Hypertension, a major cause of premature death worldwide , World Health Organisation (WHO) (2024).

JulietJones - 02.04.2025

A major cause of premature death worldwide is hypertension, according to WHO (2024). If a patient’s blood pressure is as high as 140/ 90 mmHg or higher, they have high blood pressure. Huang et al (2021) states that threatening human health today, hypertension is the most common disease, producing subsequent high-level health complications such as cardiovascular disease, strokes and the cessation of life. The British Heart Foundation (2019) clearly states there are 4 million people living with undiagnosed hypertension in the UK, of 1.3 million people living with undiagnosed hypertension are under 45 years of age. If treated in time, patients can live a long and healthy life. The intervention of a Tai Chi intervention into the National Health Service (NHS), such as a Tai Chi prescription, could prevent this quagmire of statistics documenting the financial pressure on the NHS due to undiagnosed hypertension, and a relief could be had from the expense of anti-hypertensive drugs and treatment of ensuing diseases predicated by hypertension, consuming the NHS’s financial budget, therefore relieving the pressure on the national health service by helping the population to stay healthier for longer.

Context

Evidence-Based Practice according to Silva et al (2023) is vital for health services, professionals and patients alike. Evidence-based practice enables a high-quality level of quality randomised controlled trials and systematic peer-reviewed reviews that provide strong evidence-based work in order to base their diagnoses and prognoses for their patients, which also ultimately reduces health care costs due to the increased proficiency. Examples of different databases from which the information is collated, for example. databases cited by Silva et al (2023) are “PubMed, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resources Information Centre (ERIC).” A critical appraisal and evaluation of this information regarding the successful treatments of a particular disease then takes place. The healthcare professional can then deduce the treatment that will yield the best results based on the many systematic reviews and randomised controlled trials evidenced in these databases. By focusing on the most current reviews and trials, the healthcare professionals’ treatments remain current, and confidence is had because of the evidence-based results tried and tested by the healthcare professionals’ peer review via the information collated by the many and vast databases available to the healthcare professional. Hypertension and the evidence-based Tai Chi intervention this critical review will look at are the damaging effects of hypertension and a Tai Chi evidence-based approach to its resolution. The statistics clearly state the crisis is real and needs to be addressed; WHO (2024) states that “hypertension is a major cause of premature death worldwide.” 

Hypertension is the preliminary cause of many serious health problems targeting the UK populations vulnerable, such as those with chronic illnesses such as cardiovascular diseases, the ageing population, those over the age of 40 and those living within the lower socio-economic threshold. Blood Pressure UK (2021) states that around one third of the UK population has high blood pressure, stating that in England alone, 31% of males and 26% of females have high blood pressure. Proactively improving the statistics of hypertension in these groups and the lower socio-economic group in the UK requires interventions that are both cost-effective, accessible, affordable and effective for the population without the myriads of side effects pharmacological solutions have catalogued. Tai Chi is an exercise that incorporates meditation in movement to bring about harmony of body and mind through gentle exercise and meditation. Tai Chi has been proven to lower hypertension, and this non-pharmacological intervention could and should be accessible to the lower socio-economic group in the population and beyond. The result would be less financial pressure on the National Health Service (NHS). By introducing a Tai Chi intervention into the nation's healthcare processes, the healthcare services could work in a collaborative way with healthcare providers, community centres and patient advocacy groups such as Blood Pressure UK and the British Heart Foundation to intervene in a far less intrusive way.

Intervention

Tai Chi is an exercise that incorporates meditation in movement to bring about harmony of body and mind through gentle exercise and meditation. Tai Chi has been proven to lower blood pressure, and this non-pharmacological intervention could and should be accessible to the lower socio-economic groups and beyond. The result would be less financial pressure on the NHS. By introducing a Tai Chi intervention into healthcare services in the UK, healthcare services could work in a collaborative working environment with healthcare providers, community centres and patient advocacy groups such as Blood Pressure UK and the British Heart Foundation to intervene in a far less intrusive way as compared to anti-hypertensives and the negative factors such as lifelong commitment to the anti-hypertensives solution and the known side effects of anti-hypertensives proving invaluable to an increasingly isolated community who could also find it helping with loneliness. “For instance, studies have demonstrated that Tai Chi programmes can lead to reduced healthcare utilisation and costs among older adults, those in low-income thresholds, highlighting its potential to improve health outcomes and reduce healthcare expenses.”  Perloff et al(2021). Previous interventions with regard to the treatment of hypertension mainly focused on the administering of medication to reduce high blood pressure, which has been highly effective despite the side effects mentioned earlier. 

Schneider et al (2023) states the antihypertensive medication taken as a singular pill combination decreases the risk of cardiovascular and stroke mortality, as well as the singular pill antihypertensive being more easily maintained in the body over the lifetime of the patient, as antihypertensive medication needs to be taken for life.The underlying drawback of these successful interventions for hypertension is that once medication is used to reduce high blood pressure, the patient is therefore on medication to maintain the lower level of medically induced, lower blood pressure for the rest of their life, and the medication has side effects that also need to be considered. Albrasi et al (2021) found that the side effects of antihypertensive medication are an acute cause of kidney injury, syncope, hyperkalaemia, and hypotension. Compounding this knowledge, Albrasi et al (2021) also found that falls due to dizziness caused by the antihypertensive medication was also a negative contributing factor. The intervention that will be critically reviewed is the ‘Clinical Evidence of Tai Chi Prescriptions: A Systematic Review by Jiafu Huang, Dandan Wang and Jinghao Wang. Published 11th March 2021. The study took place in China; however, by introducing this intervention into the UK nation's healthcare processes, the NHS could work in unison with healthcare providers, community centres and patient advocacy groups such as Blood Pressure UK and the British Heart Foundation to intervene in a far less intrusive way than a lifelong subscription to an anti-hypertensive medication. With the added benefits of Tai Chi, such as helping with mental health and depression, proving invaluable to an increasingly isolated community who could also find it helpful with loneliness. Perloff et al (2021) cite studies that have demonstrated that Tai Chi programs can lead to reduced healthcare utilisation and costs among older adults in low-income housing, highlighting its potential to improve health outcomes and reduce healthcare expenses.

Critical Review

Looking at the impact of this intervention critically, this review advocates for a Tai Chi prescription for a myriad of diseases, ranging from hypertension, depression and osteoarthritis to more.  It looked at circular system diseases, including hypertension, to see if a Tai Chi prescription provided an evidence-based solution to these diseases. Huang et al (2021) states that Tai Chi had a positive and beneficial effect on hypertension, stroke, coronary heart disease, and chronic heart failure patients in the randomised controlled trials (RCTs). The systematic review was also able to determine which Tai Chi prescription was best for each particular disease. For the patients with hypertension, a Tai Chi prescription of 12 weeks with Tai Chi exercise carried out two to three times a week for a duration of sixty minutes incorporating the Yang style of Tai Chi procured the best results for this demographic according to Huang et al (2021). When identifying the strengths and weaknesses of this intervention, the obvious strength was that conclusions found that Tai Chi exercise as a prescription is a non-pharmacological and effective prescription for preventing and lowering hypertension and promoting good health. The limitations were as such, according to Huang et al (2021), firstly the fact that articles published in English from English databases was a limitation that could compromise the data surveyed. Secondly included were a few blind RCTs could create bias, and thirdly, the evidence was based primarily on disease systems instead of that of a specific disease. For example, hypertension was looked at within the grouping of the circulatory disease system rather than in and of itself. 

Recommendations

The recommendations for future evidence-based practice, based on my findings, would be to recommend this non-medicated way of lowering blood pressure rates in adults. This Tai Chi Prescription clinical review clearly evidenced the lowering of hypertension in participants that did the Yang style Tai Chi for a period of six to twelve weeks, up to an average of 12 weeks.

Conclusion

Based on my findings, it would be prudent to recommend this non-medicated way of lowering blood pressure rates in adults. This Tai Chi Prescription clinical review clearly evidenced the lowering of hypertension in participants that did the Yang style Tai Chi for a period of six to twelve weeks, up to an average of twelve weeks. Being on antihypertensive medication for one’s whole life does not have to be a reality when there is evidence-based intervention that a non-medicated Tai Chi exercise prescription, focusing on the Yang Style form of Tai Chi, practised regularly, can and does reduce hypertension.

References

Albasri, A,. Hattle, M., Koshiaris,C., Dunnigan, A., Paxton, B., Fox, S.E., Smith, M., Archer,L., Levis, B., Payne, R.A., Riley, R.D., Roberts, N., Snell, K.I.E., Lay-Flurrie,S.,Usher-Smith, J., Stevens,R., Hobbs,F.D.R., McManus, R.J., Sheppard,J.P.,on behalf of STRATIFY investigators (2021). Association between antihypertensive treatment and adverse events: systematic review and meta-analysis. British Medical Journal [online], 372, article 189.

Benedictine University Library,.(2024). Evaluating Sources: The CRAAP Test [online].Chicago: Benedictine University Library. Available from: https://researchguides.ben.edu/source-evaluation [Accessed 10th July 2

Blood Pressure UK., (2021). Blood Pressure Facts and Figures [online].UK: Blood Pressure UK. Available from:https://www.bloodpressureuk.org/search/?q=how+many+people+in+th+uk+have+hyperytension  [Accessed 30^th June 2024].

British Heart Foundation., (2019). Four Million People are living with undiagnosed Blood Pressure, new estimates show [online]. UK: British Heart Foundation. Available from: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2019/may/four-million-people-are-living-with-untreated-high-blood-pressure [Accessed 30th June 2024].

Huang , J., Wang, D., and Wang, J.,(2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Hindawi: Evidence-based Complementary & Alternative Medicine [online] 2021, Article 5558805. pp. 1- 14.  

NHS., (2024). High Blood Pressure (Hypertension) [online]. NHS. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension [Accessed 29th June 2024].

Perloff, J., Thomas, C.P., Macklin, E,. Gagnon ,P.,  Tsai, T., Isaza, I., Wayne, P.M., and  Lipsitz, L., (2021).The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing. Global Advances in Health and Medicine [online],10, pp.1-8.  

Silva, A.M. da., Valentim, D.P., Martins, A. L., and Padula, R.S., (2023). Instruments to Assess Evidence-Based Practice among Health Care Professionals: A Systematic Review. Health Education & Behavior [online], 51(3), pp. 467–476. 

Schmieder, R.E., Wassmann,S., Predel, HG,.Weisser, B., et al (2023). Improved Persistence to Medication, Decreased Cardiovascular Events and Reduced All-Cause Mortality in Hypertensive Patients with Use of Single-Pill Combinations: Results from START- Study. Wolters Kluwer Health, Inc [online], 80 (5) pp.1127-1135.