What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Cardiovascular disease (n=60). Intervention: Tai Chi vs. Aerobic exercise or standard care. Primary outcome: Systolic blood pressure (MD -6.14 mmHg, 95% CI -8.44 to -3.84).

What does this research mean for the field?

Tai Chi significantly reduces systolic blood pressure by 6.14 mmHg compared to control groups. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This review aims to synthesize evidence regarding the mechanisms through which Tai Chi affects cardiovascular disease risk factors compared to aerobic exercise.

February 2, 2026Scientific Reports0 citationsOpen Access

A systematic review and meta-analysis of the mechanism of action of Tai Chi on cardiovascular disease: evidence map of aerobic and mind-body exercise pathways

JLJiayi LiuChangchun University of Science and Technology HYH. Thomas YuUniversity of Science and Technology of China YJYih-Kuen JanUniversity of Illinois Urbana-Champaign

Key Result

Tai Chi significantly reduced systolic blood pressure by 6.14 mmHg compared to control groups.

Key Points

This review aims to synthesize evidence regarding the mechanisms through which Tai Chi affects cardiovascular disease risk factors compared to aerobic exercise.
Conducted a systematic review and meta-analysis following PRISMA guidelines.
Searched multiple databases, including PubMed, Scopus, and Web of Science.
Included studies comparing Tai Chi with aerobic exercise or standard care that reported CVD-related outcomes.
Performed random-effects meta-analyses and subgroup analyses on collected data.
Tai Chi significantly reduced systolic blood pressure by an average of 6.14 mmHg.
Diastolic blood pressure decreased by an average of 3.45 mmHg after Tai Chi.
Improvements noted in HDL cholesterol levels and functional capacity measured by the 6-minute walk test.
Psychosocial benefits included reduced fatigue and depression.
Evidence mapping highlighted Tai Chi's potential effects on autonomic regulation and inflammatory pathways.

Study Design

Type

Meta-Analysis (n=60)

Structured PICO

Does Tai Chi improve cardiovascular risk factors and related biomarkers compared with aerobic exercise or standard care in individuals with or at risk for cardiovascular disease?

Population

Individuals of all ages, including adolescents, adults, and older adults, with or at risk for cardiovascular disease (60 studies included: 39 RCTs and 21 reviews).

Intervention

Tai Chi interventions (including Yang style, Sun style, 24-form, and 32-form Tai Chi) aimed at influencing cardiovascular risk factors.

Comparator

Aerobic exercise interventions, placebo control, blank control, or no intervention/standard care.

Outcome

Changes in cardiovascular risk markers such as blood pressure, lipid profiles (e.g., LDL, HDL), inflammatory markers (e.g., IL-6, CRP), and heart rate variability (HRV).surrogate

Tai Chi offers clinically meaningful improvements in blood pressure, lipid profiles, and functional capacity, serving as a potential accessible mind-body intervention for cardiovascular disease prevention.

Main Result

Effect estimate: MD -6.14 mmHg (95% CI -8.44 to -3.84)

Limitations

Comparative advantages over aerobic exercise supported largely by low- to moderate-certainty evidence.

Abstract

Cardiovascular disease (CVD) remains a leading global health burden, particularly in low- and middle-income countries. Tai Chi is a mind-body exercise with reported cardiovascular benefits, but its mechanistic pathways and comparative effects versus aerobic exercise are not well defined. To synthesize evidence on the effects and proposed mechanisms of Tai Chi on CVD risk factors and related biomarkers, compared with aerobic exercise or standard care. We conducted a systematic review and meta-analysis in accordance with PRISMA. We searched Google Scholar, PubMed, EBSCOhost MEDLINE, Scopus, ScienceDirect, and Web of Science from inception to October 2025. We included studies comparing Tai Chi with aerobic exercise and/or standard care and reporting outcomes related to CVD risk factors, functional capacity, mental health, or mechanistic biomarkers. Random-effects meta-analyses and subgroup analyses were performed where appropriate. Sixty studies were included (39 randomized controlled trials and 21 reviews). Tai Chi significantly reduced systolic blood pressure (MD -6.14 mmHg, 95% CI -8.44 to -3.84) and diastolic blood pressure (MD -3.45 mmHg, 95% CI -4.50 to -2.40). Improvements were also observed in HDL-C (SMD 0.43, 95% CI 0.16 to 0.69) and functional capacity (6-minute walk test, SMD 0.78, 95% CI 0.51 to 1.05). Reported psychosocial outcomes included reductions in fatigue and depression. Evidence mapping suggests Tai Chi may influence autonomic regulation and inflammatory/stress-related pathways (e.g., heart rate variability, IL-6, CRP), alongside improvements in lipid profile and functional performance. Tai Chi may offer clinically meaningful improvements in blood pressure, lipid-related outcomes, functional capacity, and psychosocial health. Mechanistic findings suggest potential effects on autonomic and inflammatory pathways, but comparative advantages over aerobic exercise and biomarker outcomes are supported largely by low- to moderate-certainty evidence and should be interpreted cautiously.

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