The Effect of Tai Chi on Cardiometabolic Risk Factors: Systematic Review and Meta-Analysis

Background and Aim: Cardiovascular diseases (CVDs), the leading cause of sudden death, are primarily driven by metabolic dysfunction, a core mechanism underlying their onset and progression. Emerging research suggests that Tai Chi, an ancient martial art, positively impacts metabolic health. Accordingly, we sought to conduct a systematic review to examine clinical evidence regarding the effectiveness and safety of Tai Chi in managing cardiometabolic risk factors (CRFs). Methods and Results: A comprehensive literature search of eight electronic databases identified randomized controlled trials (RCTs) that met predefined inclusion criteria, focusing on adults with CRFs such as obesity, hyperlipidemia, hypertension, and glycemic dysregulation. Interventions involving Tai Chi were compared with nonexercise controls or other exercise modalities. Outcomes included lipid profiles, blood pressure, blood glucose, body composition, and adverse events. Results: Thirteen RCTs involving 1746 participants were included. Tai Chi significantly reduced triglycerides (TG) (mean difference [MD] = -0.20, p < 0.0001), fasting blood glucose (MD = -0.36, p = 0.025), DBP (MD = -4.49, p = 0.010), and waist circumference (MD = -3.34, p = 0.0001), while increasing high-density lipoprotein cholesterol (MD = 0.09, p < 0.0001) compared with nonexercise interventions. Compared with other exercises, Tai Chi reduced total cholesterol (MD = -0.33, p = 0.007) and TG (MD = -0.14, p = 0.0056). The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment indicated the overall quality of evidence supporting these findings was moderate. No serious adverse events were reported. Conclusion: Tai Chi is an effective and safe exercise intervention for managing CRFs, especially for populations unable to engage in high-intensity exercise. While Tai Chi demonstrates modest efficacy compared with other exercises, its safety and accessibility make it a valuable option in clinical practice. Further high-quality studies are needed to confirm long-term effects and optimize intervention strategies.