Key result
Tai Chi reduces office systolic blood pressure ~2 mm Hg more than aerobic exercise in prehypertension.
Why the study?
The comparative effects of Tai Chi versus aerobic exercise on blood pressure control in patients with hypertension were uncertain.
RCT (n=342)
Single-blind
1:1 via a central web-based automated randomization system using the static random method
Yes
Mean Difference: -2.4 (95% CI -4.39–-0.41)
Absolute Event Rate: -7.01% vs -4.61%
p-value: p=0.02
Supports Tai Chi over aerobic exercise for office SBP reduction in prehypertension; extends Level 1 evidence for mind-body exercise in early BP management.
Letters1 October 2019HypertensionCara Foldes, MD, MPH and Joslyn W. Fisher, MD, MPHCara Foldes, MD, MPHBaylor College of Medicine, Houston, Texas (C.F., J.W.F.)Search for more papers by this author and Joslyn W. Fisher, MD, MPHBaylor College of Medicine, Houston, Texas (C.F., J.W.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0447 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We appreciate Byrd and Brook's (1) thoughtful and practical review of hypertension management in adult patients. However, we are concerned that the authors did not differentiate between management of hypertension in younger men and women of reproductive age, as suggested by their statement, “An angiotensin-converting enzyme (ACE) inhibitor or angiotensin-receptor blocker (ARB) is a good initial choice for younger patients with hypertension because they often respond well to suppression of the renin–angiotensin system [RAS].”Why distinguish between younger men and women? Renin–angiotensin system inhibitors are known potential teratogens (2), and the prevalence of hypertension in women of ...References1. Byrd JB, Brook RD. Hypertension. Ann Intern Med. 2019;170:ITC65-80. [PMID: 31060074]. doi:10.7326/AITC201905070 LinkGoogle Scholar2. Bullo M, Tschumi S, Bucher BS, et al. Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists: a systematic review. Hypertension. 2012;60:444-50. [PMID: 22753220] doi:10.1161/HYPERTENSIONAHA.112.196352 CrossrefMedlineGoogle Scholar3. Bateman BT, Shaw KM, Kuklina EV, et al. Hypertension in women of reproductive age in the United States: NHANES 1999-2008. PLoS One. 2012;7:e36171. [PMID: 22558371] doi:10.1371/journal.pone.0036171 CrossrefMedlineGoogle Scholar4. Creanga AA, Syverson C, Seed K, et al. Pregnancy-related mortality in the United States, 2011-2013. Obstet Gynecol. 2017;130:366-373. [PMID: 28697109] doi:10.1097/AOG.0000000000002114 CrossrefMedlineGoogle Scholar5. Whelton PK, Carey RM, Aronow WS, et al. 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: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-115. [PMID: 29133356] doi:10.1161/HYP.0000000000000065 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine, Houston, Texas (C.F., J.W.F.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0447. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHypertension James Brian Byrd and Robert D. Brook Metrics Cited byShort-term efficacy of non-pharmacological interventions for global population with elevated blood pressure: A network meta-analysis 1 October 2019Volume 171, Issue 7Page: 525KeywordsACE inhibitorsDecision makingDisclosureHealth surveysHeartHypertensionMortalityNutritionPregnancyReproductive system ePublished: 1 October 2019 Issue Published: 1 October 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Foldes et al. (2019) conducted an RCT in Prehypertension (n=342). Tai Chi vs. Moderate-intensity aerobic exercise was evaluated on Mean change in office systolic blood pressure (SBP) from baseline to 12 months (MD -2.40, 95% CI -4.39 to -0.41, p=0.02). A 12-month Tai Chi program significantly decreased office systolic blood pressure by a mean difference of 2.40 mm Hg more than moderate-intensity aerobic exercise in adults with prehypertension.
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