Effect of Tai Chi vs Aerobic Exercise on Blood Pressure in Patients With Prehypertension: A Randomized Clinical Trial

Author: Xinye Li1,2, Peifen Chang3, Min Wu1, Yuchen Jiang1, Yonghong Gao4, Hengwen Chen1, Liyuan Tao5, Dawei Wei3, Xiaochen Yang1, Xingjiang Xiong1, Yan Yang6, Xiandu Pan1,2, Ran Zhao7, Fan Yang1, Jiahao Sun8, Shengjie Yang1, Li Tian9, Xiaofang He10, Eryu Wang3, Yiyuan Yang1, Yanwei Xing1
1 Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing.
2 Graduate School of Beijing University of Chinese Medicine, Beijing, China.
3 Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
4 Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing.
5 Clinical Epidemiology Research Center of the Third Hospital of Peking University, Beijing, China.
6 Vasculocardiology Department, Fuzhou Hospital of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
7 YongDingLu Community Health Care Center, Aerospace Center Hospital, Beijing, China.
8 Traditional Chinese Medicine Department, BaiLi Traditional Chinese Medicine Clinic, Beijing.
9 Medical Department of Beijing Gulou Traditional Chinese Medicine Hospital, Beijing, China.
10 Cardiovascular Department of Affiliated Hospital of Shanxi University of Chinese Medicine, Taiyuan, China.
Conference/Journal: JAMA Netw Open
Date published: 2024 Feb 5
Other: Volume ID: 7 , Issue ID: 2 , Pages: e2354937 , Special Notes: doi: 10.1001/jamanetworkopen.2023.54937. , Word Count: 333

Prehypertension increases the risk of developing hypertension and other cardiovascular diseases. Early and effective intervention for patients with prehypertension is highly important.

To assess the efficacy of Tai Chi vs aerobic exercise in patients with prehypertension.

Design, setting, and participants:
This prospective, single-blinded randomized clinical trial was conducted between July 25, 2019, and January 24, 2022, at 2 tertiary public hospitals in China. Participants included 342 adults aged 18 to 65 years with prehypertension, defined as systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic BP (DBP) of 80 to 89 mm Hg.

Participants were randomized in a 1:1 ratio to a Tai Chi group (n = 173) or an aerobic exercise group (n = 169). Both groups performed four 60-minute supervised sessions per week for 12 months.

Main outcomes and measures:
The primary outcome was SBP at 12 months obtained in the office setting. Secondary outcomes included SBP at 6 months and DBP at 6 and 12 months obtained in the office setting and 24-hour ambulatory BP at 12 months.

Of the 1189 patients screened, 342 (mean [SD] age, 49.3 [11.9] years; 166 men [48.5%] and 176 women [51.5%]) were randomized to 1 of 2 intervention groups: 173 to Tai Chi and 169 to aerobic exercise. At 12 months, the change in office SBP was significantly different between groups by -2.40 (95% CI, -4.39 to -0.41) mm Hg (P = .02), with a mean (SD) change of -7.01 (10.12) mm Hg in the Tai Chi group vs -4.61 (8.47) mm Hg in the aerobic exercise group. The analysis of office SBP at 6 months yielded similar results (-2.31 [95% CI, -3.94 to -0.67] mm Hg; P = .006). Additionally, 24-hour ambulatory SBP (-2.16 [95% CI, -3.84 to -0.47] mm Hg; P = .01) and nighttime ambulatory SBP (-4.08 [95% CI, -6.59 to -1.57] mm Hg; P = .002) were significantly reduced in the Tai Chi group compared with the aerobic exercise group.

Conclusions and relevance:
In this study including patients with prehypertension, a 12-month Tai Chi intervention was more effective than aerobic exercise in reducing SBP. These findings suggest that Tai Chi may help promote the prevention of cardiovascular disease in populations with prehypertension.

Trial registration:
Chinese Clinical Trial Registry Identifier: ChiCTR1900024368.

PMID: 38335001 DOI: 10.1001/jamanetworkopen.2023.54937