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September 2, 2026Archives of Public HealthOpen Access

Effects of traditional Chinese exercises on blood pressure and glycemic indicators in middle-aged and older adults: a systematic review and meta-analysis

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Key result

Traditional Chinese Exercises significantly lower SBP and DBP in middle-aged and older adults versus control.

  • SMD -0.37
  • 95% CI -0.54 to -0.20
  • P<0.01

Why the study?

Traditional Chinese Exercises have shown potential to promote cardiovascular and metabolic health, but their impact on blood pressure, glucose, and the potential influences of sex and exercise dose required investigation.

Do Traditional Chinese Exercises reduce blood pressure and HbA1c in middle-aged and older adults?

Population

Middle-aged and older adults across 23 randomised controlled trials

Comparison

Traditional Chinese Exercises vs control

Design

Systematic review and meta-analysis of randomised controlled trials

Authors

JLJiahui LiuHebei Medical UniversityWZWeihao ZhangWuhan Sports UniversityYZYifan ZhouNingxia Medical University

Discussion

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Implication

Supports adjunctive traditional Chinese exercises for BP control in middle-aged/older adults; reinforces RCT evidence for non-pharmacological cardiometabolic interventions.

Key Points

  • To evaluate the effects of traditional Chinese exercises on blood pressure and glycemic control in middle-aged and older adults, and assess the impact of sex and exercise dose.
  • Systematic review and meta-analysis across PubMed, Web of Science, Embase, Cochrane Library, and Scopus.
  • Identified 23 randomized controlled trials reporting systolic blood pressure (SBP), diastolic blood pressure (DBP), or glycated hemoglobin (HbA1c).
  • Conducted subgroup analyses and meta-regression to evaluate the influence of sex, disease type, and exercise dose.
  • Traditional Chinese exercises significantly decreased both systolic blood pressure (SMD = -0.37, P < 0.01) and diastolic blood pressure (SMD = -0.37, P < 0.01).
  • Exercise interventions led to a small but statistically significant reduction in HbA1c (SMD = -0.16, P = 0.04), with comparable benefits observed across sexes.
  • Meta-regression showed no statistically significant dose-response relationship for SBP (P = 0.474) or DBP (P = 0.103), though higher doses showed a non-significant trend toward greater DBP reduction.

Study Design

Type

Meta-Analysis

Structured PICO

Do Traditional Chinese Exercises reduce blood pressure and HbA1c in middle-aged and older adults?

P
Population
Middle-aged and older adults across 23 randomized controlled trials evaluating the effects of Traditional Chinese Exercises on blood pressure and glycemic indicators over 12 to 48 weeks.
I
Intervention
Traditional Chinese Exercises (TCEs) as a class (including Tai Chi, Qigong, Baduanjin, and Yi Jin Jing), 1.5-6.8 METs, 40-120 minutes per session, 1-7 times a week for 12-48 weeks.
C
Comparator
Control conditions such as usual life, health education, or other interventions that did not include TCEs.
O
Outcome
Systolic blood pressure (SBP), diastolic blood pressure (DBP), and glycated haemoglobin (HbA1c).surrogate

Main Result

Standardized Mean Difference: -0.37 (95% CI -0.54–-0.2)

p-value: p=<0.01

Traditional Chinese Exercises provide a modest but statistically significant reduction in blood pressure and HbA1c, supporting their use as an adjunctive non-pharmacological therapy for cardiometabolic risk management in older adults.

Limitations

  • High risk of bias for blinding of participants and personnel across all included studies.
  • Considerable between-study heterogeneity for systolic blood pressure outcomes (I2 = 61%).
  • Certain degree of heterogeneity remained unexplained
  • Most included trials did not directly measure autonomic, endothelial, inflammatory, oxidative-stress, or insulin-signaling biomarkers
  • Healthy older adult subgroup was based on a small number of trials and showed substantial heterogeneity
  • Limited range of doses in previous studies

Cite This Study

Liu et al. (2026) conducted a meta-analysis in Hypertension and impaired glucose metabolism. Traditional Chinese Exercises vs. Usual life, health education, or non-TCE interventions was evaluated on Systolic blood pressure (SBP) (SMD -0.37, 95% CI -0.54 to -0.20, p=<0.01). Traditional Chinese Exercises significantly reduced systolic blood pressure (SMD -0.37) and diastolic blood pressure (SMD -0.37) in middle-aged and older adults compared to control conditions.

synapsesocial.com/papers/6a97e318c562ede874ec7ab8https://doi.org/10.1186/s13690-026-02041-8
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