Effects of Three Traditional Chinese Fitness Exercises Combined with Antihypertensive Drugs on Patients with Essential Hypertension: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Author: Lulu Dai1, Yuerong Jiang1, Peili Wang1, Keji Chen1
Affiliation:
1 National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
Conference/Journal: Evid Based Complement Alternat Med
Date published: 2021 Oct 31
Other: Volume ID: 2021 , Pages: 2570472 , Special Notes: doi: 10.1155/2021/2570472. , Word Count: 418


Objective:
To compare the efficacy of three different traditional Chinese exercises (Tai Chi, Baduanjin, and Wuqinxi) combined with antihypertensive drugs (AHD) on patients with essential hypertension (EH).

Method:
Eight electronic databases were searched to identify randomized controlled trials (RCTs) comparing the effects of traditional Chinese fitness exercises combined with AHD and AHD alone. The analysis mainly consists of network meta-analysis (NMA) and pairwise meta-analysis. The Cochrane assessment tool was adopted to assess the risk of bias of included literatures. This study used STATA/SE 15.1 (StataCorp, 2017), R software (version 4.0.1), and Cochrane's Review Manager software (version 5.4) to conduct data analysis and figures generation.

Results:
A total of 30 RCTs were included in this study, of which 16 evaluated Tai Chi plus AHD versus AHD, 11 evaluated Baduanjin plus AHD versus AHD, and 3 evaluated Wuqinxi plus AHD versus AHD. No RCT compared directly among the three traditional Chinese fitness exercises. Pairwise meta-analysis showed that Tai Chi plus AHD was significantly superior to AHD alone in reducing systolic blood pressure (SBP) and diastolic blood pressure (DBP). BDJ plus AHD was statistically superior to AHD alone in reducing SBP, DBP, and endothelin (ET) and increasing nitric oxide (NO). NMA results indicated that Tai Chi plus AHD (WMD -12.42 mmHg, 95% CI: -15.29 to -9.55) and Baduanjin plus AHD (WMD -7.03 mmHg, 95% CI: -9.80 to -4.26) were superior to AHD, and Tai Chi was more effective than other traditional exercises in lowering SBP, Tai Chi plus AHD (WMD -7.56 mmHg, 95% CI: -10.15 to -4.96) and Baduanjin plus AHD (WMD -4.51 mmHg, 95% CI: -7.38 to -1.65) were superior to AHD in reducing DBP, Baduanjin plus AHD (WMD 4.26 μmol/L, 95%CI: 2.68 to 5.83) was statistically superior to AHD in increasing NO, and Tai Chi plus AHD (WMD -7.64 pg/ml, 95% CI: -10.46 to -4.83) and Baduanjin plus AHD (WMD -9.23 pg/ml, 95% CI: -10.85 to -7.61) were superior to AHD in lowering ET.

Conclusion:
Compared with AHD alone, both Tai Chi plus AHD and Baduanjin plus AHD showed significant benefit in regulating SBP, DBP, and ET. Among the three traditional Chinese fitness exercises, Tai Chi may be the best as an adjunctive therapy for SBP reduction. These findings provided evidence for the therapeutic benefit of either Tai Chi or Baduanjin exercise as an adjunct therapy for patients with EH. Limited by the methodological quality and quantity of included studies, results need to be interpreted with caution, and it is necessary to carry out further high-quality RCTs on traditional Chinese fitness exercise-assisted treatment of EH in the future.


PMID: 34754311 PMCID: PMC8572593 DOI: 10.1155/2021/2570472

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