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Published in: BMC Complementary Medicine and Therapies 1/2020

01-12-2020 | Hypertension | Research article

The effectiveness of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials

Authors: Bao-yi Shao, Xia-tian Zhang, Robin W. M. Vernooij, Qiu-yi Lv, Yao-yang Hou, Qi Bao, Li-xing Lao, Jian-ping Liu, Ying Zhang, Gordon H. Guyatt

Published in: BMC Complementary Medicine and Therapies | Issue 1/2020

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Abstract

Background

Hypertension, a major risk factor of cardiovascular mortality, is a critical issue for public health. Although Baduanjin (Eight Brocades, EB), a traditional Chinese exercise, might influence blood pressure, glucose, and lipid status, the magnitude of true effects and subgroup differences remains unclear. Therefore, we performed a systematic review of relevant randomized controlled trials (RCTs) to evaluate the effect of EB on patient-important outcomes.

Methods

We systematically searched PubMed, the Cochrane Library, Web of Science, and Chinese databases since inception until March 30, 2020. Meta-analysis was carried out using “meta” package in R 3.4.3 software. A prespecified subgroup analysis was done according to the type of comparisons between groups, and the credibility of significant subgroup effects (P < 0.05) were accessed using a five-criteria list. A GRADE evidence profile was constructed to illustrate the certainty of evidence.

Results

Our meta-analysis, including 14 eligible trials with 1058 patients, showed that compared with routine treatment or health education as control groups, the mean difference (MD) in systolic blood pressure (SBP) of the EB groups was − 8.52 mmHg (95%CI:[− 10.65, − 6.40], P < 0.01) and diastolic blood pressure (DBP) was − 4.65 mmHg (95%CI: [− 6.55, − 2.74], P < 0.01). For blood pressure, the evidence was, however, of low certainty because of risk of bias and inconsistency, and for the outcomes of most interest to patients (cardiovascular morbidity and mortality directly), of very low certainty (measurement of surrogate only). Subgroup analysis showed there was no significant interaction effect between different type of comparisons (SBP P = 0.15; DBP P = 0.37), so it could be easily attributed to chance.

Conclusion

Regularly EB exercising may be helpful to control blood pressure, but the evidence is only low certainty for blood pressure and very low certainty for cardiovascular morbidity and mortality. Rigorously designed RCTs that carry out longer follow-up and address patient-important outcomes remain warranted.

Trial registration

PROSPERO Registration number: CRD42018095854.
Appendix
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Metadata
Title
The effectiveness of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials
Authors
Bao-yi Shao
Xia-tian Zhang
Robin W. M. Vernooij
Qiu-yi Lv
Yao-yang Hou
Qi Bao
Li-xing Lao
Jian-ping Liu
Ying Zhang
Gordon H. Guyatt
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2020
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-020-03098-w

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