Effect of Baduanjin on Blood Pressure Among Individuals With High-Normal Blood Pressure

It is challenging to achieve sustained blood pressure (BP) lowering by traditional lifestyle guidance including exercise. We aimed to evaluate the short-term effects of baduanjin on ambulatory BP with monitoring and long-term effects without monitoring among individuals with high-normal BP. We conducted a multicenter, open-label, blinded-outcome randomized controlled trial at 7 communities. Participants aged ≥40 years with systolic blood pressure (SBP) 130 to 139 mm Hg and/or diastolic BP 85 to 89 mm Hg were randomly assigned in a 2:1:1 ratio to the baduanjin, self-directed exercise alone, or brisk walking arms for a 52-week intervention. The primary outcomes were the changes in 24-hour SBP from baseline to 12 and 52 weeks. Intention-to-treat analyses of primary outcomes followed a hierarchical testing sequence: 1) superiority of baduanjin vs self-directed exercise alone at 12 weeks; 2) superiority of baduanjin vs self-directed exercise alone at 52 weeks; and 3) superiority of baduanjin vs brisk walking at 52 weeks. Among 216 eligible participants (mean age 57.3 years; 64.8% women), 108, 54, and 54 participants were randomly assigned to the baduanjin, self-directed exercise alone, and brisk walking arms, respectively. The baduanjin arm obtained a significantly greater reduction in 24-hour SBP compared with the self-directed exercise alone arm at 12 weeks (−3.1 mm Hg; 95% CI: −5.9 to −0.2 mm Hg; P = 0.036) and 52 weeks (−3.3 mm Hg; 95% CI: −6.3 to −0.3 mm Hg; P = 0.031). There was no significant difference between the baduanjin and brisk walking arms (−0.7 mm Hg; 95% CI: −3.9 to 2.6 mm Hg; P = 0.683) at 52 weeks. The effects were not heterogeneous across subgroups. No significant difference in adverse events was detected across 3 arms. Baduanjin lowered SBP after 3 months of intervention in individuals with high-normal BP, with sustained BP-lowering effect until 1 year without monitoring, and showed comparable efficacy to brisk walking. (Baduanjin Lowering Elevated Blood PreSsure Study [BLESS]; NCT05397535 )