Hypertension is the most common primary office diagnosis in the United States, with more than 35 million visits per year. Despite pharmacologic advances and nationwide education campaigns, only one-third of adult patients with hypertension in 2000 had adequate blood pressure (BP) control, far below the Healthy People 2010 goal of 50%.1 Clinical trials have consistently shown the benefits of lowering BP, with substantial reductions in cardiovascular risk, stroke, myocardial infarction, heart failure, and cardiovascular-related death.2 While pharmacologic therapy is often emphasized, the critical importance of non-pharmacologic approaches and lifestyle modifications, including physical activity and exercise, has continued to be recognized by the most recent Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) report for both primary and secondary prevention of high BP.1
In recent years, with the popularity and prevalence of mind-body therapies, there has been a growing interest in tai chi exercise for patients with hypertension.3–5 Tai chi (t'ai chi or taiji) has origins in ancient Chinese martial arts and combines gentle physical activity with elements of meditation, body awareness, imagery, and attention to breathing. The scientific literature describing tai chi is varied, with studies reporting benefits in a number of health conditions, from balance and reduction of falls in frail adults, to improvements in quality of life and symptoms of rheumatoid arthritis, the human immunodeficiency virus, cancer, and heart failure.6,7 A substantial amount of research examines the cardiovascular effects of tai chi, including cardiorespiratory fitness and exercise capacity, although BP is the most commonly evaluated effect in these studies.4,8
To date, there have been no comprehensive systematic reviews examining long-term BP effects of tai chi, and very little is known about what has been published in the Chinese language. Our objective was to conduct a systematic review of Chinese and English language literature on the effects of tai chi on BP and hypertension and to offer recommendations for future research.