Long-Term Tai Chi Practice Linked to Better Vascular Health in Middle-Aged and Older Adults

A slow, flowing martial art practiced for centuries in China may leave a measurable fingerprint on the arteries of middle-aged and older adults, according to a new cross-sectional study published in BMC Complementary Medicine and Therapies. Researchers found that long-term Tai Chi practitioners showed better vascular function and structure than adults who exercised irregularly, and the team also uncovered hints that reduced inflammation and oxidative stress could be part of the story. The findings, while observational, add a technically detailed piece of evidence to the growing science of mind-body exercise and healthy aging.

The study enrolled 391 adults aged 45 and older in China and compared three groups: 172 long-term Tai Chi practitioners, 72 conventional exercisers who regularly performed square dancing, jogging, or brisk walking, and 147 irregular exercisers. Regular exercise was strictly defined as at least three sessions per week of at least 30 minutes each, sustained for more than one year. By measuring a panel of vascular outcomes and blood biomarkers, the researchers set out to test whether Tai Chi, a mind-body exercise combining slow movement, balance, and breath control, would be associated with healthier arteries than simply being physically inactive or only occasionally active.

To capture vascular health, the team relied on several well-established noninvasive measures. Flow-mediated dilation, or FMD, reflects how well an artery widens in response to increased blood flow, a hallmark of endothelial function. Brachial-ankle pulse wave velocity, or baPWV, gauges arterial stiffness by timing how fast pressure waves travel between the arm and the ankle. The ankle-brachial index, or ABI, screens for peripheral artery disease by comparing blood pressure at the ankle with that in the arm. Carotid intima-media thickness, or IMT, measures the thickness of the inner layers of the carotid artery wall, a structural marker of early atherosclerosis. The researchers also recorded peak systolic velocity, wall shear stress, and resistance index, adding hemodynamic detail to the picture.

After adjusting for covariates and applying a modern statistical approach known as targeted maximum likelihood estimation, along with a Benjamini-Hochberg correction across the seven vascular outcomes, the results showed that Tai Chi practitioners had significantly better vascular measures than irregular exercisers. Compared with the irregular group, Tai Chi practice was associated with higher FMD by 1.39 percentage points, a meaningful gain in endothelial function. It was also linked to lower baPWV by roughly 103 centimeters per second, indicating less arterial stiffness, along with lower ABI, thinner carotid IMT by about 0.09 millimeters, and a lower resistance index, suggesting less resistance to blood flow in the peripheral circulation.

Conventional exercise also outperformed irregular exercise on endothelial function, with a 0.79 percentage point higher FMD than the irregular group. However, when the researchers directly compared Tai Chi practitioners with conventional exercisers, no significant differences emerged after statistical correction. This suggests that the vascular benefits seen in Tai Chi practitioners may not be unique to the slow, meditative art itself, but could reflect the broader effects of sustained, regular physical activity on the cardiovascular system.

Beyond the vascular measures, the team explored whether inflammation and oxidative stress might indirectly link Tai Chi practice to vascular health. They measured blood levels of high-sensitivity C-reactive protein, or hs-CRP, a marker of systemic inflammation, along with tumor necrosis factor-alpha, interleukin-6, interleukin-10, and interleukin-33. On the oxidative stress side, they measured superoxide dismutase, or SOD, an antioxidant enzyme, malondialdehyde, or MDA, a marker of lipid damage from free radicals, and glutathione peroxidase, or GPx, another antioxidant defense molecule. Exploratory analyses pointed to nominal potential indirect associations involving hs-CRP, SOD, and combined inflammatory and oxidative-stress composites, hinting that Tai Chi might partly influence vascular health by dampening chronic inflammation and bolstering antioxidant capacity.

However, the researchers are careful to note that these biomarker findings are exploratory and were not adjusted for multiple comparisons, meaning they should be treated as hypothesis-generating rather than definitive. The cross-sectional design also means the study cannot establish causality; it is possible that people with healthier vasculature are simply more likely to sustain long-term Tai Chi practice, rather than the other way around. The authors emphasize that prospective cohort studies and randomized controlled trials are needed to determine whether Tai Chi truly causes these vascular improvements and whether the biomarker pathways hold up under more rigorous testing.

The study was registered with ClinicalTrials.gov under identifier NCT06307483 and received ethical approval from the Ethics Committee of Beijing Sport University. It was supported by funding from the Tai Chi Laboratory of the Chinese Intangible Cultural Heritage Association Tai Chi Committee, the Special Fund for Basic Scientific Research of Central Universities, the Science and Technology Commission of Shanghai Municipality, and Neil Shen’s SJTU Medical Research Fund. The work reflects a collaboration spanning Beijing Sport University, Shanghai Jiao Tong University, Henan Polytechnic University, and other institutions, with support from the Sports Bureau of Wenxian, Henan Province, and Wenxian People’s Hospital.

For the general public, the takeaway is nuanced. Tai Chi appears to be associated with better vascular function and structure than being irregularly active, and the magnitude of the differences, particularly in arterial stiffness and carotid wall thickness, is notable for a low-impact, accessible exercise. Yet the absence of significant differences from conventional exercise suggests that the key ingredient may be sustained, regular movement itself, whether slow and meditative or brisk and rhythmic. For older adults seeking a gentle, sustainable way to support cardiovascular health, Tai Chi remains a promising option, but the new study stops short of proving it superior to other forms of regular exercise. Larger, longer-term, and randomized studies will be needed to determine whether the ancient practice can truly reshape the arteries, and whether the quiet interplay of inflammation and oxidative stress holds the mechanistic key.

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Subject of Research: Tai Chi

Article Title: Associations of long-term Tai Chi practice with vascular health in middle-aged and older adults: potential indirect roles of inflammation and oxidative stress – a cross-sectional study

Article References: Associations of long-term Tai Chi practice with vascular health in middle-aged and older adults: potential indirect roles of inflammation and oxidative stress – a cross-sectional study. (n.d.). https://doi.org/10.1186/s12906-026-05645-3

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05645-3

Keywords: Tai Chi, vascular health, inflammation, oxidative stress, aging, cross-sectional study, flow-mediated dilation, arterial stiffness, Associations, long-term, practice, vascular