercise training; Hypertension.

Publication types

Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Bias
Blood Pressure / physiology*
Diastole
Female
Humans
Hypertension / therapy*
Life Style*
Male
Middle Aged
Prehypertension / therapy
Systole
Tai Ji*

Grants and funding

U24 AG052175/AG/NIA NIH HHS/United States