Dear HEALTHbeat subscriber,

Many of us have heard of tai chi — a form of exercise, which began in China as a martial art. But probably few of us have considered it as part of our regular exercise plans. But this gentle, flowing physical activity offers many health benefits.  And  almost anyone — at any age — can do it. This issue of HEALTHbeat explains what tai chi can do for you and how you can get started. Also in this issue, Dr. Richard Lee, associate editor of the Harvard Heart Letter, answers a reader question about how high blood pressure can suddenly return to normal levels.

Wishing you good health,


Nancy Ferrari
Managing Editor
Harvard Health Publications
HEALTHbeat@hms.harvard.edu

Tai chi in motion

A tai chi class might include these parts:

Warm-up. Easy motions, such as shoulder circles, turning the head from side to side, or rocking back and forth, help you to loosen your muscles and joints and focus on your breath and body.

Instruction and practice of tai chi forms. Short forms — forms are sets of movements — may include a dozen or fewer movements; long forms may include hundreds. Different styles require smaller or larger movements. A short form with smaller, slower movements is usually recommended at the beginning, especially if you’re older or not in good condition.

Qigong (or chi kung). Translated as “breath work” or “energy work,” this consists of a few minutes of gentle breathing sometimes combined with movement. The idea is to help relax the mind and mobilize the body’s energy. Qigong may be practiced standing, sitting, or lying down.

No pain, big gains

Although tai chi is slow and gentle and doesn’t leave you breathless, it addresses the key components of fitness — muscle strength, flexibility, balance, and, to a lesser degree, aerobic conditioning. Here’s some of the evidence:

Muscle strength. In a 2006 study published in Alternative Therapies in Health and Medicine, Stanford University researchers reported benefits of tai chi in 39 women and men, average age 66, with below-average fitness and at least one cardiovascular risk factor. After taking 36 tai chi classes in 12 weeks, they showed improvement in both lower-body strength and upper-body strength.

In a Japanese study using the same strength measures, 113 older adults were assigned to different 12-week exercise programs, including tai chi, brisk walking, and resistance training. People who did tai chi improved more than 30% in lower-body strength and 25% in arm strength — almost as much as those who participated in resistance training, and more than those assigned to brisk walking.

“Although you aren’t working with weights or resistance bands, the unsupported arm exercise involved in tai chi strengthens your upper body,” says internist Dr. Gloria Yeh, an assistant professor at Harvard Medical School. “Tai chi strengthens both the lower and upper extremities and also the core muscles of the back and abdomen.”

Flexibility. Women in the 2006 Stanford study significantly boosted upper- and lower-body flexibility as well as strength.

Balance. Tai chi improves balance and, according to some studies, reduces falls. Proprioception — the ability to sense the position of one’s body in space — declines with age. Tai chi helps train this sense, which is a function of sensory neurons in the inner ear and stretch receptors in the muscles and ligaments. Tai chi also improves muscle strength and flexibility, which makes it easier to recover from a stumble.

Q: After being diagnosed with high blood pressure several years ago, my doctor prescribed two blood pressure medications for me. They helped, giving me an average blood pressure of 110/65. Recently, I ended up the hospital for a different health problem. There, my blood pressure got so low I was told to stop taking these medications. I have been off them since, and my blood pressure is staying at about 105/65. Why? Will my blood pressure get high again?

A. Congratulations on getting your blood pressure under such great control — however you managed to do it! Without knowing anything else about your situation, my guess is that you have been making lifestyle changes over the years that have been good for your blood pressure. Losing weight, increasing exercise, quitting smoking, cutting back on salt and alcohol, and adopting a healthful eating plan like the DASH diet can reduce, or even eliminate, the need for medications to control blood pressure.

Will your high blood pressure return? The odds are in favor of that happening — by age 75, three in four Americans have high blood pressure — though you can try to beat those odds with continued prevention efforts. Keep on top of your blood pressure by monitoring it at home now and then. Ask your doctor to check your meter to be sure it is giving accurate readings. Also, alternate the arm you use to take the readings. When atherosclerosis partly blocks the main artery carrying blood to one arm, a blood pressure measurement done on that arm can be lower than it is in the rest of the body. If your blood pressure is normal in both arms, you may be one of the people who doesn’t need medicine with the right attention to diet and exercise.

This Question and Answer first appeared in the June 2009 Harvard Heart Letter, available at www.health.harvard.edu/heart.