TY - JOUR
T1 - The effectiveness of Baduanjin exercise for hypertension
T2 - a systematic review and meta-analysis of randomized controlled trials
AU - Shao, Bao-Yi
AU - Zhang, Xia-Tian
AU - Vernooij, Robin W M
AU - Lv, Qiu-Yi
AU - Hou, Yao-Yang
AU - Bao, Qi
AU - Lao, Li-Xing
AU - Liu, Jian-Ping
AU - Zhang, Ying
AU - Guyatt, Gordon H
N1 - Publisher Copyright:
© 2020 The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/10/8
Y1 - 2020/10/8
N2 - Background: Hypertension, a major risk factor of cardiovascular mortality, is a critical issue for public health. Although Baduanjin (Eight Brocades, EB), a traditional Chinese exercise, might influence blood pressure, glucose, and lipid status, the magnitude of true effects and subgroup differences remains unclear. Therefore, we performed a systematic review of relevant randomized controlled trials (RCTs) to evaluate the effect of EB on patient-important outcomes. Methods: We systematically searched PubMed, the Cochrane Library, Web of Science, and Chinese databases since inception until March 30, 2020. Meta-analysis was carried out using "meta"package in R 3.4.3 software. A prespecified subgroup analysis was done according to the type of comparisons between groups, and the credibility of significant subgroup effects (P < 0.05) were accessed using a five-criteria list. A GRADE evidence profile was constructed to illustrate the certainty of evidence. Results: Our meta-analysis, including 14 eligible trials with 1058 patients, showed that compared with routine treatment or health education as control groups, the mean difference (MD) in systolic blood pressure (SBP) of the EB groups was - 8.52 mmHg (95%CI:[- 10.65, - 6.40], P < 0.01) and diastolic blood pressure (DBP) was - 4.65 mmHg (95%CI: [- 6.55, - 2.74], P < 0.01). For blood pressure, the evidence was, however, of low certainty because of risk of bias and inconsistency, and for the outcomes of most interest to patients (cardiovascular morbidity and mortality directly), of very low certainty (measurement of surrogate only). Subgroup analysis showed there was no significant interaction effect between different type of comparisons (SBP P = 0.15; DBP P = 0.37), so it could be easily attributed to chance. Conclusion: Regularly EB exercising may be helpful to control blood pressure, but the evidence is only low certainty for blood pressure and very low certainty for cardiovascular morbidity and mortality. Rigorously designed RCTs that carry out longer follow-up and address patient-important outcomes remain warranted. Trial registration: PROSPERO Registration number: CRD42018095854.
AB - Background: Hypertension, a major risk factor of cardiovascular mortality, is a critical issue for public health. Although Baduanjin (Eight Brocades, EB), a traditional Chinese exercise, might influence blood pressure, glucose, and lipid status, the magnitude of true effects and subgroup differences remains unclear. Therefore, we performed a systematic review of relevant randomized controlled trials (RCTs) to evaluate the effect of EB on patient-important outcomes. Methods: We systematically searched PubMed, the Cochrane Library, Web of Science, and Chinese databases since inception until March 30, 2020. Meta-analysis was carried out using "meta"package in R 3.4.3 software. A prespecified subgroup analysis was done according to the type of comparisons between groups, and the credibility of significant subgroup effects (P < 0.05) were accessed using a five-criteria list. A GRADE evidence profile was constructed to illustrate the certainty of evidence. Results: Our meta-analysis, including 14 eligible trials with 1058 patients, showed that compared with routine treatment or health education as control groups, the mean difference (MD) in systolic blood pressure (SBP) of the EB groups was - 8.52 mmHg (95%CI:[- 10.65, - 6.40], P < 0.01) and diastolic blood pressure (DBP) was - 4.65 mmHg (95%CI: [- 6.55, - 2.74], P < 0.01). For blood pressure, the evidence was, however, of low certainty because of risk of bias and inconsistency, and for the outcomes of most interest to patients (cardiovascular morbidity and mortality directly), of very low certainty (measurement of surrogate only). Subgroup analysis showed there was no significant interaction effect between different type of comparisons (SBP P = 0.15; DBP P = 0.37), so it could be easily attributed to chance. Conclusion: Regularly EB exercising may be helpful to control blood pressure, but the evidence is only low certainty for blood pressure and very low certainty for cardiovascular morbidity and mortality. Rigorously designed RCTs that carry out longer follow-up and address patient-important outcomes remain warranted. Trial registration: PROSPERO Registration number: CRD42018095854.
KW - Baduanjin
KW - Hypertension
KW - Meta-analysis
KW - Randomized controlled trials
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85092563505&partnerID=8YFLogxK
U2 - 10.1186/s12906-020-03098-w
DO - 10.1186/s12906-020-03098-w
M3 - Review article
C2 - 33032580
SN - 2662-7671
VL - 20
SP - 1
EP - 12
JO - BMC complementary medicine and therapies
JF - BMC complementary medicine and therapies
IS - 1
M1 - 304
ER -