Heart attacks are often the unfortunate culmination of years of unhealthy lifestyle choices, and it’s necessary to lead a healthier lifestyle to avoid having another one. Some of the dietary and exercise changes and rehabilitation programs that doctors recommend to heart patients can seem more than a little intimidating, especially for inactive people. But a small study suggests that Tai Chi can be a gentle way for people with heart problems to get moving at a less overwhelming pace. 
Heart disease kills 600,000 people in the U.S. every year and is responsible for 1 in 4 deaths. It’s the leading cause of death in both men and women. 
For many, a heart attack isn’t a once-and-done deal. Of the 735,000 people in the U.S. who suffer a heart attack every year, 2 out of 7 will have already experienced one.
The study was conducted by Dr. Elena Salmoriago-Blotcher, assistant professor of medicine and epidemiology at Brown University’s Warren Alpert School of Medicine & Public Health, and colleagues. Twenty-nine adults who had recently had a heart attack were randomly assigned to two groups. 
One group practiced Tai Chi twice a week for 12 weeks by attending sessions at the hospital. The participants in the other group attended Tai Chi sessions three times a week for 24 weeks. Both groups received DVDs so that they could practice at home.
Most of the 21 men and eight women in the study had also had a previous heart attack or had undergone bypass surgery to clear a blocked artery. All the volunteers were physically inactive and had rejected conventional cardiac rehabilitation, but expressed an interest in Tai Chi. Additionally, all continued to have high cardiovascular risk factors, such as high cholesterol, diabetes, obesity, overweight, and smoking. 
After 3 months, those in the group that practiced Tai Chi more frequently were more physically active, compared with those in the less-frequent group. This was even more true after six month – those who were asked to attend Tai Chi sessions three times a week were actually practicing it even more, and they were engaging in more physical activity outside of the sessions, such as riding their bikes and climbing up and down the stairs at home – activities they had previously found intimidating.
“People like it, and they came. We retained pretty much everybody for the length of the study. And there is a preliminary indication that the longer program may improve physical activity. We changed behavior.” 
The study was intended to determine whether Tai Chi could replace traditional exercise programs associated with cardiac rehabilitation. What researchers actually wanted to find out was whether people who find exercise off-putting would engage in Tai Chi as a way of becoming more physically active.
Due to the small size of the study, Salmoriago-Blotcher and her team couldn’t determine whether the activity changed the volunteers’ fitness levels and other measures of metabolic health.
After someone has a heart attack, it’s not uncommon for that person to worry that strenuous exercise could cause another cardiac event. More than 60% of patients turn down conventional cardiac rehabilitation. The findings suggest that Tai Chi could serve as a gentle, less nerve-wracking way for cardiac patients to start getting physical activity, while improving physical fitness and lowering the risk of another heart attack.  
“Tai chi is an interesting, promising exercise option. I think based on what we found, it’s a reasonable and safe step to offer tai chi within cardiac rehab. If someone says they are afraid of exercising, we could ask if they are interested in doing tai chi,” Salmoriago-Blotcher said. 
And once those patients become more physically active through Tai Chi, doctors can consider switching them to a more intensive traditional cardiac rehab program.
“If proven effective in larger studies, it might be possible to offer it as an exercise option within a rehab center as a bridge to more strenuous exercise, or in a community setting with the educational components of rehab delivered outside of a medical setting.” 
The study, which was by the National Center for Complementary and Integrative Health, is published in the Journal of the American Heart Association (JAMA).