Managing High Blood Pressure Using Qigong Practices

High blood pressure or hypertension (HTN) is a major public health issue affecting almost a billion people worldwide. HTN is often called a “silent killer” because while it has no obvious symptoms, untreated HTN can often lead to strokes, heart attacks and other health issues. As of 2015, an estimated 75 million adults in the U.S. had HTN.

Management of hypertension is typically addressed through lifestyle changes, diet and antihypertensive medications. A diet high in vegetables, fruits, and low-fat dairy type foods can help lower blood pressure among people having hypertension, as well as those without. Also, a diet low in sodium can also help to lower blood pressure across age, gender, race, weight, and physical activity subgroups. Other methods for lowering high blood pressure can include weight reduction if overweight or obese, increasing physical activity, and moderate alcohol consumption.¹

High blood pressure or hypertension is a disease in itself but also a major risk factor for other diseases. Normal blood pressure is typically 120 systolic (maximum pressure during one heartbeat) over 80 diastolic (minimum pressure between two heartbeats). Systolic blood pressure over 115 mmHg is usually considered as higher than normal. An average and sustained blood pressure of 140/90 would be defined as hypertension and considered to put an individual at risk of specific health issues. Medical studies have shown that an increase of hypertension is connected to an increasing rate of cardiovascular issues such as heart failure, atrial fibrillation, stroke, myocardial infarction, and premature mortality.

Blood pressure over 180/110 mmHg, if left untreated can overcome normal microvascular autoregulation. This can often lead to severe damage to the body’s blood circulation within the smallest blood vessels (microcirculation) resulting in a syndrome of accelerated or malignant hypertension and possibly cerebral hemorrhage where there is bleeding in or around the brain, which can be immediate threats to one’s life.²

information from the Mayo Clinic lists various factors that can put someone at a higher risk of experiencing hypertension and its relative ailments:

Age. As people grow older, the risk of high blood pressure increases. Up until around age 64, hypertension is more common with men. Women after age 65, are at higher risk of having high blood pressure.
Race. Those of African heritage often acquire high blood pressure earlier in life and more often than other ethnicities. Serious complications related to hypertension such as heart attack, kidney failure and stroke are more common in those of African heritage.
Family history. High blood pressure has a tendency to be hereditary.
Obesity and overweight. The more someone weighs, the more oxygen and nutrients are needed to be transported through the blood to tissues. Increased blood flow increases the pressure on the blood vessel walls throughout the body.
Lack of physical activity. People who are more sedentary often have higher heart rates making the heart having to work more with each contraction. Less physical activity also contributes to the risk of being overweight or obese.
Smoking and tobacco use. Smoking or chewing tobacco can immediately raise blood pressure temporarily, while the chemicals in tobacco may cause damage to the lining of the artery walls.
High salt (sodium) diet. High sodium in your diet may cause the body to retain fluid, which leads to an increase in blood pressure.
Low potassium diet. Potassium helps keep the balance of the amount of sodium in the cells of our body. If there is not enough potassium in our diet, sodium can build up in the blood.
Excess alcohol consumption. Excessive drinking can cause damage to the heart. More than one drink per day for women and more than two drinks per day for men can affect blood pressure.
Stress. Stress left unchecked can cause a temporary increase in blood pressure. Habits related to stress like binge eating, tobacco use and excess alcohol can lead to further increases of blood pressure.
Chronic conditions. Certain chronic conditions can also increase risk of high blood pressure. These would include diabetes, kidney disease and sleep apnea.³

In recent years, news and media outlets have brought some attention to complementary alternative medicine (CAM) as options to use with or without pharmaceutical approaches to manage high blood pressure. Among these methods would be meditation, tai chi, qigong and its root origin of yoga. A research study conducted in 2015 titled Qigong for Hypertension: A Systematic Review, investigated the use of qigong practices for hypertension. It was widely distributed through various internet outlets such as PubMed, NCBI, Medicine, ResearchGate, Harvard Library and others.

Qigong has its root origin in yoga. Tai chi and daoyin are types of qigong (or basically yoga) where the body is trained to perform “yoga in motion” where exercises are linked together to form sets of movements. While all of these methods have quite different names, they all share the same Eastern Indian origins and similar philosophy. All of these types of exercise use mindful breathing with deliberate body positioning. The mind is focused inward on one’s thoughts, breathing and posture. All have elements for mind, body & spiritual (or higher consciousness) development. These practices have been practiced for thousands of years (origins between 5000-1500 BC), and Tai Chi originated in the 12th century. The following is a basic translation of these methods:

Qi, chi or gi = air, energy, or breath
Gong or kung = work or effort
Qigong = energy or breath work
Daoyin = guide the qi, stretch the body (sometimes referred to as Taoist yoga)
Tai chi, taiji, tai chi chuan = supreme ultimate fist
Yoga = to join or unite

The systematic review of this study was conducted in coherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only RCTs investigating the effects of qigong on high blood pressure (hypertension) were included. The results from this meta-analysis study suggests that qigong is an effective therapy for hypertension.

At the time of this study in 2015, China had roughly 5% of its 1.3 billion population practicing qigong on a regular basis. They believe qigong to improve health, prevent illness, and extend life by addressing a wide range of ailments and conditions. These ailments would include hypertension, chronic pain, fatigue, stress, movement disorders, cancer, depression, anxiety, heart failure, coronary heart disease, cardiac rehabilitation, diabetes, metabolic syndrome, chronic obstructive pulmonary disease, immune function and to enhance the overall quality of life (QOL). Qigong here is widely practiced by middle-aged and elderly people, many who cannot engage in moderate-to-vigorous–intensity aerobic exercise. This makes qigong more appropriate for elderly patients, being a gentle alternative to intense physical activities. Static (non-moving) qigong can be practiced which has even lower physical demands.

The results from this meta-analysis study suggests that qigong is an effective therapy for hypertension. Qigong is better than no intervention but with antihypertensive drugs. However, it was found that qigong was inferior to exercise in lowering high blood pressure. Additionally, qigong used as a supplemental therapy to antihypertensive drugs, can significantly lower hypertension. Qigong could be recommended as a complementary intervention for hypertensive patients.

If other well-designed RCTs were to offer a high quality of methodology confirming that qigong is beneficial, it could be used as a recommended evidence-based complementary or alternative therapy for the management of high blood pressure on a global scale.

Due to inferior systematic quality of some of the included studies, further RCTs with strictly designed methods need to be pursued along with long-term follow-up focusing on definitive clinical outcomes are required in order to confirm the results. From here, a higher level of evidence could support qigong as an alternative to regular conventional exercise for elderly patients. In contrast, negative outcomes can challenge the clinical evidence supporting qigong.

A methodical search for literature was executed from 7 databases, from their respective inceptions up until April of 2014. These databases included PubMed, the Chinese National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Cochrane Library, EMBASE, the Chinese Biomedical Literature Database, and the Wanfang database. Randomized controlled trials were a mixture identifying interventions of qigong as either practice alone (monotherapy) or adjunctive therapy with antihypertensive (high blood pressure lowering) drugs versus no intervention, exercise, or antihypertensive drugs for hypertension.

The controls included wait-list control, jogging, conventional exercises, no exercise, oryzanol, or antihypertensive drugs. Participants in the treatment group were given the same type and dosage of antihypertensive drugs, and with the same standard that was used for the control group. All studies were parallel-designed and single-centered.

A total of 2349 patients with hypertension were evaluated. Participants were of any age, gender, and ethnic origin, being clinically diagnosed as hypertensive in any stage, with at least 1 of the current or past guidelines or definitions of hypertension. Of the trials, 18 were held in China and 2 trials were conducted in South Korea. From data presented in the study, participant ages ranged from as young as 21 and as old as 84. The average age appeared to be in the mid 50’s. The data compiled in this study spanned from as early as 1959 up until 2014. The duration of qigong treatments ranged from 8 weeks to 12 months.

All studies showed qigong as either monotherapy or supplemental therapy to hypertension drugs in the treatment group. Two of the trials had a 3-group study design with 1 trial including jogging, qigong, and antihypertensive drugs groups, while the other trial included qigong plus antihypertensive drugs groups. Practice sessions for that practicing qigong, were usually at least 15 minutes long and sometimes up to 60 minutes. 1-2 practice sessions per day were reported in the data.⁴

I find it quite commendable that there was data compiled from over such a long period of time for this study. Qigong is so embedded within Asian culture for thousands of years, where in the United States it is relatively new to our country. I have found as usual with many of these medical studies regarding ancient Eastern methods, the researchers are careful to say that more research and investigation is required. Regardless of the research, these methods have been used for thousands of years by other cultures that look beyond the scientific data and see a strong correlation between the mind, body and spiritual connection affecting health and well-being.

I feel that qigong is a great method to reduce hypertension, having worked with hundreds of individuals over my 40 years of teaching these methods. Any methods that encourage mindful regulation of one’s breathing patterns, can have a profound positive effect on their autonomic nervous system. Management of the “fight or flight” response of the sympathetic nervous system or “rest and digest” response of the parasympathetic nervous system, is directly connected to the body’s autoregulation of the cardiovascular system and consequently high blood pressure.

References

¹ Langford, A. T., Solid, C. A., Gann, L. C., Rabinowitz, E. P., Williams, S. K., & Seixas, A. A. (2018). Beliefs about the causes of hypertension and associations with pro-health behaviors. Health Psychology, 37(12), 1092–1101. https://doi-org.northernvermont.idm.oclc.org/10.1037/hea0000687

² Gabb, G. (2020). What is hypertension? Australian Prescriber, 43(4), 108–109. https://doi-org.northernvermont.idm.oclc.org/10.18773/austprescr.2020.025

³High blood pressure (hypertension). (n.d.). Www.Mayoclinic.Org. Retrieved July 18, 2021, from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410

⁴ Xiong, X., Wang, P., Li, X., & Zhang, Y. (2015). Qigong for hypertension: a systematic review. Medicine, 94(1), e352. https://doi-org.northernvermont.idm.oclc.org/10.1097/MD.0000000000000352

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