Tai Chi rehabilitation program enhances blood pressure control and modulates inflammatory and Brain-Gut peptides in hypertension

Background: Hypertension (HTN), a chronic inflammatory condition, is a major cardiovascular risk factor. Dysregulation of inflammatory cytokines and brain-gut peptides contributes to its progression. This study aimed to evaluate the effects of a Tai Chi rehabilitation program on blood pressure, inflammatory cytokines [interleukin-6 (IL-6), interleukin-10 (IL-10)], and brain-gut peptides [neurotensin (NT), gastrin (GAS)] in patients with HTN, hypothesizing that Tai Chi would improve these parameters compared with Fitness exercise or no intervention. Methods: A randomized controlled trial enrolled 105 patients with HTN and coronary heart disease. Participants were randomized into the Tai Chi group ( n = 35), Fitness group ( n = 35), or Blank group ( n = 35). The intervention lasted 24 weeks (3 sessions per week, 60 min per session, 40–60% heart rate reserve). Blood pressure and serum levels of IL-6, IL-10, NT, and GAS were measured before and after the intervention using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed with SPSS version 27, applying paired t-tests, analysis of variance (ANOVA), and Pearson correlation. Results: Ninety participants completed the study (Tai Chi group: 31, Fitness group: 28, Blank group: 31). The Tai Chi group showed significant reductions in systolic blood pressure (SBP) and IL-6 ( p < 0.001), along with increases in IL-10, NT, and GAS ( p < 0.001) compared to baseline. Compared with the Fitness group, the Tai Chi group achieved greater increases in NT and GAS ( p < 0.05). Compared with the Blank group, the Tai Chi group demonstrated superior reductions in SBP and IL-6 ( p < 0.05). Reductions in IL-6 were negatively correlated with increases in NT and GAS ( p < 0.001). Conclusion: Tai Chi rehabilitation lowered systolic blood pressure, reduced inflammation, and improved brain-gut peptides, supporting its role as a complementary therapy for hypertension. The modest sample size, 14.3% dropout rate, and recruitment from two hospitals may limit generalizability, and larger multi-center studies with longer follow-up are needed. Trial registration: : The trial was registered with the International Traditional Medicine Clinical Trial Registry (Registration No. ITMCTR2024000813; registration date: 2024/12/13). Supplementary Information: The online version contains supplementary material available at 10.1186/s12906-026-05265-x.