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High blood pressure: Is tai chi or aerobic exercise more effective?

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New research finds that tai chi may be more beneficial in lowering blood pressure than some other forms of exercise. Cherish Bryck/Stocksy
  • Higher than normal blood pressure, even blood pressure that is only mildly elevated, can pose a health risk.
  • If doctors can detect elevated blood pressure early, people can take steps to minimize their risk of developing more serious high blood pressure.
  • A recent study found that regular tai chi may be more effective at lowering elevated blood pressure than regular aerobic exercise.

Exercise is a critical component of a healthy lifestyle. It can aid in the management and prevention of high blood pressure. Research is ongoing about the most effective exercise options to manage specific conditions.


A new study published in JAMA Network Open compared the effects of tai chi and aerobic exercise on lowering blood pressure among participants with prehypertension.


After twelve months of four one-hour tai chi or aerobic exercise sessions a week, the tai chi group experienced a more significant reduction in blood pressure readings.


The results point to the potential benefits of tai chi to improve cardiovascular health.


Blood pressure: What numbers are considered high?

Blood pressure is a good indicator of cardiovascular health. When it gets too high, it can increase the risk of stroke and heart disease. Medical professionals divide blood pressure readings into several categories to track how high someone’s blood pressure is and what interventions may be most helpful to keep it in a healthy range.


A typically normal blood pressure reading is less than 120 mmHg systolic and less than 80 mmHg diastolic. An elevated reading is between 120-129 mmHg systolic and less than 80 mmHg diastolic. High blood pressure stage one is between 130-139 mmHg systolic or 80-89 mmHg diastolic. Then, high blood pressure stage 2 is 140 mmHg or higher systolic or 90 mmHg or higher diastolic.


A term that is not as typical anymore is prehypertension, which has to do with blood pressure that is higher than normal but not quite high enough to be considered high blood pressure stage two.


Dr. Rigved Tadwalkar, board certified consultant cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, explained to Medical News Today:


“Prehypertension is defined as having a systolic blood pressure between 120 and 139 mmHg or a diastolic blood pressure between 80 and 89 mmHg. It is important to note that prehypertension is not the same as hypertension (persistently high blood pressure). However, people with prehypertension are at an increased risk of developing hypertension, as well as heart disease, stroke, and other cardiovascular problems.”


People with blood pressure above normal levels can take several steps toward management. One of the main interventions is regular exercise. A variety of options for exercise exist, like walking and biking.


Tai chi is one form of exercise that continues to be an interesting area of study. It involves gentle movements and balance. It may help with several areas of health, like fall prevention and pain control.


Researchers of the current study wanted to see if tai chi helped lower blood pressure and how it compared to other exercises.


Tai chi vs. aerobic exercise: Which is better?

This study was a randomized clinical trial that included 342 adults. All participants had prehypertension, which researchers defined as “systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic BP (DBP) of 80 to 89 mm Hg.”


The researchers excluded participants who had certain conditions like diabetes, coronary heart disease, or chronic kidney disease. The average age of participants was around 50 years.


The researchers divided participants into two intervention groups. One group did tai chi, and the other participated in aerobic exercise. Each group participated in four one-hour supervised sessions a week of their activity for one year. The tai chi group did a 24-form Yang-style tai chi, and the aerobic exercise group did activities like jogging, cycling, and brisk walking.


The primary outcome that researchers measured was systolic blood pressure after twelve months. They also looked at several secondary outcomes, like changes in systolic blood pressure after six months and average changes in diastolic blood pressure readings.


Overall, the group participating in tai chi saw the most improvement in blood pressure readings. After one year, the tai chi group saw an average decrease of 7.01 mmHg in systolic blood pressure. In contrast, the aerobic group saw an average decrease of 4.61 mmHg in systolic blood pressure.


In addition, more participants in the tai chi group experienced blood pressure readings in a normal range after twelve months. The researchers also found that 24-hour ambulatory systolic blood pressure readings were lowered more in the tai chi group than in the aerobic group.


The results add to the evidence of tai chi being a helpful intervention for cardiovascular health.


Dr. Cheng-Han Chen, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was also not involved in the study, noted to MNT:


“In this study, regular tai chi was found to improve blood pressure better than aerobic exercise in patients with prehypertension. This is a useful finding, as it gives us another avenue to be able to treat elevated blood pressure.”


“Longer term studies should be considered to assess whether tai chi can prevent progression to clinical hypertension. In patients with elevated blood pressure, tai chi can provide a low impact form of exercise that can potentially improve blood pressure. It also has the added benefit of helping with balance and flexibility. However, clinical utility and uptake will depend on the availability of proper training in the technique,” he added.


But how does tai chi lower blood pressure?

This research does have certain limitations. First, the study was conducted in a single country, and future research could include more diversity among participants. The researchers were unable to look at intervention effects among subgroups.


The researchers also acknowledge that the results of the secondary outcomes are exploratory. Future research can work on confirming these findings. A total of 17.3% of participants discontinued their participation, leaving only a certain number of participants to analyze.


Dr. Tadwalkar offered the following words of caution in interpreting the study’s results:


“It’s important to remember that this was a fairly small study, and more research is needed to confirm these findings and assess the long-term effects of Tai Chi on cardiovascular health. Additionally, the study didn’t explore the mechanisms by which Tai Chi might exert its blood pressure-lowering effects. Understanding these mechanisms could provide valuable insights for future research and clinical practice.”


However, as the authors of the study note, tai chi as an intervention could still be beneficial, as it’s something many age groups can do in community settings. People interested in trying tai chi can seek appropriate guidance from professionals.


“Ultimately, tai chi may join forces with established methods to offer a personalized approach to blood pressure management and overall well-being. However, remember that consulting a physician remains crucial for an individualized treatment plan tailored to one’s specific needs and health status,” Dr. Tadwalkar noted.


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