{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T22:54:38Z","timestamp":1770332078228,"version":"3.49.0"},"reference-count":67,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T00:00:00Z","timestamp":1635638400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81373822"],"award-info":[{"award-number":["81373822"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2021,10,31]]},"abstract":"<jats:p>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\u2019s 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 \u221212.42\u2009mmHg, 95% CI: \u221215.29 to \u22129.55) and Baduanjin plus AHD (WMD \u22127.03\u2009mmHg, 95% CI: \u22129.80 to \u22124.26) were superior to AHD, and Tai Chi was more effective than other traditional exercises in lowering SBP, Tai Chi plus AHD (WMD \u22127.56\u2009mmHg, 95% CI: \u221210.15 to \u22124.96) and Baduanjin plus AHD (WMD \u22124.51\u2009mmHg, 95% CI: \u22127.38 to \u22121.65) were superior to AHD in reducing DBP, Baduanjin plus AHD (WMD 4.26\u2009\u03bcmol\/L, 95%CI: 2.68 to 5.83) was statistically superior to AHD in increasing NO, and Tai Chi plus AHD (WMD \u22127.64 pg\/ml, 95% CI: \u221210.46 to \u22124.83) and Baduanjin plus AHD (WMD \u22129.23 pg\/ml, 95% CI: \u221210.85 to \u22127.61) 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.<\/jats:p>","DOI":"10.1155\/2021\/2570472","type":"journal-article","created":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T16:35:17Z","timestamp":1635698117000},"page":"1-14","source":"Crossref","is-referenced-by-count":10,"title":["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"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-4534","authenticated-orcid":true,"given":"Lulu","family":"Dai","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-9005","authenticated-orcid":true,"given":"Yuerong","family":"Jiang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peili","family":"Wang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4621-6539","authenticated-orcid":true,"given":"Keji","family":"Chen","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2016_99"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(09)60212-9"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61766-8"},{"issue":"10053","key":"4","first-page":"1659","article-title":"GBD 2015 Risk Factors Collaborators, \u201cGlobal, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","year":"2016","journal-title":"Lancet (North American Edition)"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.14"},{"issue":"6","key":"6","article-title":"Withdrawal of antihypertensive drugs in older people","volume":"6","author":"E. Reeve","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1592\/phco.21.11.940.34520"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000001052"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000001961"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1177\/0003319708316012"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-004-2580-6"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1097\/hjr.0b013e3280128bbb"},{"issue":"24","key":"13","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.018487","article-title":"Exercise reduces ambulatory blood pressure in patients with hypertension: a systematic review and meta-analysis of randomized controlled trials","volume":"9","author":"G. Saco-Ledo","year":"2020","journal-title":"Journal of the American Heart Association"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-4304-8_5"},{"issue":"19","key":"15","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1016\/j.jacc.2017.11.005","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"71","author":"P. K. Whelton","year":"2018","journal-title":"Journal of the American College of Cardiology"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-099921"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-020-03098-w"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-020-1031-y"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2683"},{"issue":"32","key":"20","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000021577","article-title":"Effects of Baduanjin exercise on essential hypertension: a meta-analysis of randomized controlled trials","volume":"99","author":"Y. Guan","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2015.01.002"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7141.2008.07565.x"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2009.01210.x"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8503047"},{"key":"25","article-title":"Tai chi for primary prevention of cardiovascular disease","volume-title":"Cochrane Database of Systematic Reviews","author":"L. Hartley","year":"2014"},{"issue":"4","key":"26","first-page":"143","article-title":"Taijiquan systematic reviews of primary effects on blood pressure and quality of life of patients with hypertension","volume":"17","author":"Y. C. Zheng","year":"2015","journal-title":"Journal of Liaoning University of Traditional Chinese Medicine"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097621"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.016"},{"issue":"3","key":"29","first-page":"182","article-title":"2018 Chinese guidelines for prevention and treatment of hypertension-A report of the revision committee of Chinese guidelines for prevention and treatment of hypertension","volume":"16","author":"Joint Committee for Guideline Revision","year":"2019","journal-title":"Journal of Geriatric Cardiology"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"31","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0","author":"J. P. T. Higgins","year":"2011"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099682"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2018.04.007"},{"key":"34","first-page":"18","article-title":"Effects of Taijiquan on blood pressure in patients with hypertension","volume":"4","author":"F. Z. Chen","year":"2013","journal-title":"Today Nurse"},{"issue":"22","key":"35","first-page":"340","article-title":"Application of Baduanjin in rehabilitation nursing of elderly patients with hypertension","volume":"6","author":"L. H. Chen","year":"2016","journal-title":"Journal of Frontiers of Medicine"},{"key":"36","article-title":"The Mechanism of Baduanjin qigong reduce blood pressure of type 1 hypertension-from vascular endothelium function","author":"Q. Y. Chen","year":"2013"},{"issue":"10","key":"37","first-page":"1359","article-title":"Effects of Taijiquan exercise on hypertension patients\u2019 NO consistency in Plasma, the activity of RBC Na+-K+, ATPase and Ca2+-Mg2+ATPase","volume":"29","author":"X. X. Chen","year":"2006","journal-title":"Journal of Beijing Sport University"},{"issue":"2","key":"38","first-page":"157","article-title":"The intervention effect of Baduanjin fitness qigong on patients with phlegm-dampness hypertension","volume":"36","author":"D. G. Dong","year":"2020","journal-title":"Chinese Journal of Applied Physiology"},{"issue":"2","key":"39","first-page":"11","article-title":"Influence of Baduanjin on anxiety and depression in 38 elderly patients with essential hypertension","volume":"52","author":"W. Y. Fan","year":"2021","journal-title":"Fujian Journal of Traditional Chinese Medicine"},{"issue":"14","key":"40","first-page":"1617","article-title":"The effect of shadow boxing exercise on the long-term quality of life in middle-aged and elderly patients with primary hypertension","volume":"16","author":"Q. Y. Han","year":"2010","journal-title":"Chinses Journal of Modern Nursin"},{"issue":"3","key":"41","first-page":"252","article-title":"Rehabilitation therapeutic effect of baduanjin training in aged patients with hypertension","volume":"24","author":"X. He","year":"2015","journal-title":"Chinese Journal of Cardiovascular Rehabilitation Medicine"},{"issue":"19","key":"42","first-page":"104","article-title":"Effect of Baduanjin on elderly patients with liver-yang hypertension and Anxiety","volume":"25","author":"Y. H. Jiang","year":"2019","journal-title":"Journal of Qilu Nursing"},{"issue":"9","key":"43","first-page":"48","article-title":"Study for the intervention effect of Wuqinxi for elder hypertension patients with obesity","volume":"28","author":"W. Li","year":"2015","journal-title":"Medical Information"},{"issue":"16","key":"44","first-page":"12","article-title":"Effects of Baduanjin on blood pressure and quality of life in patients with isolated systolic hypertension","volume":"7","author":"H. Y. Liang","year":"2016","journal-title":"Chinese Manipulation & Rehabilitation Medicine"},{"issue":"7","key":"45","first-page":"1645","article-title":"The promoting effect of fitness qigong Wuqinxi on the rehabilitation of elderly hypertension patients","volume":"33","author":"H. Lin","year":"2013","journal-title":"Chinese Journal of Gerontology"},{"issue":"12","key":"46","first-page":"3024","article-title":"Promoting effect of Baduanjin on rehabilitation of elderly hypertension patients","volume":"37","author":"Q. Lin","year":"2017","journal-title":"Chinese Journal of Gerontology"},{"issue":"5","key":"47","first-page":"64","article-title":"A study on the combination of Taijiquan with health management in the treatment of community patients with essential hypertension","volume":"23","author":"J. Liu","year":"2017","journal-title":"Guiding Journal of Traditional Chinese Medicine and Pharmacy"},{"issue":"6","key":"48","first-page":"1396","article-title":"Effects of Taijiquan on blood pressure, hemorheology and long-term quality of life in elderly patients with hypertension","volume":"38","author":"T. Liu","year":"2018","journal-title":"Chin J Gerontol"},{"key":"49","article-title":"The research of blood pressure variability and quality of life effect on patients with liver-yang hyperactivity type hypertension by Taijiquan","author":"W. Q. Liu","year":"2016"},{"issue":"33","key":"50","first-page":"43","article-title":"Clinical study of Taijiquan combined with medicine in treating essential hypertension","volume":"3","author":"H. Luo","year":"2006","journal-title":"China Medical Herald"},{"issue":"10","key":"51","first-page":"65","article-title":"Effect of Tai Chi exercise on blood pressure, plasma nitrogen monoxidum and endothelin in hypertensive patients","volume":"48","author":"H. N. Mao","year":"2006","journal-title":"Chinese Journal of Clinical Rehabilitation"},{"issue":"1","key":"52","first-page":"4","article-title":"Clinical observation of baduanjin exercise on the rehabilitation treatment of grade 1 hypertension in the elderly","volume":"9","author":"H. S. Pan","year":"2010","journal-title":"Journal of Nanjing Institute of Physical Education"},{"key":"53","first-page":"2114","article-title":"Effects of Wuqinxi on blood pressure and quality of life in elderly patients with essential hypertension stage I and II","volume":"12","author":"A. M. Shen","year":"2010","journal-title":"China Journal of Chinese Materia Medica"},{"key":"54","article-title":"Study on the effect of Taijiquan exercise on the quality of life in elderly patients with hypertension","author":"Q. Q. Sun","year":"2010"},{"issue":"2","key":"55","first-page":"67","article-title":"Effects of traditional sports on clinical symptom of aged intellectual patients with essential hypertension","volume":"32","author":"Q. H. Tang","year":"2009","journal-title":"Journal of Beijing Sport University"},{"issue":"09","key":"56","first-page":"75","article-title":"Empirical study of Taijiquan interventions on the prevention and cure of hypertension","volume":"34","author":"X. J. Wang","year":"2011","journal-title":"Journal of Beijing Sport University"},{"issue":"7","key":"57","first-page":"38","article-title":"Effect of 24-style simplified Taijiquan on blood pressure and quality of life in patients with hypertension","volume":"38","author":"H. Xu","year":"2016","journal-title":"Hubei Journal of Traditional Chinese Medicine"},{"key":"58","first-page":"1638","article-title":"Effect of simplified Taijiquan on grade I hypertension in the elderly","volume":"11","author":"D. M. Xu","year":"2015","journal-title":"China Journal of Chinese Materia Medica"},{"key":"59","article-title":"Effect of Baduanjin on quality of life and autonomic nervous response in patients with hypertension","author":"H. Yang","year":"2014"},{"issue":"3","key":"60","first-page":"223","article-title":"Effects of Baduanjin exercise on vascular endothelial function in elderly patients with grade 1 hypertension","volume":"29","author":"L. W. Zheng","year":"2014","journal-title":"Chinese Journal of Rehabilitation Medicine"},{"key":"61","article-title":"Tai Chi for essential hypertension: efficacy and safety evaluation and mechanism research","author":"D. L. Zhong","year":"2019"},{"issue":"3","key":"62","first-page":"130","article-title":"Research on the intervention effect on people with borderline hypertension in community by baduanjin and health education","volume":"4","author":"M. Yang","year":"2013","journal-title":"Chinese Manipulation & Rehabilitation Medicine"},{"issue":"5","key":"63","first-page":"494","article-title":"Contrastive analysis of rehabilitation effect of Tai Chi and walking on patients with hypertension","volume":"24","author":"H. T. Zhou","year":"2015","journal-title":"Chinese Journal of Convalescent Medicine"},{"issue":"15","key":"64","first-page":"60","article-title":"Effects of Tai Ji Quan on blood pressure and lipid profile in patients with stage I essential hypertension","volume":"13","author":"S. W. Zhou","year":"2007","journal-title":"International Medicine and Health Guidance News"},{"issue":"8","key":"65","first-page":"26","article-title":"Effect of Wuqinxi on blood pressure and C-reactive protein in patients with hypertension","volume":"4","author":"C. X. Hong","year":"2007","journal-title":"World Health Digest\u00b7Medical Monthly"},{"key":"66","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2017047"},{"key":"67","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-159"}],"container-title":["Evidence-Based Complementary and Alternative Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ecam\/2021\/2570472.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ecam\/2021\/2570472.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ecam\/2021\/2570472.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T16:35:51Z","timestamp":1635698151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/ecam\/2021\/2570472\/"}},"subtitle":[],"editor":[{"given":"Woon-Man","family":"Kung","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,10,31]]},"references-count":67,"alternative-id":["2570472","2570472"],"URL":"https:\/\/doi.org\/10.1155\/2021\/2570472","relation":{},"ISSN":["1741-4288","1741-427X"],"issn-type":[{"value":"1741-4288","type":"electronic"},{"value":"1741-427X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10,31]]}}}