Improve Cardiovascular Function in Heart Failure Patients with Tai Chi
By John M. de Castro, Ph.D.
“Tai chi has proven especially beneficial for people with heart failure, who tend to be tired and weak as a result of their heart’s diminished pumping ability. The upper- and lower-body movements safely strengthen the heart and major muscle groups.” – Harvard Health Letter
Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart failure, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.
Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction and stress reduction. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.
Since Tai Chi is both a mindfulness practice and an exercise, it may be an acceptable and effective treatment for heart failure patients. In today’s Research News article “The Effects of Tai Chi Training in Patients with Heart Failure: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770613/ ), Ren and colleagues review, summarize, and perform a meta-analysis of the 11 published research studies with a combined 636 patients, on the effectiveness of Tai Chi practice for the treatment of heart failure patients.
They report that the research findings support the conclusions that Tai Chi practice significantly increases the distance that the patients can walk in 6 minutes. It also significantly reduces heart rate and the levels of serum B-type natriuretic peptide; a marker of heart failure and significantly increases left ventricular ejection fraction; a marker of heart health. But, they also report that Tai Chi practice did not improve a number of other measures of cardiac function; including systolic and diastolic blood pressure, maximum oxygen uptake, and timed get up and go.
These results are encouraging and suggest that Tai Chi practice can improve many aspects of cardiac function in patients with heart failure. But, its’ usefulness must be tempered with the understanding that not all measure of heart health are improved. This suggests that that Tai Chi practice should be used in combination with other therapies to improve the symptoms of heart failure. The fact that it’s gentle and safe, convenient, inexpensive and social make it an ideal exercise to be employed as a step toward more intense exercises for heart health. It should be helpful in helping the 60% of heart failure patients who refuse exercise programs to slowly improve and transition into more intense exercise.
So, improve cardiovascular function in heart failure patients with Tai Chi.
“for people who don’t do cardiac rehab, tai chi may be a way to entice them to start exercising in a gentle, less intimidating way. It may also act as a gateway to other types of more traditional and intensive exercise that have been shown to improve fitness and potentially lower risk of having further heart attacks.” – Alice Park
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Xiaomeng Ren, Yanda Li, Xinyu Yang, Jie Li, Huilong Li, Zhengzhong Yuan, Yikun Sun, Hongcai Shang, Yanwei Xing, Yonghong Gao. The Effects of Tai Chi Training in Patients with Heart Failure: A Systematic Review and Meta-Analysis. Front Physiol. 2017; 8: 989. Published online 2017 Dec 7. doi: 10.3389/fphys.2017.00989
Abstract
Heart Failure (HF) is associated with significantly high morbidity and mortality. We performed a meta-analysis and updated new evidences from randomized controlled trials (RCTs) to determine the effects of Tai Chi (TC) in patients with HF. Electronic literature search of Medline, PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan Fang Database was conducted from inception of their establishment until 2017. And we also searched Clinical Trials Registries (https://clinicaltrials.gov/ and www.controlled-trials.com) for on-going studies. A total of 11 trials with 656 patients were available for analysis. The results suggested that TC was associated with an obviously improved 6-min walk distance [6MWD, weighted mean difference (WMD) 65.29 m; 95% CI 32.55–98.04] and quality of life (Qol, WMD −11.52 points; 95% CI −16.5 to −6.98) and left ventricular ejection fraction (LVEF, WMD 9.94%; 95% CI 6.95 to 12.93). TC was shown to reduce serum B-type natriuretic peptide [BNP, standard mean difference (SMD) −1.08 pg/mL; 95% CI −1.91 to −0.26] and heart rate (HR, WMD −2.52 bpm; 95% CI −3.49 to −1.55). In summary, our meta-analysis demonstrated the clinical evidence about TC for HF is inconclusive. TC could improve 6MWD, Qol and LVEF in patients with HF and may reduce BNP and HR. However, there is a lack of evidence to support TC altering other important long-term clinical outcomes so far. Further larger and more sustainable RCTs are urgently needed to investigate the effects of TC.