A traditional Chinese mind-body practice that combines slow, structured movement, deep breathing and meditative focus lowered blood pressure (BP) as effectively as brisk walking, according to results of the BLESS trial published Feb. 18 in JACC. BP reductions were seen after three months and sustained for one year.

Baduanjin is a widely practiced, standardized eight-movement sequence that integrates aerobic, isometric, flexibility and mind-body components. Practiced for centuries and commonly performed in community settings across China, the routine typically takes 10-15 minutes and requires no equipment and only minimal initial instruction, allowing it to be performed in a wide range of settings. Because it is low- to moderate-intensity, it is considered safe and accessible for many adults.

In BLESS, the first large, multicenter randomized trial to look at the impact of baduanjin on BP, Boxuan Pu, BMed, et al., followed 216 participants across seven communities to determine changes in 24-hour systolic BP from baseline to 12 and 52 weeks. Participants were 40 years old or older and had a systolic BP of 130-139 mm Hg. They were randomly assigned to one of three arms: baduanjin, self-directed exercise alone or brisk walking for the 52-week intervention.

Compared to self-directed exercise, practicing baduanjin five days a week reduced 24-hour systolic BP approximately 3 mm Hg and office systolic BP by 5 mm Hg at both three months and one year, which is comparable to reductions seen with some first-line medications. Baduanjin showed comparable results and safety profile to brisk walking at one year.

Notably, the benefits were sustained even without ongoing monitoring, a key challenge for many lifestyle interventions that struggle to maintain long-term adherence outside structured programs.

"Given its simplicity, safety and ease at which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible and scalable lifestyle intervention for individuals trying to reduce their [BP]," concludes Jing Li, MD, PhD, senior author of the study.

"Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost approaches can be validated through high-quality randomized research," said Harlan M. Krumholz, MD, SM, FACC, JACC Editor-in-Chief. "The [BP] effect size is similar to that seen in landmark drug trials, but achieved without medication, cost or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings."