Is Qigong effective in lowering blood pressure for hypertensive patients?
Date of publication of the systematic review: January 2015
Design
Systematic review of 20 randomized controlled trials (RCTs).
Participants
2349 hypertensive patients. The reviewers did not report mean age and gender proportion of the participants.
Intervention
Qigong was provided within a range from 8 weeks to 12 months. The duration of each Qigong session lasted for 15 to 60 minutes. The frequency varied from 2 times per day to 5 to 6 times per week.
Comparator
Comparison 1: Qigong versus no intervention;
Comparison 2: Qigong versus conventional exercise and jogging;
Comparison 3: Qigong versus antihypertensive drugs.
Major Outcomes
Outcome 1: Systolic blood pressure (SBP), (mmHg);
Outcome 2: Diastolic blood pressure (DBP), (mmHg).
Settings
The included trials were performed in outpatient settings.
Comparison    Qigong versus no intervention
Main Results
Compared to no intervention group, Qigong showed significant benefits in lowering both the SBP (pooled weighted mean difference (pooled WMD): -17.40, 95% CI: -21.06 to -13.74) and DBP (pooled WMD: -10.15, 95% CI: -13.99 to -6.30).
Comparison 1: Tai Chi training versus no intervention among hypertensive patients
Outcomes (units) No. of studies (Total no. of participants) Mean value(SD) / No. of participants Heterogeneity test (I2) Pooled WMD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (mmHg) 3 (130) Not reported / 71 Not reported / 59 33% -17.40 (-21.06 to -13.74) <0.00001 High
2 (mmHg) 3 (130) Not reported / 71 Not reported / 59 61% -10.15 (-13.99 to -6.30) <0.00001 Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval.
Comparison    Qigong versus conventional exercise and jogging
Main Results
Compared to the exercise group, Qigong showed significant increase in the SBP for hypertensive patients (pooled weighted mean difference (pooled WMD): 6.51, 95% CI: 2.81 to 10.21) and it did not show significant difference in the DBP (pooled WMD: 0.67, 95% CI: -1.39 to 2.73).
Comparison 2: Tai Chi training versus conventional exercise and jogging among hypertensive patients
Outcomes (units) No. of studies (Total no. of participants) Mean value(SD) / No. of participants Heterogeneity test (I2) Pooled WMD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (mmHg) 2 (169) Not reported / 86 Not reported / 83 0% 6.51 (2.81 to 10.21) 0.0006 High
2 (mmHg) 2 (169) Not reported / 71 Not reported / 59 0% 0.67 (-1.39 to 2.73) 0.52 Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval.
Comparison    Qigong versus antihypertensive drugs
Main Results
Compared to the antihypertensive drugs group, Qigong showed significant effects in reducing both the SBP (pooled weighted mean difference (pooled WMD): -7.91, 95% CI: -16.81 to -1.00) and the DBP (pooled WMD: -6.08, 95% CI: -9.58 to -2.58).
Comparison 3: Tai Chi training versus antihypertensive drugs among hypertensive patients
Outcomes (units) No. of studies (Total no. of participants) Mean value(SD) / No. of participants Heterogeneity test (I2) Pooled WMD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (mmHg) 4 (169) Not reported / 288 Not reported / 147 82% -7.91 (-16.81 to -1.00) 0.08 Moderate
2 (mmHg) 4 (169) Not reported / 288 Not reported / 147 73% -6.08 (-9.58 to -2.58) 0.0007 Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval
Comparison    Qigong versus no intervention
Main Results
Compared to no intervention group, Qigong showed significant benefits in lowering both the SBP (pooled weighted mean difference (pooled WMD): -17.40, 95% CI: -21.06 to -13.74) and DBP (pooled WMD: -10.15, 95% CI: -13.99 to -6.30).
Comparison 1: Tai Chi training versus no intervention among hypertensive patients
Outcomes (units) 1 (mmHg) 2 (mmHg)
No. of studies (Total no. of participants) 3 (130) 3 (130)
Mean value(SD) / No. of participants Intervention Not reported / 71 Not reported / 71
Comparator Not reported / 59 Not reported / 59
Pooled WMD (95% CI) -17.40 (-21.06 to -13.74) -10.15 (-13.99 to -6.30)
p value <0.00001 <0.00001
Overall quality of evidence* High Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval.
Comparison    Qigong versus conventional exercise and jogging
Main Results
Compared to the exercise group, Qigong showed significant increase in the SBP for hypertensive patients (pooled weighted mean difference (pooled WMD): 6.51, 95% CI: 2.81 to 10.21) and it did not show significant difference in the DBP (pooled WMD: 0.67, 95% CI: -1.39 to 2.73).
Comparison 2: Tai Chi training versus conventional exercise and jogging among hypertensive patients
Outcomes (units) 1 (mmHg) 2 (mmHg)
No. of studies (Total no. of participants) 2 (169) 2 (169)
Mean value(SD) / No. of participants Intervention Not reported / 86 Not reported / 71
Comparator Not reported / 83 Not reported / 59
Pooled WMD (95% CI) 6.51 (2.81 to 10.21) 0.67 (-1.39 to 2.73)
p value 0.0006 0.52
Overall quality of evidence* High Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval.
Comparison    Qigong versus antihypertensive drugs
Main Results
Compared to the antihypertensive drugs group, Qigong showed significant effects in reducing both the SBP (pooled weighted mean difference (pooled WMD): -7.91, 95% CI: -16.81 to -1.00) and the DBP (pooled WMD: -6.08, 95% CI: -9.58 to -2.58).
Comparison 3: Tai Chi training versus antihypertensive drugs among hypertensive patients
Outcomes (units) 1 (mmHg) 2 (mmHg)
No. of studies (Total no. of participants) 4 (169) 4 (169)
Mean value(SD) / No. of participants Intervention Not reported / 288 Not reported / 288
Comparator Not reported / 147 Not reported / 147
Pooled WMD (95% CI) -7.91 (-16.81 to -1.00) -6.08 (-9.58 to -2.58)
p value 0.08 0.0007
Overall quality of evidence* Moderate Moderate
Keys: WMD = weighted mean difference; SD = standard deviation; CI = confidence interval
Conclusion
Benefits
Compared to no intervention group, Qigong showed significant effects in lowering both systolic and diastolic blood pressures. Compared to exercise, Qigong showed significant increase in systolic blood pressure for hypertensive patients. This may mean that exercise is a better option for lowering systolic blood pressure. However, Qigong did not show significant difference in diastolic blood pressure. For outcome 1 in comparison 1 and 2, the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect. For outcomes 2 in comparison 1 and 2, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. Compared to the antihypertensive drugs group, Qigong showed significant effects in reducing both systolic and diastolic blood pressures. The overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
Among the 20 included trials, only one adverse event was reported. In that trial, a woman in the Qigong group experienced vestibular neuronitis.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/25569652
The synopsis is based on the following article:
Xiong X, Wang P, Li X, Zhang Y. Qigong for hypertension: a systematic review. Medicine. 2015 Jan; 94(1):e352.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.