The Efficacy of Tai Chi and Qigong Exercises on Blood Pressure and Blood Levels of Nitric Oxide and Endothelin-1 in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Dingcheng Liu,Gang Wang,Meixiao Sheng,Yanqin Zou,Lan Yi

doi:10.1155/2020/3267971

Abstract

Objective Tai Chi and Qigong are the two similar traditional Chinese wellness exercises. A strong body of published clinical randomized controlled trials (RCTs) has investigated the health benefits of Tai Chi and Qigong exercises (TCQE) in patients with essential hypertension (EH). This is the first meta-analysis to evaluate the efficacy of TCQE on blood pressure (BP) and blood levels of nitric oxide (NO) and endothelin-1 (ET-1) in EH patients and explore the potential antihypertensive mechanism of TCQE. Methods We conducted a literature retrieval for Chinese and English studies in seven databases from their respective inceptions until January 14, 2020. All RCTs examining clinical efficacy of TCQE for EH patients were considered. The major therapeutic outcomes of TCQE were changes in the blood levels of NO, ET-1, and BP in EH patients. Methodological quality of the included RCTs was detected via The Cochrane Risk of Bias tool. We evaluated the data reported and performed the meta-analysis by Review Manager 5.3 software. Results 9 RCTs involving 516 EH patients were included. The intervention duration lasted from 1.5 months to 6 months. The results of comprehensive analysis showed that compared with control interventions, experimental interventions were more effective in reducing the systolic blood pressure and the diastolic blood pressure and contributed higher blood levels of NO and lower blood levels of ET-1. Conclusions TCQE could be an effective complementary and alternative therapy for EH. The lower BP in EH patients who practice TCQE may have some connection with exercise-related increased blood NO levels and decreased blood ET-1 levels. However, further research is needed to make clear the efficacy of TCQE in management of EH and the mechanism of lowering BP in TCQE.

Highlights

In our article, we update the latest evidence in clinical randomized controlled trials (RCTs) and further review the efficacy of traditional Chinese medical exercises (Tai Chi and qi gong (Qigong)) for the essential hypertension (EH) patients, focusing on the exercise-related changes of blood nitric oxide (NO) and ET-1 levels. e primary aim of our study is to evaluate the efficacy of Tai Chi and Qigong exercises (TCQE) on lowering the blood pressure (BP) of patients with EH
There is insufficient evidence to suggest that lifestyle modifications alone reduce morbidity or mortality in hypertensive patients [22, 57]. e importance of regular physical activity in EH has been extensively investigated over the last decades and has emerged as a major modifiable factor contributing to optimal BP control [59]
Our study aimed to evaluate the role of endothelial-derived factors (NO and ET-1) in the reduced BP associated with TCQE

Summary

Introduction

Hypertension (HT) is a major health care problem, affecting more than 1 billion people globally and being a major risk factor for stroke, chronic kidney disease, and myocardial infarction [1, 2]. HT is a multifactorial disease involving environmental and genetic factors together with risk-conferring behaviors. E cause of the disease is identified in 10% of the cases (secondary hypertension), but in 90% of the cases no etiology is found (primary or essential hypertension [EH]) [4]. ED emerges as a promising therapeutic target of agents that are readily available in clinical practice. In this context, a better understanding of its role in EH becomes of great importance [7]

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