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A systematic review of the literature on the effect of tai chi exercise on blood pressure (BP) was performed. The authors searched Medline, CAB, Alt HealthWatch, BIOSIS previews, Science Citation Index, and EMBASE systems (inception through January 2007); researched Chinese Medical, China Hospital Knowledge, China National Knowledge Infrastructure, and China Traditional Chinese Medicine databases (inception to June 2005); and performed hand searches at the medical libraries of Beijing and Nanjing Universities. Clinical studies of tai chi examining BP as an outcome published in English or Chinese were included. Studies reporting only acute exercise effects were excluded. Data were extracted in a standardized manner and 2 independent investigators assessed methodologic quality. Twenty-six studies examining patients with and without cardiovascular conditions met inclusion criteria: 9 randomized controlled trials, 13 nonrandomized studies, and 4 observational studies. Study heterogeneity precluded formal meta-analyses. Twenty-two studies (85%) reported reductions in BP with tai chi (3–32 mm Hg systolic and 2–18 mm Hg diastolic BP reductions). Five randomized controlled trials were of adequate quality (Jadad score ≥3). No adverse effects were reported. Tai chi exercise may reduce BP and serve as a practical, nonpharmacologic adjunct to conventional hypertension management.

<h3>Objective</h3><p>To conduct a systematic review of reports on the physical and psychological effects of Tai Chi on various chronic medical conditions.</p><h3>Data Sources</h3><p>Search of 11 computerized English and Chinese databases.</p><h3>Study Selection</h3><p>Randomized controlled trials, nonrandomized controlled studies, and observational studies published in English or Chinese.</p><h3>Data Extraction</h3><p>Data were extracted for the study objective, population characteristics, study setting, type of Tai Chi intervention, study design, outcome assessment, duration of follow-up, and key results.</p><h3>Data Synthesis</h3><p>There were 9 randomized controlled trials, 23 nonrandomized controlled studies, and 15 observational studies in this review. Benefits were reported in balance and strength, cardiovascular and respiratory function, flexibility, immune system, symptoms of arthritis, muscular strength, and psychological effects.</p><h3>Conclusions</h3><p>Tai Chi appears to have physiological and psychosocial benefits and also appears to be safe and effective in promoting balance control, flexibility, and cardiovascular fitness in older patients with chronic conditions. However, limitations or biases exist in most studies, and it is difficult to draw firm conclusions about the benefits reported. Most indications in which Tai Chi was applied lack a theoretical foundation concerning the mechanism of benefit. Well-designed studies are needed.</p>