Effect of Health Qigong Ba Duan Jin on Blood Pressure of Individuals with Essential Hypertension

To the Editor: Essential hypertension, persistently high arterial blood pressure with no known organic cause, is challenging but treatable risk factor for cardiovascular disease.1 Individuals with untreated hypertension are at greater risk of heart failure, stroke, and renal failure.2 Lifestyle modifications are advocated for the prevention, treatment, and control of hypertension, with exercise being an integral component. Several studies have reported that qigong is effective in lowering blood pressure (BP).3 As a traditional Chinese health and fitness qigong exercise routine, Ba duan jin [八段锦] dates to the Song dynasty (960–1279). Ba duan jin is part of the New Health Qigong Exercise Series compiled and published by the Chinese Health Qigong Association.4 Practice of Ba duan jin improves cardiovascular function and helps decrease BP in older adults with hypertension.5-8 The purpose of this study was to investigate whether Ba duan jin may be an appropriate treatment strategy to reduce BP in individuals with hypertension and the possible mechanism of the effects. Forty-eight individuals with essential hypertension (mean age 65.6 ± 7.8) were randomized to two groups: 24 to a Ba duan jin Qigong Group (BQG) and 24 to a control group (CG). Subjects provided written informed consent to participate in the study as approved by the ethics review committee of Beijing Sport University. The BQG trained in Ba duan jin (Figure 1) five times per week for 6 months. Sessions included a 5-minute warm-up, 30 minutes of Qigong exercise, and a 5-minute cool-down. The CG received no intervention. Weight, waist circumference, systolic BP (SBP), diastolic BP (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides, fasting glucose, serum nitric oxide (NO), and plasma endothelin-1 (ET-1) were measured for each subject at baseline and after 6 months. Significant increases in HDL-C (P = .04) and serum NO (P = .03) and significant decreases in SBP (P = .008), DBP (P = .04), LDL-C (P = .002), TC (P = .04), triglycerides (P = .049), fasting glucose (P = .049), plasma ET-1 (P = .04) were found in the BQG after 6 months of Ba duan jin Qigong exercise but not in the CG, which remained at baseline levels (Table 1). This randomized clinical trial provides evidence that 6 months of Ba duan jin Qigong training was effective in improving the SBP, DBP, HDL-C, LDL-C, TC, triglycerides, fasting glucose, serum NO, and plasma ET-1 of individuals with essential hypertension. This study evaluated the effect of Ba duan jin Qigong training on BP, blood lipids, blood glucose, and vascular endothelium function of individuals with essential hypertension. The study results confirm the hypothesis; the SBP, DBP, HDL-C, LDL-C, TC, triglycerides, fasting glucose, serum NO, and plasma ET-1 of individuals with essential hypertension can be improved by a 6-month Ba duan jin Qigong intervention (Table 1). A previous study showed that long-term adherence to Ba duan jin Qigong training can significantly decrease the BP and blood lipids of individuals with essential hypertension.5 The current study shows that Ba duan jin Qigong training reduces skeletal muscle plasma ET-1 levels and increases serum NO of individuals with essential hypertension (Table 1). This could be one of the mechanisms underlying the attenuation in ET-1-mediated vascular tone after training in older individuals. Serum NO has been shown to inhibit the transcription and release of ET-1, which may explain some of the changes seen in the ET-1 system.9, 10 The current finding that Ba duan jin Qigong training increases vascular NO bioavailability could explain part of the reduction in plasma ET-1 with qigong training. The result is consistent with findings that long-term practice of Ba duan jin improves vascular endothelium function in older adults with hypertension.6 In the present investigation, data analysis indicated that HDL-C (P = .03), serum NO (P = .03), SBP (P = .009), DBP (P = .04), LDL-C (P = .003), TC (P = .048), triglycerides (P = .04), fasting glucose (P = .048), plasma ET-1 (P = .04) improved significantly in the BQG but not in the CG after a 6-month intervention (Table 1). It is not surprising that greater improvement in BP blood lipids, blood glucose, and vascular endothelium function was found in the BQG than in the CG because the BQG training was task specific. A combination of strength and relaxation or dynamism and inertia helps to improve circulation in the channels and collaterals and smooths the actions of the joints and the blood circulation. It improves cardiovascular function and helps cure such illnesses as coronary artery sclerosis.8 The results of this study indicate that Ba duan jin Qigong exercise may have the potential to improve SBP, DBP, HDL-C, LDL-C, TC, triglycerides, fasting glucose, serum NO, and plasma ET-1. These findings may contribute to the future planning of community-based exercise programs for individuals with essential hypertension. The authors thank the subjects for participating in the study. Conflict of Interest: The authors have declared no conflict of interest. No funding was received for this study. Author Contributions: Xiao: study concept and design, performed the experiments, acquisition of subjects and data, preparation of first draft and final manuscript. Yang: data analysis and interpretation. Zhuang: performed the experiments, acquisition of subjects and data. Sponsor's Role: No funding was received for this study.