| Part ?: Effectiveness and safety of Tai Chi for essential hypertension: systematic review and meta-analysisObjective To Systematically evaluate the effectiveness and safety of Tai Chi for essential hypertension.Methods The Cochrane Library,Medline(via Pub Med),EMbase(via OVID),web of science,CNKI,CBM,VIP and Wan Fang databases were electronically searched to identify randomized controlled trials(RCTs)of Tai Chi for essential hypertension from the inception of the database to January 2019.Two reviewers screened literatures,extracted data and assessed risk of bias of the included RCTs independently.The meta-analysis was conducted with Rev Man 5.3 software.And the GRADE profiler software was used for evaluation quality of evidence.Results 28 RCTs with 2834 essential hypertension patients were included,1483 patients in the Tai Chi group and 1351 patients in the control group.The results of the meta-analysis showed that,compared with the control group,Tai Chi group had lower SBP(MD=-13.67,95%CI-16.33 to-11.01,P<0.00001),lower DBP(MD=-7.51,95%CI-9.16 to-5.86,P<0.00001),lower TC(MD=-0.67,95%CI-0.95 to-0.40,P<0.00001),lower TG(MD=-1.51,95%CI-2.68 to-0.33,P=0.01),lower HDL-C(SMD=-1.62,95%CI(-2.93 to-0.31,P=0.02),lower LDL-C(SMD=-2.11,95%CI-3.32 to-0.91,P=0.0006),lower NO(MD=0.82,95%CI 0.59 to 1.05,P<0.00001)with statistically significant.There was no statistically significant difference of BMI between the two groups(MD=-0.08,95%CI-1.07 to 0.92,P=0.88).The quality of Tai Chi for SBP and DBP is considered “high”.No serious adverse event occurred in Tai Chi group.Conclusions 1.Tai Chi is better than the control group in lowering blood pressure and blood lipid;2.The quality of Tai Chi for SBP and DBP is considered “high”;3.Tai Chi has good safety for hypertension preliminarily.Part ?: Effectiveness of 24 simplified Tai Chi for ambulatory blood pressure and gut microbiota in essential hypertensionObjective To observe the effectiveness of 24 simplified Tai Chi for the ambulatory blood pressure and gut microbiota of subjects with essential hypertension,and to explore the possible mechanism of Tai Chi to lower blood pressure by using gut microbiota as a target,providing a more objective evidence for the application and promotion of Tai Chi.Methods Randomized and controlled trial was designed.19 subjects with essential hypertension who matched the inclusion criteria were randomly divided into Tai Chi group and waiting list group.At the same time,8 healthy subjects with matching age and gender were selected as healthy group.Subjects in Tai Chi group kept the diet and living habits unchanged and practiced 24 simplified Tai Chi 3 times a week,1 hour for each time,a total of 12 weeks.Waiting list group and healthy group kept the diet and living habits unchanged.Subjects received 24-hour ambulatory blood pressure monitoring,gut microbiota analysis and blood lipid levels test before and after the intervention.Results 1.Baseline The baselines between Tai Chi group,waiting list group and healthy group showed no statistical differences and were consistent and comparable.2.24-hour ambulatory blood pressure(1)After intervention,24 h MSBP and n MDBP of Tai Chi group were significantly lower than those before the intervention,which decreased 9.00±13.92 mm Hg and 7.2±6.91 mm Hg,respectively(P<0.01);n MSBP and the highest SBP were significantly lower than those before intervention,which decreased 15.8±15.40 mm Hg and 14.4±15.54 mm Hg,respectively(P<0.05);(2)There was a statistically significant of the difference in n MSBP and the highest SBP between the Tai Chi group and waiting list group after intervention(P<0.05,P<0.01,respectively);(3)Compared with pre-intervention,both daytime and nighttime blood pressure load of Tai Chi group decreased,while the nighttime blood pressure load of SBP decreased significantly(P<0.05);(4)There was no statistical difference in circadian rhythm between the two groups before and after intervention(P>0.05),but the circadian rhythm before and after intervention in the Tai Chi group had a significant improvement trend.3.16 S r DNA PCR sequencing data analysis results(1)Alpha diversity The Alpha diversity box plot showed that the level of microbiota diversity decreased significantly in hypertensive subjects compared with healthy subjects.The microbiota diversity had an upward trend in Tai Chi group and waiting list group after intervention,but the trend of Tai Chi group was more significant.(2)Difference analysis(1)Effects of exercise on the relative abundance of gut microbiota After intervention,the relative abundance of Escherichia_coli(Escherichia),Bacteroides,and Bifidobacterium of EH subjects increased significantly compared with that before intervention(P<0.05);(2)Effects of Tai Chi on the relative abundance of gut microbiota After Tai Chi intervention,the relative abundance of Bacteroides and Bifidobacterium in the genus of Tai Chi group was significantly higher than that before intervention(P<0.01,P<0.05,respectively);the relative abundance of Eubacterium,Ruminococcus,Escherichia had a downward trend;compaired with waiting list group,the abundance of Bacteroides and Bifidobacterium in Tai Chi group was increased(P<0.05).(3)Effects of Tai Chi on the ratio of Firmicutes and Bacteroidetes(F/B)After intervention,the F/B value of Tai Chi group had a downward trend,while the F/B value of waiting list group had an upward trend(P>0.05).4.Safety No serious adverse event occurred in this study.Only one subject in Tai Chi group was excluded due to hospitalization for a cold,and had nothing to do with Tai Chi.Conclusions 1.Tai Chi can significantly reduce the blood pressure level of hypertensive subjects,especially 24 h MSBP and nighttime blood pressure,which is better than waiting list group with no serious adverse events;2.Compared with healthy subjects,relative abundance and diversity of gut microbiota in hypertensive subjects changed;there is a statistical difference in abundance of Eubacterium,Bacteroides,Bifidobacterium in hypertensive subjects;3.The antihypertensive effect of Tai Chi may be related to its role in regulating gut microbiota imbalance. |
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