24-Week Tai Chi Programme Reduces Blood Pressure and Alters Stress-Related Biomarkers in People with Hypertension

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High blood pressure (hypertension) is linked to disruption of the body’s neuro-endocrine-immune network — the interconnected systems governing nerve signalling, hormones, and inflammation. While Tai Chi has been explored as a non-drug approach to managing hypertension, the biological pathways involved have not been well understood.

This randomised controlled trial assigned 105 adults with primary hypertension to one of three groups: a standardised Tai Chi programme, a comparable aerobic exercise programme, or a control group. All participants were followed for 24 weeks. Researchers used several analytical methods — including linear mixed-effects models, principal component analysis, and structural equation modelling — to examine changes in blood pressure and a range of neuro-endocrine-immune-related markers, including acetylcholine, GABA, cortisol, and the inflammatory marker TNF-α.

Intention-to-treat analysis showed that Tai Chi significantly lowered blood pressure while also producing favourable shifts across multiple neuro-endocrine-immune biomarkers. The combined pattern suggested a coordinated reduction in physiological stress alongside an anti-inflammatory effect. Structural equation modelling identified a specific mediating pathway — acetylcholine influencing cortisol, which in turn affected TNF-α and ultimately systolic blood pressure — as a plausible mechanism underlying these benefits. Aerobic exercise served as an active comparator, allowing some differentiation of Tai Chi’s effects.

Conclusion: This trial provides mechanistic evidence that Tai Chi may reduce blood pressure in part by rebalancing neuro-endocrine-immune signalling, supporting its potential role in non-pharmacological hypertension management.

Source: Fang H, Li C, Zhou Q and colleagues. Scandinavian journal of medicine & science in sports (2026). View on PubMed (PMID 42154956) · doi:10.1111/sms.70272

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