Therapeutic effects of forest bathing on older adult patients with essential hypertension: evidence from a subtropical evergreen broad-leaved forest.

The short version

This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly. The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire. After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups. These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.

Key findings

• In a 3-day study, older adults with essential hypertension who stayed in a subtropical forest showed significantly lower blood pressure afterward (both systolic and diastolic) than a comparable group who stayed in the city.
• The forest group also had significantly lower levels of hs-CRP, a sensitive marker of inflammation linked to cardiovascular risk, than the city group.
• Mood improved more in the forest group, with significantly less tension-anxiety and significantly more vigor and energy compared with the city group.
• The forest program combined several gentle activities — forest walking, a traditional Qigong practice called eight trigrams boxing, meditation, and a tea ceremony — so the specific contribution of the forest setting itself, apart from these other practices, could not be isolated.
• The trial was small (36 participants, unevenly split 24 forest to 12 city) and lasted only three days, so longer and larger studies are needed before forest bathing can be recommended as a standard part of hypertension care.

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