ABSTRACT
Qigong and tai chi are both considered tools in the toolbox of traditional Chinese medicine (TCM). Qigong has been in existence for thousands of years, whereas tai chi is of a more recent origin. Both are considered low-impact exercises that have numerous health benefits. The present article reviews some studies on the treatment of hypertension and high blood pressure using one or both of these tools of TCM. Numerous studies have found that tai chi and qigong exercises can have a significant positive impact on blood pressure, nitric oxide and endothelin-1 levels.
Keywords: Qigong; Chi Gong; Tai Chi; Taiji; Taijiquan; Traditional Chinese Medicine; TCM; Hypertension; Blood Pressure; Nitric Oxide; Endothelin-1
Introduction
Tai chi, also referred to as taiji or taijiquan, is considered
both a martial art and a kind of low-impact exercise. Its origins
are unclear, but it apparently dates back at least to the thirteenth
century. The oldest style is the Chen style, which originated in the
Chen village in China [1,2]. The second oldest style, and also the
most popular style, practiced by more people than any other style,
is the Yang style [3]. The other main styles are the Wu and Wu Hao
styles [4], and the Sun style [5], which is the youngest of the five
main styles. The various styles of tai chi have much in common,
although there are some differences, which we need not discuss
in this article. One of the main common features of all styles of tai
chi is that they generate healing life energy (qi, pronounced chee),
which serves to boost the body’s immune system and prevent the
onset of illness and disease. Qi energy also has a beneficial effect on
treating existing illness. Many articles and books have been written
about the health benefits of tai chi [6-7], so we need not go into the
details here. Suffice it to say that many medical studies have found
that the regular practice of tai chi can lead to many health benefits,
including the treatment of existing diseases and illnesses.
Qigong has been around a lot longer than tai chi, perhaps
thousands of years [8]. Many books and articles have been written
about this traditional Chinese medicine tool as well [9-74]. It is
also a set of gentle exercises that generate qi, which has beneficial
healing effects for a wide variety of ailments, including, but not
limited to ankylosing spondylitis [75-76], anxiety and stress
reduction [77-82], arthritis [83-89], autism [90], back pain [91-92],
cancer [93-115], cognitive impairment [116-119], COPD [120-121],
COVID-19 [122-123], depression [124-134], elder care [135-138],
fibromyalgia [139-141], longevity [142-144], Parkinson’s Disease
[145-146], and traumatic brain injury [147], to name a few. The
present article focuses on the beneficial effects of tai chi and qigong
exercises on hypertension and blood pressure. It reviews a few
studies that have found beneficial effects and cites a number of
other studies for further reading and research.
Methodology
The PubMed.gov database [148] was searched to find studies that had been done to determine the effectiveness of tai chi and qigong exercises on blood pressure and hypertension.
Findings
The findings reported upon in this article are representative of
the numerous studies that have been done examining the effects of tai chi and qigong on blood pressure and hypertension. Additional
studies on this topic are cited in the reference section below Liu et
al. [149] conducted a meta-analysis to determine the effectiveness
of tai chi and qigong exercises in the treatment of essential
hypertension (EH). Specifically, they looked at blood pressure (BP),
levels of nitric oxide (NO), and endothelin-1 (ET-1). Exercises were
performed from 1.5 to 6 months. Nine randomized controlled tests
(RCTs) of 516 EH patients in China found that those who did the
exercises were able to reduce both systolic and diastolic blood
pressure. The exercises also contributed to higher NO blood levels
and lower ET-1 blood levels. Although the difference in treatment
outcomes using tai chi and qigong exercises versus antihypertensive
drugs was statistically insignificant, combining the two therapies
resulted in significantly better outcomes than what would occur
using only tai chi and qigong or drug therapy. Thus, tai chi and
qigong exercises were equally effective as drug therapy in the
treatment of hypertension, only without the side-effects that may
be present with drug therapy. Liu et al. concluded that tai chi
and qigong exercises could be an effective complementary and
alternative therapy for EH patients.
The tai chi exercises varied by study, and included the Yang-
24 form, Yang-8, and Chen-style tai chi. The qigong exercises
also varied by study, and included Mawangdui Daoyinshu and
Baduanjin, among others. Subgroup analyses were performed for
the different types of tai chi and qigong, and some were found to
be more effective than others. One subgroup analysis of changes
in systolic blood pressure ranked the effectiveness of the various
exercises as follows, from most to least effective:
a) Chen-style tai chi
b) Mawangdui Daoyinshu Qigong
c) Self-compiled qigong
d) Yang-style tai chi
An examination of different subgroups found that some tai chi
and qigong exercises were more effective than others in lowering
diastolic blood pressure. The ranking, from most to least effective,
was:
a. Chen-style tai chi
b. Self-compiled qigong
c. Mawangdui Daoyinshu Qigong
d. Yang-style tai chi
Liu et al. concluded that Chen-style tai chi might be most
effective in reducing blood pressure, while Yang-style tai chi might
be the least effective. The authors also compared the effectiveness
of the various tai chi and qigong exercises on improving NO levels.
The ranking from most to least effective was:
a. Yang-style tai chi
b. Baduanjin Qigong
c. Mawangdui Daoyinshu Qigong
Chen-style tai chi and self-compiled qigong were not statistically
significant in improving NO levels. The authors also analyzed
subgroup data on the effectiveness of tai chi and qigong in reducing
ET-1. The ranking from most to least effective was:
a. Baduanjin Qigong
b. Yang-style tai chi
c. Mawangdui Daoyinshu Qigong
Self-compiled qigong was found not to be statistically significant
in lowering ET-1 levels. Thus, it appears that Baduanjin and Yangstyle
tai chi may be more effective than other exercises in improving
NO and ET-1 scores.
If one were to interpret the findings of this study, one might
conclude that choosing qigong and or tai chi therapy might be
superior to drug therapy for the treatment of EH for two reasons.
Although the study found that qigong/tai chi therapy and drug
therapy are equally effective in treating EH, qigong/tai chi therapy
has two distinct advantages over drug therapy: qigong/tai chi
therapy has no adverse side-effects, and it does not cost anything.
Drug therapy, on the other hand, sometimes has adverse sideeffects,
and it is not free. The study also found that combining
qigong/tai chi therapy with drugs might be superior to choosing
just one of the two options.
Pan et al. [150] conducted a systematic review of randomized
controlled trials on the effects of tai chi on blood pressure, body
mass index (BMI), and quality of life (QOL) on patients suffering
from hypertension. Their meta-analysis of 24 studies containing
2,095 patients (1,074 in the treatment group and 1,021 in the
control group) found that the intervention group had significantly
better outcomes for systolic blood pressure (SBP) [p ≤ 0.001],
diastolic blood pressure (DBP) [p ≤ 0.001], physical functioning [ p
≤ 0.001], role-physical [p ≤ 0.001], general health [p = 0.001], bodily
pain [p ≤ 0.001], vitality [p ≤ 0.001], social functioning [p = 0.027],
role-emotional [p = 0.003], and mental health [p = 0.001] compared
to the control group. However, the differences in BMI between the
groups were insignificant. Pan et al. concluded that tai chi is an
effective therapy to improve SBP and DBP for patients suffering from
essential hypertension. Zou et al. [151] found that the practice of
baduanjin was beneficial for quality of life (p = 0.004), sleep quality
(p = 0.001), balance (p = 0.004), handgrip strength (p = 0.007),
trunk flexibility (p = 0.006), systolic (p = 0.0004) and diastolic (p
= 0.005) blood pressure, and resting heart rate (p = 0.0005). They
examined the results of various studies on each of these topics. In
the case of the effect of baduanjin on blood pressure, they examined
9 studies having a total of 743 participants.
Ladawan et al. [152] investigated the effects of qigong exercise
on cognitive function, blood pressure and cardiorespiratory
fitness in 12 healthy middle-aged subjects who performed qigong
exercises in 60-minute sessions, three times a week for eight weeks.
They found that the exercises resulted in significant improvements
in Trail Making Tests Part A (p = 0.04), systolic blood pressure
(p = 0.0001), diastolic blood pressure (p = 0.005), mean arterial
pressure (p < 0.001) and maximal workload (p = 0.032). Twelve
weeks after cessation of the exercises, they had all returned to the
baseline. The authors concluded that it is necessary to perform
qigong regularly to maintain the improved health effects.
Ching et al. [153] examined data on 370 subjects from seven
randomized controlled trials (RCTs). The following six types of
qigong exercises were used:
a) Conventional Qigong
b) Guolin Qigong
c) Shuxinpingxue Gong
d) Dongeui Qigong
e) Ba Duan Jin Qigong
f) Mawangdui Daoyinshu Qigong
They found that the practice of qigong exercises had a
significant effect on reducing systolic (p < 0.001) and diastolic (p
< 0.001) blood pressure. The above studies are representative of
the studies that have been done in recent years on the effectiveness
of tai chi and qigong on reducing high blood pressure. Some other
recent studies are listed in the reference section at the end of this
article [154-188].
Conflict of Interests
None.
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