An Explanation of the Research Connecting Tai Chi and Heart Health

An Explanation of the Research Connecting Tai Chi and Heart Health

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A diagnosis of congestive heart failure, arrhythmia, or recovering from a heart attack is troubling because traditional activities that most of us are familiar with to get in shape, can stress the heart or are too exhausting. We simultaneously know we need to improve cardiac fitness but may not be able to do the activities we have always done. Thankfully, the connection between tai chi and heart health goes back hundreds of years and has been built into the movements of the form. Now, modern medicine is uncovering what eastern practitioners have known for centuries. 

The research behind tai chi and heart health has shown that the slow, gentle movements of tai chi helps to reduce blood pressure and improve cardiac fitness. It is effective and safe for both recovery patients and people who feel tired because their heart function has decreased. 

I need to be frank here, current medical studies have not found a significant difference between tai chi and other forms of exercise when measuring improvements in heart disease factors like oxygen update or volume of blood that is being moved (left ventricular ejection fraction). I am a 20+ practitioner of tai chi and would love to tell you that tai chi is a cure for heart disease. It is not.

However, tai chi has many additional benefits that regular exercise does not. Secondly, tai chi does not stress the heart and is a better, if not the only choice for many people who suffer from heart disease and fatigue but would still benefit from staying active. 

What I find difficult about accepting that there is a connection between tai chi and heart health is that everything that I have been told about what strengthens the heart is pretty cardiovascular in nature. Things like running, sports, or fast walking, were all good for the heart. It’s even right there in the name: “cardi-vascular.” This creates a huge problem if you want to improve the health of your heart but can’t stress the heart or have issues with fatigue. 

This is where tai chi comes in. I am going to use this space to come at this topic two ways: 

Let’s cover the western research on using tai chi for heart conditions so that we have confidence that tai chi is a good choice and feel safe about doing it. Yes, it’s true that studies of people with heart conditions who have done tai chi have improved health and fitness markers. This is true because of increased activity, increased community, reduced stress, and choosing an activity that can be undertaken continually.

Secondly, we’ll jump in and talk about how tai chi accomplishes improvements in cardiovascular fitness with slow gentle movements. 

Disclaimer: You need to talk to your doctor about doing any activity if you have a heart condition. But know that tai chi is completely modifiable in that you can do less movements, shorten the time, and even do tai chi in a chair. Make sure you find a class or style that is right for you because there is a lot of variability in what they focus on.

Current Research on Tai Chi and Heart Health

This may seem counterintuitive, but I want to start with two research studies showing that tai chi had no effect on specific measures of heart disease. I want to dispel any notion that tai chi is a substitute for modern interventions. Rather, by the end of this we will arrive at a place where we see that people who are using tai chi as part of their treatment are enjoying more active lives with greater outcomes such as increased stamina, reduced fatigue, and greater independence. 

It is wrong to say that tai chi cures heart disease. On the other hand, it is an understatement to say that tai chi improves heart health. 

Study #1 Tai Chi Exercise in Patients With Chronic Heart Failure A Randomized Clinical Trial

This was an extremely detailed study where they took 100 participants with heart disease and divided them into a tai chi and education-only group. The members were considered “stable” meaning there were no changes in their status, medication, or any incidences such as heart attacks in prior recent months. What I love about this research is how thorough they were for measuring a variety of outcomes at the end of the study. 

They had people rate their activity levels. They measured mood. They measured socioeconomic dimensions like climbing stairs and spending money on their heart failure treatment. They measured quality of life and mental outlook. They took blood samples. They used walking and bicycle riding tests to measure fitness and use of oxygen. 


Here’s what they found: Tai chi is safe. Tai chi has a good rate of adherence leading to long term improvements. Tai chi “may provide value in improving daily exercise, quality of life, self-efficacy, and mood in frail, deconditioned patients.”

Here’s what they did not find: There were no significant changes in the physiological factors such as changes in oxygen uptake or improvements in the distance they could walk in six minutes. 

Again, independently tai chi is not a cure for heart disease but has the potential for improving all measures related to quality of life for heart disease sufferers. Secondly, it is a 1) safe way to 2) consistently stay active and engage socially which does indeed influence health markers. Thirdly, physical activity and socialization improve mental and physical health thereby aiding in a healthy heart. 

Study #2: Health benefits of tai chi – What is the evidence?

This next study is a collective study meaning that they gathered all available research at the time of writing and analyzed the research outcomes to look for trends. In this case, they scoured the journals looking for studies that were focused on tai chi and heart health. As a researcher, I can tell you that this type of study takes a lot of time and dedication to get right but is really worthwhile to the scientific field because it helps everyone get on the same page and investigate in new directions rather than reinventing the wheel. Also, if results are true they should be repeatable. The only way to show this is to compare similar research. In some sense it is a bit easier though because you are not having to undertake clinical trials or find study subjects. Let’s take a look.

Researchers Patricia Huston and Bruce McFarlane looked across a 45 year time span which included over 500 research trials published in 120 reviews. What they did was qualify the results from each study by adding them to five groups.

  • Excellent
  • Good
  • Fair
  • Preliminary
  • Non-existent (no direct benefit)

Here’s what they found.

Excellent research outcomes in studies on tai chi for heart conditions were found for:

  • Preventing falls
  • Osteoarthritis
  • Parkinson disease
  • Rehabilitation for pulmonary disease
  • Improving cognitive capacity

Good outcomes of research on tai chi and heart health were reported for:

  • Depression
  • Cardiac and stroke rehabilitation
  • Dementia

Fair research evidence was found to improve the quality of life for:

  • Cancer patients
  • Fibromyalgia
  • Hypertension
  • Osteoporosis.

No direct benefit was found in to treat and cure of:

  • Diabetes
  • Rheumatoid arthritis
  • Chronic heart failure

Here it is important to note that tai chi alone is not curing these three disorders. However, there has been research showing how people with diabetes, arthritis, and heart failure are benefitting from using tai chi WITH other medical treatments. Click on those links to read how to use tai chi together.

First of all, I would thank these researchers if I could. I truly believe in the healing capacity of tai chi but believe it suffers from being painted as a panacea or cure-all. You can see from the list above that tai chi does so many good things that either directly or indirectly impacts our health in a positive way. 

Summing it all up, tai chi is great at improving our quality of life because it improves things like our thinking, independence, and balance. And this isn’t just for people who are suitably healthy. It is also great at improving quality of life with chronic disease or a degenerative diagnosis. If you are in any form of rehab, tai chi can enhance your results. But alas, you need medical treatment and dietary changes to treat diabetes, arthritis, or heart failure. These three conditions benefit from staying active, losing weight, and increasing mobility. These are all tenets of tai chi or any exercise program. However, tai chi is very special in how it can be undertaken by anyone and how it protects the heart. Let’s cover that next.

using tai chi for heart conditions

13 Research-Based Benefits of Tai Chi for Heart Conditions

I want to begin by describing the experience of practicing tai chi so that it’s both clear how tai chi differs from regular exercise and explains how the benefits of tai chi also encompass improving heart conditions.

  • You gather socially with individuals who come from all walks of life and all ages but who share in this idea that it would be enjoyable to calm down for an hour to focus on yourself or your health. Or, you dedicate a few minutes to unwind and be alone. You shut off the screens and straighten up the room you are in or head outside to feel the sun on your face and look at some trees.
  • You stand for a moment. Really stand there and concentrate on your breath. Usually you realize how long it’s been since you’ve done this. It’s simple and comforting.
  • You start moving so slowly that your only choice is to think about what you are doing. The series of movements are purposefully complex and it requires concentration.
  • Your only main job is to make sure each breath is deep and full. This shuts down your stress hormones and slows your heart rate. You breath primarily through the nose, oxygenating the blood.
  • There is a slight bend to all of your joints putting pressure on your leg muscles and back muscles which results in a nice workout depending on how long you want to practice and how deep you want to go.
  • When you punch, kick, or move quickly you exhale vigorously rather than holding your breath which releases all tension from the chest and heart.
  • All your movements wind, constricting and unconstricting the muscles around the bones, squishing toxins out of the tissues and into the blood to be cleansed and released by the kidneys.
  • You hang out outside and enjoy the new state you have put your body or mind in. Or, you laugh at the mistakes you made with your friends, hear about there lives, and promise to see them next week.

Tai chi is physical exercise with mental, emotional, and social benefits. With that in mind, let’s tackle the benefits of tai chi for heart conditions directly. Understand that I am totally biased! Rather than just listening to me, here is a quote from one more study of 100 individuals titled: The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure. I have added the numbering so we can use it to shape our discussion.

“We identified themes related to the patient’s experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: [1] social support and [2] self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more [3] global empowerment and [4] perceived control. Additional themes in TC included [5] mindfulness/self-awareness, [6] decreased stress reactivity, and [7] renewed social role. These themes mirrored improvements in previously reported quantitative measures ([8] quality-of-life…and [9] mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., [10] decreased pain, [11] improved energy, [12] endurance, [13] flexibility).”

1. Social Support

Support means that you have a body of people around you who know what you are going through. They are not necessarily giving advice, nor can they completely understand what you are going through, but they are there with empathy and understanding. A tai chi class levels the playing field making all of us beginners and open to learning. It is also a community where the one thing that everyone shares is a focus on improvement and health.

2. Self-Efficacy

Self-efficacy is a huge component to dealing with health issues. Recently, when dealing with a medical crisis with aging parents, I swear that half of our time was spent sorting through appointments and advocating for services, prescriptions, help, authorizations… It was exhausting! At the time when you have the least strength or are not feeling well you are also expected to sort through tons of new information and be your own-best representative. Tai chi is not only a mental and physical break from the mess but turns us into someone who is continually acting in their own best interest and tackling the changes in heart health conditions rather than being a victim of it.

3. Global Empowerment

I like the idea of global empowerment because it hints at the fact that we not only have the ability to make change but we can help others in our world to improve their life too. This defines the tai chi community in a nutshell. For hundreds of years, people have been going through the effort of learning the movements and philosophy of tai chi. Many who have benefitted have shared. Century after century this not only continues but continues to grow. We all age and we all face health issues, of which, heart conditions are very common. We can join the masses that are not taking diagnoses sitting down.

4. Perceived Control

Heart conditions can result in fatigue, shortness of breath, reduced balance, light-headedness, and even fears of over-exertion. All of these undermine our sense that we are able to exert any sense of control on our situation. Tai chi teaches adaptation and movements that conserve energy to extend any activity that we are doing.

5. Mindfulness / Self-Awareness

Self-awareness and tai chi share a direct connection. Concentrating on the immediate environment and our breath during the form is where we practice. Then we can take it out into life and practice in the grocery story, while driving, and even in the doctor’s office. We wrote a separate article Connecting Mindfulness and Tai Chi to diver deeper into this topic.

6. Decreased Stress Activity

Stress usually comes with repetitive negative thinking and tension in the body. Not only is this unenjoyable but can raise blood pressure. Tai chi gives us a break from the stressful patterns and actively works to release this tension improving heart health.

“Regular and more than six months Tai Chi exercises had a beneficial effect…reducing psychological distress, promoting resilience, and reducing the BMI and blood pressure level in heart-failure patients.”

Effects of community-based meditative Tai Chi programme on improving quality of life, physical and mental health in chronic heart-failure participants

7. Renewed Social Role

Fatigue and a reduced sense of safety when moving can drastically limit the time a person spends out in society and participating in community events. People with heart conditions have also shared being embarrassed by their limitations or not wanting to be a burden. A tai chi class is a safe, accepting environment with like-minded individuals who understand and are working to improve their health.

8. Quality of Life

The study quoted above directly focused on measures of quality of life. Quality of life in essence is the combination of all 13 of these benefits of tai chi for heart conditions. When we can move, when we feel empowered and confident, when we have social support, and even the belief that we can face what is thrown at us, we have a better quality of life.

9. Mood

I think mood is a 50/50 combo of what you are thinking and how you are feeling. It is a sliding scale that we move up and down each day and life events can drastically change your mood pretty quickly. Tai chi has been shown to improve mood by being able to pause the negative thinking, get us up and moving and interacting with others, and altering our posture and breath to improve our physiology so that we are feeling better.

“TC had produced significant positive chances in depression and some HRV parameters (mean heart rate, RMSSD, HF, LFnorm, and HFnorm) (p < 0.05), whereas these positive results were not observed in the control group.”

The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression

10. Decreased Pain

Pain is decreased by the release of tension, expansion of the joints, proper alignment so we can relearn movements and postures so we are not in pain, and breathing through the pain when you are hurt. All of these are easily accomplished by tai chi. My practice was instrumental in healing my own back pain a few years ago so I am a big believer here.

11. Improved Energy

Tai chi is an “internal energy art” meaning that its primary purpose is to improve and raise the energy of the body. This takes place in two ways. It simultaneously reduces things that tax the system like stress, poor posture, and tension while expanding the body and increasing oxygen uptake. All important aspects of heart health.

12. Endurance

Tai chi forms, albeit slow and simple, range from 13 to 108 movements. The long form takes months to learn and 15+ minutes to perform correctly. The learning is slow and methodical so it not only positively affects physical endurance but also extends cognition and our ability to bite into juicy political, social, or philosophical problems to debate with our friends.

13. Flexibility

This is a no-brainer. The long drawn-out stretches of tai chi with the raising and falling stances creates flexibility. When considering using tai chi for heart conditions, flexibility is a big component because it contributes to self-empowerment and your ability to be active or just get things done around the house. Expanding on the idea of flexibility, anyone with a debilitating condition knows they have had to learn to be more flexible in their thinking and how they want things to go. Tai chi is “easy to do, yet difficult to master” which gives us the humility we need to remain mentally flexible and to learn to accept.

Resources on Using Tai Chi for Heart Conditions

There are many ways you can learn more about tai chi and start practicing if you have a heart condition. It is important that you get the right resources though because tai chi often has to be modified to accommodate people who have not been active, experience fatigue, or who cannot get their heart rate above a certain level. Harvard published a whole book on the topic and a practitioner in Australia focuses his practice on modifying tai chi for specific conditions. 

Tai Chi for Heart Conditions on YouTube

This video on heart health is about an hour long so you get the full picture of the benefits and all of the movements. 

Tai Chi for Heart Conditions Video

Tai Chi for Heart Conditions Video

Dr. Lam also produced a video series that you can buy to walk you through specific exercises. 

The Harvard Medical School Guide to Tai Chi: 12 Weeks to a Healthy Body, Strong Heart, and Sharp Mind

The Harvard Medical School did an extremely extensive study on tai chi and then wrapped it up really nicely in a book! It contains much of the original research and how they developed protocols to test out on groups of participants. It includes the illustrations and plan you would need to get up and running. 

Scott Prath

Scott has been practicing and teaching tai chi and qigong since 2000. He is a lead instructor for the Austin Chen Tai Chi Association. His interest in the internal martial arts began after traveling in India and Nepal, and he has since traveled to China to train. Scott has published over 100 articles on tai chi with a focus on research showing the benefits of practicing.

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