Effects and exercise-prescription moderators of Tai Chi on cardiometabolic risk factors in middle-aged and older women: a systematic review and meta-analysis

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• Picked for Pharmacology (medical) (top studies of the week, 27 September 2026): High-quality evidence in a top journal
• Picked for Epidemiology (top studies of the week, 27 September 2026): Systematic review/meta‑analysis of Tai Chi in women

Abstract

INTRODUCTION: Cardiometabolic risk increases substantially in middle-aged and older women, particularly during and after the menopausal transition. Tai Chi is a low-to-moderate intensity mind-body exercise that may offer an accessible non-pharmacological strategy for cardiometabolic risk management. However, women-specific evidence and the role of exercise-prescription characteristics remain unclear. This systematic review and meta-analysis evaluated the effects of Tai Chi on cardiometabolic risk factors in middle-aged and older women and examined whether effects varied by baseline health status, comparator type, and intervention dose. METHODS: PubMed, Web of Science, the Cochrane Library, Embase, and CNKI were searched from inception to September 2025 for randomized controlled trials of structured Tai Chi programmes in women aged 45 years or older. Cardiometabolic outcomes were pooled using random-effects models, with moderator, sensitivity, publication bias, and GRADE analyses conducted where appropriate. RESULTS: Eighteen randomized controlled trials were included. Tai Chi was associated with significant reductions in systolic blood pressure, diastolic blood pressure, LDL-C, triglycerides, and total cholesterol, whereas no clear effects were observed for HDL-C or fasting blood glucose. However, heterogeneity was substantial for most significant outcomes, and prediction intervals generally crossed the null, indicating that effect magnitude and consistency may vary considerably across future comparable settings. Pulse wave velocity was summarized narratively because only two studies reported this outcome and measurement sites differed. Subgroup analyses suggested that baseline health status, comparator type, and intervention duration might partly explain heterogeneity, although these analyses were exploratory. DISCUSSION: Tai Chi may improve selected cardiometabolic outcomes in middle-aged and older women, particularly blood pressure and atherogenic lipid markers. However, the certainty and generalizability of these findings remain limited. Larger trials using standardized Tai Chi prescriptions and consistent outcome measures are needed. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251146060, PROSPERO, CRD420251146060.

Abstract as published, via PubMed.