A Gentle Exercise That May Help Lower Blood Pressure

Many people with high-normal blood pressure (levels that are elevated but not yet in the hypertension range) are told to exercise more to help prevent progression to high blood pressure. However, sticking with exercise long enough to see lasting blood pressure improvements can be challenging.

A new study published in the Journal of the American College of Cardiology explored whether a gentle, structured movement practice called baduanjin could help lower blood pressure more effectively than usual self-directed exercise or brisk walking.

Baduanjin is a traditional mind-body exercise that combines eight slow movements, breathing and focus. It is often described as low-impact and accessible, making it appealing for middle-aged and older adults. The practice generally takes about 10 to 15 minutes to complete.

“Given its simplicity, safety and ease at which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible and scalable lifestyle intervention for individuals trying to reduce their blood pressure,” said senior investigator Jing Li, M.D., Ph.D., director of the Department of Preventive Medicine, National Center for Cardiovascular Diseases in Beijing, China.

Investigators conducted a yearlong clinical trial across seven community sites, enrolling adults aged 40 and older who had high-normal blood pressure. Participants had systolic blood pressure between 130 and 139 mm Hg and/or diastolic blood pressure between 85 and 89 mm Hg — a group at increased risk of developing full hypertension.

A total of 216 participants took part in the study. About two-thirds were women, and the average age was just over 57 years. Participants were randomly assigned to one of three groups: a baduanjin exercise program, self-directed exercise based on general lifestyle advice or brisk walking. The intervention lasted 52 weeks.

The main goal of the study was to see how much participants’ average 24-hour systolic blood pressure changed after 12 weeks and again after one year. Blood pressure was measured using ambulatory monitoring, which tracks readings throughout the day and night and provides a more accurate picture than single office measurements.

After three months, people practicing baduanjin experienced a greater drop in systolic blood pressure than those following self-directed exercise advice. On average, 24-hour systolic blood pressure was about 3 mm Hg lower in the baduanjin group compared with the self-directed exercise group, and office systolic blood pressure was reduced by 5 mm Hg.

Importantly, the blood pressure benefit from baduanjin was still present after one year, even without ongoing monitoring. At 52 weeks, the baduanjin group continued to show significantly greater blood pressure reductions than the self-directed exercise group.

When compared with brisk walking, baduanjin showed similar effectiveness. There was no meaningful difference in blood pressure reduction between the baduanjin and brisk walking groups at one year, suggesting that both approaches can be helpful for blood pressure control.

The team also found that the benefits of baduanjin were consistent across different subgroups, including age and sex, and that no increase in adverse events occurred in any group. This suggests the practice is safe and well tolerated.

“Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost approaches can be validated through high-quality randomized research,” said Harlan M. Krumholz, M.D., FACC, editor-in-chief of the Journal of the American College of Cardiology and the Harold H. Hines Jr. Professor at the Yale School of Medicine. “The blood pressure effect size is similar to that seen in landmark drug trials, but achieved without medication, cost or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings.”