Qigong for hypertension: A systematic review

The purpose of this review was to evaluate the efficacy and safety of qigong for hypertension.A systematic literature search was performed in 7 databases from their respective inceptions until April 2014, including the Cochrane Library, EMBASE, PubMed, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, Wanfang database, and Chinese National Knowledge Infrastructure. Randomized controlled trials of qigong as either monotherapy or adjunctive therapy with antihypertensive drugs versus no intervention, exercise, or antihypertensive drugs for hypertension were identified. The risk of bias was assessed using the tool described in Cochrane Handbook for Systematic Review of Interventions, version 5.1.0.Twenty trials containing 2349 hypertensive patients were included in the meta-analysis. The risk of bias was generally high. Compared with no intervention, qigong significantly reduced systolic blood pressure (SBP) (weighted mean difference [WMD]=-17.40mm Hg, 95% confidence interval [CI] -21.06 to -13.74, P<0.00001) and diastolic blood pressure (DBP) (WMD=-10.15mm Hg, 95% CI -13.99 to -6.30, P<0.00001). Qigong was inferior to exercise in decreasing SBP (WMD=6.51mm Hg, 95% CI 2.81 to 10.21, P=0.0006), but no significant difference between the effects of qigong and exercise on DBP (WMD=0.67mm Hg, 95% CI -1.39 to 2.73, P=0.52) was identified. Compared with antihypertensive drugs, qigong produced a clinically meaningful but not statistically significant reduction in SBP (WMD=-7.91mm Hg, 95% CI -16.81 to 1.00, P=0.08), but appeared to be more effective in lowering DBP (WMD=-6.08mm Hg, 95% CI -9.58 to -2.58, P=0.0007). Qigong plus antihypertensive drugs significantly lowered both SBP (WMD=-11.99mm Hg, 95% CI -15.59 to -8.39, P<0.00001) and DBP (WMD=-5.28mm Hg, 95% CI, -8.13 to -2.42, P=0.0003) compared with antihypertensive drugs alone. No serious adverse events were reported.The meta-analysis suggests that qigong is an effective therapy for hypertension. However, more rigorously designed randomized controlled trials with long-term follow-up focusing on hard clinical outcomes are required to confirm the results.