| Background:Prehypertension,defined as blood pressure(BP)in the range of 120-139/80-89 mmHg.Recent years,epidemiological surveys showed a high incidence rate of prehypertension.Prehypertension increases the incidence of hypertension and leads to a significant increase in the risk of cardiovascular disease.As the transitional stage between normal BP and hypertension,prehypertension plays a key role of the prevention and treatment of hypertension and cardiovascular diseases,and should be actively intervened.Current guidelines recommend regular aerobic exercise as a means of reducing BP,which can lower BP.However,aerobic exercise has certain limitations.The low exercise compliance of patients and the venue restrict effective training of aerobic exercise.Tai Chi,a form of traditional fitness exercises in China,is safe,low-cost and not restricted by venue.Tai Chi is suitable for all kinds of population to practice.Tai Chi combines strength and softness,and dynamic and static movements.It has the functions of dredging the meridians,smoothing qi and blood,and harmonizing Yin and Yang.A large number of studies have suggested that long-term persistence of Tai Chi exercise can effectively reduce and maintain BP level.However,in prehypertension population,studies comparing Tai Chi to aerobic exercise are limited.Objective:We aimed to study the influence of Tai Chi compared with aerobic exercise on reducing office BP and 24-hour ambulatory blood pressure monitoring(ABPM)in prehypertensive population,further evaluate whether Tai Chi is better than aerobic exercise,providing scientific reference for the health management of prehypertension patients.Methods:This study is a randomized controlled trial.A total of 342 patients with prehypertension were collected from Guang’anmen Hospital of China Academy of Chinese Medical Sciences and Dongzhimen Hospital of Beijing University of Chinese Medicine.Patients with prehypertension are randomized by central randomization management system(IWR)to one of two intervention groups:aerobic exercise group or Tai Chi group.Lifestyle intervention was performed in both groups.The aerobic exercise group was combined with moderate intensity aerobic exercise held four times a week,60 minutes each time on the basis of lifestyle intervention.Tai Chi group was combined with 24-form Yang-style Tai Chi exercises held four times a week,60 minutes each time on the basis of lifestyle intervention.The intervention period was 12 months.We observed two groups of patients with general data(age,gender,weight,BMI,history of hyperlipidemia,history of hypertension in first-degree relatives,etc.).We observed the change of office BP,ambulatory blood pressure,the variability of BP,laboratory data and the short-form health survey-36(SF-36)score after the treatment.Then carried out statistical analysis.Results:From July 2019 to January 2021,according to the inclusion and exclusion criteria,a total of 342 subjects were included and 59 subjects dropped out.Finally,283 cases were included in the analysis,including 142 cases in Tai Chi group and 141 cases in aerobic exercise group.1.General data:The general data(age,gender,BMI,history of hyperlipidemia,history of hypertension in first-degree relatives,etc.)of patients in the two groups showed no significant difference(P>0.05),which was comparable.2.Office BP:There was no significant difference in SBP and DBP between the two groups before treatment(P>0.05),which was comparable.After treatment,SBP and DBP in two groups were significantly decreased compared with before treatment,and the differences were statistically significant(P<0.05).The decrease of office SBP after treatment in Tai Chi group was significantly better than that in aerobic exercise group(-7.36 mmHg vs.-4.68 mmHg,P=0.017<0.05),and the decrease of office DBP after treatment in Tai Chi group was significantly better than that in aerobic exercise group(-4.27 mmHg vs.-2.65 mmHg,P=0.044<0.05).3.Ambulatory blood pressure:There was no significant difference in BP levels assessed through ABPM between the two groups before treatment(P>0.05),which was comparable.The 24-hour mean SBP,24-hour mean DBP,daytime mean SBP,daytime mean DBP and nighttime mean SBP assessed through ABPM in Tai Chi group were significantly lower than those before treatment,and differences were statistically significant(P<0.05).There was no significant difference in nighttime mean DBP in Tai Chi group after treatment,compared with before treatment(P>0.05).The 24-hour mean SBP,24-hour mean DBP,daytime mean SBP and daytime mean DBP assessed through ABPM in aerobic exercise group were significantly lower than those before treatment,and differences were statistically significant(P<0.05).There was no significant difference in nighttime mean SBP and nighttime mean DBP in aerobic exercise group after treatment,compared with those before treatment(P>0.05).The decrease of 24-hour mean SBP in Tai Chi group was significantly better than that in aerobic exercise group(-3.80 mmHg vs.-1.60 mmHg,P=0.021<0.05),and the decrease of nighttime mean SBP in Tai Chi group was significantly better than that in aerobic exercise group(-3.68 mmHg vs.-0.15 mmHg,P=0.007<0.05).4.BP variability:The BP variability was evaluated by standard deviation(SD)and average real variability(ARV).There was no significant difference in BP variability between the two groups before treatment(P>0.05),which was comparable.The 24-hour SBP-SD in Tai Chi group was significantly higher than that before treatment,and the difference was statistically significant(P<0.05).The 24-hour SBP-ARV in aerobic exercise group was significantly higher than that before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in 24-hour DBP-SD,24-hour SBP-ARV and 24-hour DBP-ARV in Tai Chi group after treatment,compared with those before treatment(P>0.05).There was no significant difference in 24-hour SBP-SD,24-hour DBP-SD and 24-hour DBP-ARV in aerobic exercise group after treatment,compared with those before treatment(P>0.05).There was no significant difference in the changes of 24-hour SBP-SD,24-hour DBP-SD,24-hour SBP-ARV and 24-hour DBP-ARV before and after treatment between the two groups(P>0.05).5.Laboratory data:The laboratory data include blood lipid(total cholesterol,triglycerides,high density lipoprotein-cholesterol and low density lipoprotein-cholesterol),blood glucose(fasting blood glucose and glycated hemoglobin),serum uric acid and serum creatinine.There was no significant difference in blood lipid,blood glucose,SUA and SCr between the two groups before treatment(P>0.05),which was comparable.There was no significant difference in blood lipid,blood glucose,SUA and SCr between after treatment and before treatment in both the two groups(P>0.05).6.SF-36 score:There was no significant difference in the scores of SF-36 items between the two groups before treatment(P>0.05),which was comparable.After treatment,the scores of general health,social functioning,mental health and mental health component in Tai Chi group were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of physical functioning,role physical,bodily pain,vitality,role emotional and physical health component between after treatment and before treatment in Tai Chi group(P>0.05).There was no significant difference in the scores of physical functioning,role physical,bodily pain,general health,vitality,social functioning,role emotional,mental health,physical health component and mental health component between after treatment and before treatment in aerobic exercise group(P>0.05).After treatment,the score of social functioning in Tai Chi group was significantly better than that in aerobic exercise group(P<0.05).Conclusions:1.Tai Chi can effectively reduce the office SBP and DBP of patients with prehypertension,and the clinical effect is significantly better than aerobic exercise.2.Tai Chi can effectively reduce 24-hour mean SBP,24-hour mean DBP,daytime mean SBP,daytime mean DBP and nighttime mean SBP in patients with prehypertension,and the clinical effect of Tai Chi on reducing 24-hour mean SBP and nighttime mean SBP is significantly better than aerobic exercise.3.Tai Chi can effectively improve the physical and mental health,and quality of life of patients with prehypertension from the three dimensions of general health,social functioning,mental health;and can significantly improve the social functioning score of SF-36 of patients with prehypertension compared with aerobic exercise. |
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