Hypertension, as a cardiovascular and cerebrovascular disease, is endangering human life and health. To address this issue, this article conducted a study on the impact of Tai Chi exercise on middle-aged and elderly hypertensive patients. The study selected a certain number of middle-aged and elderly hypertensive patients for comparative experiments to observe the changes in blood pressure, heart rate, body fat, and other indicators after Tai Chi exercise; evaluate the impact of Tai Chi on the quality of life of hypertensive patients; and reveal the mechanism of Tai Chi in preventing and treating hypertension. The research results indicate that through Tai Chi exercise, patients' systolic blood pressure, diastolic blood pressure, and pulse pressure difference all show a significant decrease. At the same time, Taijiquan can intensify fat burning and consumption in the body, reduce fat content, improve body mass index and body fat rate, and also improve the central neuromodulation function of the elderly.