Effect of Health Qigong Mawangdui Daoyinshu on Blood Pressure of Individuals with Essential Hypertension

To the Editor: Hypertension is an important public health concern worldwide.1 Hypertension can damage various organs and raise the risk of coronary heart disease, heart failure, chronic kidney disease (CKD), and stroke.2, 3 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.4-7 As a traditional Chinese health and fitness Qigong exercise routine, Mawangdui Daoyinshu (MD) 马王堆导引术 dates back to the Qin and Han dynasties (221 BC–220 AD).8 The practice of MD consists of 12 movements. It takes approximately 17 minutes to perform the whole set exercises twice. It has been proved that practice of MD improves the immunity function and physical fitness and prevents dementia in elderly adults.9 The purpose of this study was to investigate whether MD may be an appropriate treatment strategy to reduce the blood pressure (BP) of individuals with hypertension and the possible mechanism of the effects. Sixty individuals with essential hypertension (mean age: 66.3 ± 5.8 years) were randomized into two groups: 30 to a Mawangdui Daoyinshu Qigong (MDQ) group and 30 to a control group. Subjects provided written informed consent to participate in the study as approved by the ethics review committee of Beijing Sport University. MDQ (Figure 1) was performed five times per week for 6 months; this included a warm-up (5 minutes), the Qigong exercise (34 minutes), and a cool-down (5 minutes). Controls received no intervention. Weight (kg), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), stroke volume (SV), cardiac output (CO), cardiac index (CI), total peripheral resistance (TPR), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), fasting glucose (FG), serum nitric oxide (NO), and plasma endothelin-1 (ET-1) were measured for each subject at baseline and 6 months later. Significant increases in HDL-C (P = .04) and NO (P = .03) and decreases in SBP (P = .02), DBP (P = .048), TPR (P = .04), LDL-C (P = .04), FG (P = .048), ET-1 (P = .04) were found in the MDQ group after 6 months of MDQ exercise, but not in the control group, which remained at the same preintervention performance level (Table 1). This randomized clinical trial provides evidence that a 6-month MDQ intervention was effective in improving the SBP, DBP, HDL-C, LDL-C, TPR, FG, serum NO, and plasma ET-1 of individuals with essential hypertension. The study results confirm the hypothesis: the SBP, DBP, HDL-C, LDL-C, TPR, FG, serum NO, and plasma ET-1 of individuals with essential hypertension can be improved by a 6-month MDQ intervention (Table 1). The finding that MDQ training reduces skeletal muscle plasma ET-1 and TPR and increases the serum NO of individuals with essential hypertension (Table 1) indicates that this could be one of the mechanisms underlying the attenuation in ET-1-mediated vascular tone after training in older individuals. NO has been shown to inhibit the transcription and release of ET-1,10 and training-induced changes in the bioavailability of this vasoactive substance could therefore potentially explain some of the observed changes in the ET-1 system. The result is consistent with the hypothesis that the long-practice of qigong has a positive effect on vascular endothelium function in older adults with hypertension.4-7 Analysis indicated that HDL-C (P = .04), serum NO (P = .03), SBP (P = .01), DBP (P = .04), LDL-C (P = .04), FG (P = .047), and plasma ET-1 (P = .04) levels improved significantly in the MDQ group after a 6-month intervention (Table 1). It is not surprising that greater improvement in blood pressure, blood lipid, blood glucose, and vascular endothelium function was found in the MDQ group than in controls because MDQ training was task specific. Many MD movements aim to extend and stimulate internal organs by rotating and stretching the limbs and trunk. MD helps to improve circulation in the channels and collaterals and smooth the action of the joints and blood circulation. MDQ improves cardiovascular function and helps to cure such illnesses as coronary artery sclerosis. The results of this study indicate that MDQ may have the potential to improve SBP, DBP, HDL-C, LDL-C, TPR, FG, serum NO, and plasma ET-1. These findings may contribute to the future planning of community-based exercise programs of individuals with essential hypertension. The authors thank the subjects for participating in the study. Conflict of Interest: The author has declared no conflict of interest. No funding was received for this study. Author Contributions: Chen: study concept and design, performing the experiments, acquisition of subjects and data, analysis and interpretation of data, preparation of first draft and final manuscript. Sponsor's Role: None.