Umbrella review shows strong evidence for Tai Chi and aerobic exercise benefits in cardiometabolic risk factors
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Key Takeaway
Consider Tai Chi or aerobic exercise for cardiometabolic risk factor reduction in adults with CV risk factors.
This umbrella review synthesizes findings from 16 meta-analysis publications evaluating aerobic exercise, Tai Chi, HIIT, resistance training, Yoga, and Qigong in adults with at least one CV risk factor. The primary outcome assessed was cardiometabolic risk factors, with secondary outcomes including waist circumference, systolic blood pressure, diastolic blood pressure, and total cholesterol. Follow-up durations were at least 6 months or 3 months.
Strong evidence for a benefit was found for aerobic exercise and waist circumference reduction compared to a control group in males and females with metabolic syndrome. The mean difference was -3.44 cm with a 95% CI of -4.81, -2.07. Strong evidence for a benefit was found for Tai Chi and systolic blood pressure reduction after at least 6 months, with a mean difference of -8.80 mmHg and a 95% CI of -11.28, -6.32. Diastolic blood pressure reduction showed a mean difference of -7.58 mmHg at 3 months and -4.62 mmHg after at least 6 months. Total cholesterol reduction following Tai Chi training in adult males and females with essential hypertension showed a mean difference of -8.46 mg/dL with a 95% CI of -11.7, -5.4.
The role of HIIT, resistance, Yoga, and Qigong training in cardiometabolic health is uncertain as these interventions did not show any convincing evidence for a benefit. A limitation noted is that subjects with CV risk factors but no history of CVD are lacking. Safety data, including adverse events and discontinuations, were not reported. Funding or conflicts of interest were not reported.
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View Original Abstract ↓
PURPOSE: Physical activity (PA) is important for the prevention and management of cardiovascular (CV) disease (CVD). We aim to investigate the effect of different types of exercise on cardiometabolic risk factors in these subjects with CV risk factors but no history of CVD is lacking.
METHODS: PubMed and Scopus databases were searched up to November 2025 for systematic reviews and meta-analyses of randomized controlled trials (RCTs). The population studied referred to adults with at least one CV risk factor.
RESULTS: 16 meta-analysis publications were included. Strong evidence for a benefit was found for i) aerobic exercise and waist circumference (WC) reduction compared to control group in males and females with metabolic syndrome [Mean Difference (MD) -3.44 (95% CI -4.81, -2.07) cm, ii) Tai Chi and SBP reduction after ≥6 months [MD -8.80 (95% CI -11.28, -6.32) mmHg], DBP reduction after 3 months [MD -7.58 (95% CI -8.56, -6.60) mmHg] and after ≥6 months of Tai Chi training [MD -4.62 (95% CI -6.09, -3.16) mmHg], and total cholesterol reduction following Tai Chi training in adult males and females with essential hypertension [MD -8.46 (-11.7, -5.4) mg/dL] compared to control group. HIIT, resistance, Yoga and Qigong training did not show any convincing evidence for a benefit in cardiometabolic parameters.
CONCLUSION: The most convincing evidence relates to a benefit from Aerobic or Tai Chi training mainly in SBP and DBP reduction and secondarily to WC and total cholesterol reduction. The role of HIIT, Resistance, Yoga and Qigong training in cardiometabolic health is uncertain.
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