Abstract

Objective: This study utilized systematic review and meta-analysis to quantitatively assess the effects of Tai Chi, a traditional mind-body exercise, versus high-intensity interval training, a modern exercise approach, on resting systolic and diastolic blood pressure. It also examined the efficacy and safety of these exercise modalities across various populations and intervention characteristics, identifying suitable demographic targets and optimal intervention strategies. The findings aim to inform clinical practice and the development of exercise prescriptions for high-risk groups, thereby providing diverse and effective non-pharmacological strategies to mitigate the global hypertension burden.
Methods: This study systematically searched seven databases (PubMed, Web of Science, Cochrane Library, Embase, EBSCO, MEDLINE, and CINAHL) and included randomized controlled trials that employed Tai Chi or high-intensity interval training as interventions, with systolic and diastolic blood pressures as the primary outcome measures. The methodological quality of the included literature was assessed using the Cochrane Collaboration's risk-of-bias assessment tool, and meta-analysis was conducted using RevMan 5.4 software.
Results: This Meta-analysis included a total of 23 randomized controlled trials (10 on Tai Chi and 13 on HIIT), involving 1,683 participants. The results showed that Tai Chi could significantly reduce systolic blood pressure (SBP) (MD = -6.63 mmHg, 95% CI: -10.72, -2.55, P = 0.001), but did not significantly reduce diastolic blood pressure (DBP) (MD = -0.85 mmHg, 95% CI: -3.29, 1.58, P = 0.49). HIIT could also significantly reduce SBP (MD = -4.00 mmHg, 95% CI: -7.49, -0.51, P = 0.02), but had no significant effect on DBP (MD = -0.77 mmHg, 95% CI: -3.11, 1.58, P = 0.52). Subgroup analysis suggested that Tai Chi had a more significant blood pressure-lowering effect in people aged ≥60 years and with an intervention period of ≥12 weeks; HIIT had a better blood pressure-lowering effect in people aged <60 years and with an intervention period of <12 weeks. There was high heterogeneity in the SBP analysis of both groups (I² > 80%), but sensitivity analysis showed that the results were robust, and no significant publication bias was found.
Conclusion : Tai Chi and high-intensity interval training (HIIT) effectively lower systolic blood pressure in adults, with Tai Chi showing slightly greater efficacy. Tai Chi is particularly beneficial for older adults and those requiring long-term interventions, while HIIT is more suitable for younger individuals and short-term interventions. Neither exercise significantly affects diastolic blood pressure. When designing personalized exercise plans, factors such as age, health status, and exercise preferences should be considered, prioritizing sustainable and safe methods. Further high-quality research is needed to determine optimal exercise strategies for diverse populations.