Comparison of the therapeutic effects of traditional Chinese medicine exercise therapies on blood pressure, lipids, and sleep quality among older patients suffering from hypertension: a systematic review and network meta-analysis

Purpose: This study aimed to compare the therapeutic effects of traditional Chinese medicine exercise therapies on blood pressure, blood lipid, quality of life, Pittsburgh sleep quality index (PSQI), and heart rate (HR) among older patients suffering from hypertension through a network meta-analysis (NMA). Methods: A total of eight databases (in Chinese or English)-PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, CQVIP, and China Biology Medicine disc (CBM disc)-were systematically retrieved up to 7 August 2025, in order to determine eligible randomized controlled trials (RCTs) evaluating the therapeutic effects of different traditional Chinese medicine exercises on blood pressure in older populations. Literature screening was performed based on inclusion and exclusion criteria. Data extraction and quality evaluation were performed through Stata 17.0 and R (version 4.3.3) within this NMA framework. Results: This study included 44 RCTs, involving 3,478 older patients suffering from hypertension. Wuqinxi (WQX) and Qigong (QG) showed equivalent effects in reducing systolic blood pressure (SBP) and diastolic blood pressure (DBP). Baduanjin (BDJ) was most effective in improving total cholesterol, low-density lipoprotein cholesterol (LDL-C), and PSQI. Tai Chi demonstrated the most significant effects in improving triglyceride (TG). The surface under the cumulative ranking curve ranking indicated that WQX (85.7%) and QG (76.8%) had the highest potential to be the best exercise interventions for improving SBP and DBP. BDJ was the most beneficial intervention for improving TC (95.1%), LDL-C (95.1%), and PSQI (80.5%). Conclusion: Traditional Chinese medicine exercises exhibit different therapeutic effects in older patients with hypertension. Patients engage in targeted exercises based on their own conditions. WQX, QG, and BDJ may be the most effective therapies, while TC (Tai Chi) is the least effective intervention. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251049049, Registration No: CRD420251049049.