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HEART Insight:
doi: 10.1097/01.HEARTI.0000452803.00961.17
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How Tai Chi Impacts Cardiovascular Health (Online bonus)

Fuerst, Mark L.

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Tai Chi is an interesting but not yet proven approach for the prevention and rehabilitation of multiple heart diseases. “Tai Chi impacts key cardiovascular disease risk factors, including blood pressure, cholesterol and blood sugar levels, and inflammation, as well as specific cardiovascular conditions including coronary artery disease,” says Peter Wayne, Ph.D., assistant professor of medicine at Harvard Medical School and the director of research for the Osher Center for Integrative Medicine, jointly based at Harvard Medical School and Brigham and Women's Hospital in Boston.

Several systematic reviews have summarized the research evidence for the benefits of Tai Chi for heart health. Here is a review of some of the relevant research.

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HIGH BLOOD PRESSURE

Many studies have shown that Tai Chi can lower high blood pressure. “In a 2008 systematic review conducted by our group, we identified 26 studies that assessed the impact of Tai Chi on blood pressure,” says Wayne. “We found that in 85 percent of trials, Tai Chi lowered blood pressure, with improvements ranging from 3 to 32 mmHg in systolic pressure and from 2 to 18 mmHg in diastolic pressure.

Collectively, these data suggest Tai Chi may be as effective in controlling blood pressure as other lifestyle approaches including weight loss, a low-sodium diet and moderating alcohol use.”

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HIGH BLOOD CHOLESTEROL LEVELS

A handful of studies, including randomized controlled trials (the gold standard of medical research), have examined the effects of Tai Chi on cholesterol and related lipids. Some have found that Tai Chi leads to favorable changes compared with control groups that had no interventions. Other trials among those who were obese, diabetic or had lipid disorders, and also among healthy people, have reported positive effects of Tai Chi on cholesterol and blood cholesterol levels.

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IMPAIRED BLOOD SUGAR CONTROL

A few studies have reported improvements in blood sugar control following Tai Chi training. One Hong Kong study of 207 healthy adults compared 12 weeks of Tai Chi to strength and resistance training as well as to a usual-care (control) group. The older participants in this study had various heart disease risk factors. The results show that levels of fasting glucose and other blood sugar markers in both exercise groups were not different than in the control group. However, other randomized controlled trials have not reported any apparent benefit of Tai Chi on glucose metabolism, notes Wayne.

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INFLAMMATION

Inflammation, the process by which your body fights off infection and heals itself, is now widely believed to be associated with the development of heart disease. Although the precise connections between inflammation and heart disease are not yet fully understood, increased inflammation is associated with narrowing and clotting of the arteries, which are linked to heart disease and stroke.

One key marker of inflammation is the protein C-reactive protein (CRP). High levels of CRP in the blood indicate an increased risk of heart disease. Low levels of CRP indicate a low risk. A few small studies suggest that Tai Chi may reduce inflammation and CRP levels. One recent randomized controlled trial including Taiwanese obese patients who had Type 2 diabetes found that 12 weeks of Tai Chi reduced their CRP levels but conventional exercise did not.

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EXERCISE AND FITNESS

There is good evidence that Tai Chi can improve overall fitness in both healthy people and those with heart disease. A recent study of more than 370 relatively healthy adults conducted in Hong Kong compared the effects of a 12-week Tai Chi program to both brisk walking and those who did not exercise. At 12 weeks, exercise capacity (the ability to increase physical activity) increased in both the Tai Chi and walking groups about equally. In addition, Tai Chi led to improved weight loss and general physical fitness. Interestingly, the Tai Chi group did this with a one-third less increase in heart rate. “These results support the idea that when exercise intensity is a concern, as it is in many heart conditions, Tai Chi may be the preferred form of exercise since it puts less demand on the heart,” says Wayne.

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CORONARY HEART DISEASE

A handful of studies have evaluated the potential benefits of Tai Chi for patients diagnosed with coronary heart disease. One study in England using patients recovering from a heart attack found improvements in systolic blood pressure in both the Tai Chi and aerobic exercise groups, but only the Tai Chi group showed improvements in diastolic blood pressure. “In addition, those who did Tai Chi were more likely to stick with exercise compared to the aerobic exercisers or a control group,” says Wayne.

The editors of Heart Insight are intrigued with the potential benefits of Tai Chi but would advise considering this as just one potential component of a more complete program to improve heart health.

© 2014 by the American Heart Association

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