Research and other articles on tai chi and qigong
Medscape Medical News > Conference News
Tai Chi Resembles Drugs, Aerobics in Blood Pressure Lowering
Laird Harrison
June 01, 2016
BOSTON — Tai chi can lower blood pressure in older people as effectively as drugs or aerobic exercise, a new meta-analysis suggests.
The traditional Chinese discipline offers possibilities for older people who can't or don't want to exercise strenuously, said Linda Pescatello, PhD, from the University of Connecticut in Storrs.
"Tai chi is low intensity, it's social, and this modality would be very attractive to older adults," she told Medscape Medical News. This means that "they may be more adherent to it than to other forms of exercise."
And tai chi can provide other benefits, such as improved balance, she added.
Dr Pescatello and coauthor Yin Wu, MA, also from the University of Connecticut, presented the finding here at the American College of Sports Medicine 2016 Annual Meeting.
It comes on the heels of results from the SPRINT trial, recently reported by Medscape Medical News, which showed that people 75 years and older with hypertension benefit when target systolic blood pressure is 120 mm Hg, which is lower than current guidelines.
But antihypertensive drugs can cause adverse reactions and aerobic exercise can be difficult or uncomfortable, especially for people with comorbidities, such as osteoarthritis.
To understand how effective an alternative tai chi could be, the researchers looked at the medical literature and searched for ways to combine the effects of many small studies.
They found 28 studies of tai chi that measured blood pressure, and judged them to be of moderate quality. The studies consisted of 1296 people who did tai chi and 919 people who served in nonexercise control groups.
In the pooled cohort, average age was 62.1 years, average body mass index was 25.8 kg/m², average systolic blood pressure was 135.5 mm Hg, and average diastolic blood pressure was 80.5 mm Hg. Sixty-two percent of the people were women, 56% were Asian, and 39% were white.
On average, tai chi was performed for 61.1 minutes per session, 2.9 times a week, for 20.6 weeks.
Systolic and Diastolic Blood Pressure Lowering
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During this time, the average drop in systolic blood pressure was 6 mm Hg and in diastolic blood pressure was 3 mm Hg. "Reductions are comparable to first-line antihypertensive medications," said Dr Pescatello. "They are consistent with what has typically been prescribed."
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The researchers also identified some trends in the data. First, they found that the reduction in systolic blood pressure was greater in people who performed tai chi more frequently.
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When tai chi was practiced more than three times a week, the average reduction in systolic pressure was 9.6 mm Hg, when it was practiced three times a week, the average reduction was 5.3 mm Hg, and when it was practiced fewer than three times a week, the average increase in systolic pressure was 1.1 mm Hg (P = .002).
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For studies in which blood pressure was a primary outcome, the average reduction in systolic blood pressure was 9.1 mm Hg, whereas for those in which blood pressure was a secondary outcome, the average reduction was 1.3 mm Hg (P < .001).
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When the researchers combined those two findings, they showed that when blood pressure was a primary outcome, the average reduction in systolic pressure in people who performed tai chi more than three times a week was 13.6 mm Hg.
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Average reduction in diastolic pressure was greater in people with higher resting pressure than in those with lower resting pressure (4.0 vs 0.1 mm Hg). And reductions in diastolic pressure were greater in studies at higher risk for bias.
The researchers point out that all the studies in their analysis defined tai chi as a low-intensity physical activity with elements of attention to breathing and relaxation. But most said nothing about the intensity of the tai chi exercises, the type of breathing or relaxation techniques, and how blood pressure was measured, which could be a limitation of the meta-analysis.
Tai chi might reduce blood pressure through a variety of mechanisms. For example, Wu explained, it could reduce stress or improve autonomic control.
This study "goes to show you don't need to do crazy intense exercise to get cardiovascular benefits," said Sarah Herrick, PhD, from the Massachusetts College of Liberal Arts in North Adams.
During the same poster session, she presented a study that showed that yoga decreases anxiety and that heart rate varies during bouts of yoga.
Yoga, too, has shown the capacity to lower blood pressure, Wu pointed out.
Dr Pescatello, Mr Wu, and Dr Herrick have disclosed no relevant financial relationships.
American College of Sports Medicine (ACSM) 2016 Annual Meeting: Abstract 288. Presented June 1, 2016.
Studies on benefits of Tai Chi
1. Tai chi puts young readers in a better class
- A primary school in Henbury Bristol reported dramatic improvement in Year 7 pupils’ reading abilities thanks to a daily routine of exercise including elements of tai chi. (The Times, 25.6.2013) (Doing tai chi certainly helps concentration and control)
2. Key findings of Arthritis Research UK’s recently updated research on various alternative remedies & complementary therapies
- winners in the therapy section included acupuncture (5 star) & tai chi (4 star), stating that the benefits of the two therapies are probably the result of ‘their effects on muscle tone & posture’ (The Times 14.1.2013, Dr. Mark Porter)
3. Tai chi as exercise
- LSE & Stanford University researchers looked at 305 trials of 339.274 people, comparing the effects of drugs & exercise regimes in warding off heart disease, rehabilitating stroke patients, treating heart failure and preventing diabetes. They concluded that, apart from diuretics for heart failure patients proving more effective, ‘exercise interventions should be considered as a viable alternative to, or alongside, drug therapy’
- ‘1 in 3 Alzheimer’s cases could be prevented by exercise & education’ research from Lancet Neurology journal claimed. They identified 7 problems which increased the risk of dementia (inactivity, obesity, depression, high blood pressure, diabetes smoking and lack of education). In the UK, 21% of dementia cases are linked to inactivity. (Times, 15.7.2014)
- ‘tai chi gently twists and elongates tense tissues and opens the body to release the central nervous system; it boosts the brain and memory as efficiently as both erious mental exercises and strenuous aerobic exercise; doctors acknowledge that it improves arterial compliance (expansion & contraction of the arteries, crucial for heart health); (from article by Florence Waters in Telegraph Weekend, 14.6.2014)
- ‘Exercise is essential to grow back your brain’ Study of 120 people aged 60-80, one group walked briskly ¾ times a week, another group did light stretching exercise. They were given cognitive tests & MRI scan before & after 12 months. It showed the first group’s hippocampus (memory area of brain) & pre-frontal cortex (decision making area) both increased volume by 2%. The control group’s brain regions shrank by 1.5%, in line with annual decline in elderly brain volume. (Times, 18.2.2014)
- In a small sample from a questionnaire of my students after 2 years doing tai chi, most reported some improvements in general health; mobility (stronger legs, better at bending); posture; stability (better balance); energy level; stress level (calming) and general concentration. All this contributes to lessening the risk of falls for those over 60 and those who suffers from osteo arthritis.
Compiled by Magdalen Kit Fong FRY 2016
Abstract
Effects of Mind-Body Exercises on Cognitive Function in Older Adults: A Meta-Analysis
Wu, C.,Yi, Q.,Zheng, X.,Cui, S.,Chen, B.,Lu, L.,Tang, C.
J Am Geriatr Soc
DOI: 10.1111/jgs.15714
BACKGROUND/OBJECTIVES: Mind-body exercise has positive effects on cognitive performance, according to clinical observation and experts' recommendations. However, its potential benefits for the cognitive function of aging adults are uncertain and still lack systematic estimations. Therefore, we conducted a systematic review and meta-analysis to evaluate the overall efficacy and effectiveness of mind-body exercises for cognitive performance in aging individuals with or without cognitive impairment.
DESIGN: A systematic review and meta-analysis.
SETTING AND PARTICIPANTS: We searched related trials through June 2018 from four databases: Medline, Embase, PsycINFO (all via Ovid), and the Cochrane Library/Central Register of Controlled Trials. MEASUREMENTS: Methodological quality was assessed using the Cochrane Risk of Bias Tool. A meta-analysis of comparative effects was performed using Review Manager v.5.3 software, and publication bias was examined using Egger's test.
RESULTS: A total of 32 randomized controlled trials with 3624 participants were ultimately included in this meta-analysis. The results revealed that mind-body exercises as a whole had benefits in improving global cognition compared with that of the control group (mean difference [MD] = 0.92; 95% confidence interval [CI] = 0.33-1.51; p = .002) and were more effective than control interventions in promoting cognitive flexibility (MD = -8.80; 95% CI = -15.22 to -2.38; p = .007), working memory (MD = 0.32; 95% CI = 0.01-0.64; p = .05), verbal fluency (standardized mean difference [SMD] = 0.27; 95% CI = 0.09-0.45; p = .003), and learning (SMD = 0.24; 95% CI = 0.10-0.39; p = .001) on cognitively intact or impaired older adults. In dose-subgroup analysis, only moderate exercise intensity (60-120 min per week) significantly increased global cognition scores compared with those of the control group (MD = 1.15; 95% CI = 0.34-1.97; p = .006).
CONCLUSION: Mind-body exercises, especially tai chi and dance mind-body exercise, are beneficial for improving global cognition, cognitive flexibility, working memory, verbal fluency, and learning in cognitively intact or impaired older adults. Moderate intensity is recommended as the optimal dose for older adults.