High blood pressure is a leading threat to cardiovascular health, putting the heart, brain, kidneys, and other organs and tissues at risk. Lifestyle changes are crucial for both preventing hypertension and managing it – representing a non-pharmacological approach to treatment. This means that whether someone is trying to avoid developing high blood pressure or is already taking medication to control it, factors like a healthy diet, regular exercise, and stress management are essential.
Recent research suggests an ancient Chinese mind-body practice, Baduanjin, may be an effective tool in managing these factors. A clinical trial evaluating its effectiveness was published this month in the Journal of the American College of Cardiology.
An Ancient Exercise Tradition
Baduanjin is a standardized sequence of eight movements that combines gradual, structured movements, deep breathing, and meditative concentration. It integrates aerobic, isometric, and flexibility components with a strong focus on the mind-body connection.
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Practiced in China for centuries, the sequence typically lasts between 10 and 15 minutes, requires no equipment, and demands minimal initial instruction. Due to its low to moderate intensity, it’s considered a safe and accessible practice for many adults.
“Given its simplicity, safety, and ease of long-term adherence, Baduanjin can be implemented as an effective, accessible, and scalable lifestyle intervention for individuals attempting to lower their blood pressure,” said Jing Li, lead author of the study and director of the Department of Preventive Medicine at the National Center for Cardiovascular Diseases in Beijing, China.
Adherence is a key factor. Medical guidelines for managing hypertension recommend regular physical activity for prevention and treatment, but maintaining routines that require equipment or ongoing supervision can be challenging for many, particularly older adults.
How to Practice Baduanjin
The practice is based on eight basic movements. The article published in the Journal of the American College of Cardiology includes videos (in Chinese and English) with step-by-step instructions. Here’s a breakdown of each movement:
Each exercise is performed eight times, slowly but with intention. Paying attention to your breath throughout each movement is crucial.
1. Holding the Sky
Raise your hands with palms facing up and arms extended. This stretches the upper body, targeting the shoulders and neck. TIP: As you raise your palms, stretch your entire body and root your feet into the ground. Lower your hands while relaxing your waist and releasing your shoulders.
2. Drawing the Bow
Works on the lungs, intestines, and heart. Develops muscles in the legs, forearms, and hands. Corrects poor posture in the back, shoulders, and neck.
TIP: Keep your arms aligned while “drawing the bow.” Knees should not extend past your toes.
3. Separating Heaven and Earth
While one hand rises, the other lowers. Strengthens the joints and muscles of the spine, shoulders, forearms, and wrists. Increases flexibility.
TIP: Push upwards and downwards from the base of your palms, with arms extended but elbows unlocked. Press your big toes firmly into the ground.
4. Looking Backwards
Helps prevent tension. Stretches the muscles of the neck and shoulders, as well as the eye muscles. Improves blood flow to the neck, waist, and brain.
TIP: Turn your head while keeping your torso facing forward. Avoid twisting your waist or leaning your body.
5. Swinging the Head
Lower your body, squat, and rotate your waist. Improves flexibility and works muscles in the head, neck, waist, abdomen, glutes, and legs.
TIP: The circular movement originates in the waist and hips. As you swing your head, gently round your chest and maintain the fluidity of the movement.
6. Grasping the Feet, Touching the Sky
Lower your hands behind your legs and touch your feet to strengthen your kidneys and waist. Increases flexibility in the legs and back.
TIP: Descend vertebra by vertebra as you bend over. As you rise, let your arms guide the movement and extend your body, keeping your chest open and lower back aligned.
7. Punching with the Fists
Increase energy by punching forward. Controlled tension and subsequent relaxation of muscles, tendons, and ligaments.
TIP: Keep your forearm and elbow close to your torso when punching and retracting. Your gaze accompanies the movement with firm intention.
8. Shaking the Back
Raise and lower your heels, stimulating the spine and joints and ligaments of the legs through vibration.
TIP: As you raise your heels, gently activate your pelvic floor and draw in your abdomen. As you lower, exhale relaxedly and allow your body to absorb the vibration.
The Study
The work was the first multicenter, randomized controlled trial to evaluate the impact of Baduanjin on blood pressure. This rigorous study design strengthens the reliability of the findings.
The study included 216 participants aged 40 and older with systolic blood pressure between 130 and 139 mmHg and/or diastolic blood pressure between 85 and 89 mmHg. According to the American Heart Association and American College of Cardiology guidelines, this is considered stage 1 hypertension. Diagnostic thresholds for hypertension differ internationally; in Argentina, a diagnosis is typically made at 140/90 mmHg.
Participants, with an average age of 57 years and two-thirds being women, were randomly assigned to one of three groups for 52 weeks: 1) Baduanjin, 2) self-directed exercise (without a specific program, but with a recommendation of at least 150 minutes of moderate-intensity exercise per week), and 3) brisk walking.
The primary goal was to measure changes in 24-hour systolic blood pressure (ambulatory monitoring) from the start to 12 and 52 weeks. The analysis compared Baduanjin to self-directed exercise, and then to brisk walking.
Lasting Effects
The group practicing Baduanjin experienced a significantly greater reduction in 24-hour systolic blood pressure compared to the self-directed exercise group: 3.1 mmHg at 12 weeks and 3.3 mmHg at 52 weeks.
However, when comparing Baduanjin to brisk walking, no significant differences were observed after one year; the effect was similar with both interventions. There were also no relevant differences in adverse events between the three groups.
Importantly, the benefits were maintained even without continuous follow-up, a common challenge in lifestyle interventions.
“Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, and low-cost approaches can be validated through high-quality randomized research,” noted Harlan M. Krumholz, editor-in-chief of the Journal of the American College of Cardiology and professor of medicine at Yale University.
“The magnitude of the effect on blood pressure is similar to that observed in landmark clinical trials, but was achieved without medication, cost, or side effects. This makes it highly scalable for prevention, even in resource-limited settings,” Krumholz added, who was not involved in the study.
The Non-Pharmacological Pillars
The latest Argentine Consensus on Arterial Hypertension, published in 2025 by the Argentine Society of Hypertension, the Argentine Society of Cardiology, and the Argentine Federation of Cardiology, reaffirms that lifestyle changes are the cornerstone of hypertension prevention and treatment.
Recommendations include weight reduction, sodium restriction, increased potassium intake and the DASH diet, regular physical activity, moderate alcohol consumption, smoking cessation, incorporating probiotics into the diet, stress management, and consideration of environmental factors such as noise and air pollution. These all contribute to a comprehensive strategy that complements, but does not replace, pharmacological treatment when necessary.
*Photos and videos extracted from JACC.
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