PURPOSE: To conduct a systematic review of the literature evaluating Tai Chi exercise as an intervention for patients with cardiovascular disease (CVD) or with CVD risk factors (CVDRF). METHODS: We searched (1) Medline, CAB Alt HealthWatch, BIOSIS previews, Science Citation Index, Embase, and Social Science Citation Index from inception through October 2007; (2) Chinese Medical Database, China Hospital Knowledge, China National Knowledge Infrastructure, and China Traditional Chinese Medicine Database from inception through June 2005; and (3) the medical libraries of Beijing and Nanjing Universities. Clinical studies published in English and Chinese including participants with established CVD or CVDRF were included. Data were extracted in a standardized manner; 2 independent investigators assessed methodological quality, including the Jadad score for randomized controlled trials (RCTs). RESULTS: Twenty-nine studies met inclusion criteria: 9 RCTs, 14 nonrandomized studies, and 6 observational trials. Three studies examined subjects with coronary heart disease, 5 in subjects with heart failure, and 10 in heterogeneous populations that included those with CVD. Eleven studies examined subjects with CVDRF (hypertension, dyslipidemia, impaired glucose metabolism). Study duration ranged from 8 weeks to 3 years. Most studies included fewer than 100 subjects (range 5 to 207). Six of 9 RCTs were of adequate quality (Jadad >= 3). Most studies reported improvements with Tai Chi, including blood pressure reductions and increases in exercise capacity. No adverse effects were reported. CONCLUSION: Preliminary evidence suggests that Tai Chi exercise may be a beneficial adjunctive therapy for some patients with CVD and CVDRF. Further research is needed.
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