Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project

First Published January 8, 2020 Research Article Find in PubMed

Authors

1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
,
1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
, 2
 
Department of Epidemiology and Biostatistics, Nanjing Medical University, China
by this author
, 3
 
Department of Prevention Medicine, Shenzhen University School of Medicine, China
by this author
, 4
 
Department of Cardiology, Fujian Provincial People's Hospital, China
by this author
, 5
 
Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, China
by this author
, 6
 
Sichuan Center for Disease Control and Prevention, China
by this author
, 7
 
Department of Cardiology, Kailuan Hospital, China
by this author
, 1
 
Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China
by this author
...
First Published Online: January 8, 2020

The role of tea consumption in the primary prevention of atherosclerotic cardiovascular disease remains unclear in cohort studies. This prospective cohort study aimed to investigate the associations of tea consumption with the risk of atherosclerotic cardiovascular disease and all-cause mortality.

We included 100,902 general Chinese adults from the project of Prediction for ASCVD Risk in China (China-PAR) in 15 provinces across China since 1998. Information on tea consumption was collected through standardized questionnaires. Outcomes were identified by interviewing study participants or their proxies, and checking hospital records and/or death certificates. Cox proportional hazard regression models were used to calculate hazard ratios and their corresponding 95% confidence intervals related to tea consumption.

During a median follow-up of 7.3 years, 3683 atherosclerotic cardiovascular disease events, 1477 atherosclerotic cardiovascular disease deaths, and 5479 all-cause deaths were recorded. Compared with never or non-habitual tea drinkers, the hazard ratio and 95% confidence interval among habitual tea drinkers was 0.80 (0.75–0.87), 0.78 (0.69–0.88), and 0.85 (0.79–0.90) for atherosclerotic cardiovascular disease incidence, atherosclerotic cardiovascular disease mortality, and all-cause mortality, respectively. Habitual tea drinkers had 1.41 years longer of atherosclerotic cardiovascular disease-free years and 1.26 years longer of life expectancy at the index age of 50 years. The observed inverse associations were strengthened among participants who kept the habit during the follow-up period.

Tea consumption was associated with reduced risks of atherosclerotic cardiovascular disease and all-cause mortality, especially among those consistent habitual tea drinkers.

1. GDB 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980--2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736--1788.
Google Scholar
2. Institute for Health Metrics and Evaluation. GBD compare data visualization, https://vizhub.healthdata.org/gbd-compare/ (2019, accessed 10 June 2019).
Google Scholar
3. Mineharu, Y, Koizumi, A, Wada, Y, et al. Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women. J Epidemiol Community Health 2011; 65: 230240.
Google Scholar | Crossref | Medline | ISI
4. de Koning Gans, JM, Uiterwaal, CS, van der Schouw, YT, et al. Tea and coffee consumption and cardiovascular morbidity and mortality. Arterioscler Thromb Vasc Biol 2010; 30: 16651671.
Google Scholar | Crossref | Medline | ISI
5. Hertog, MG, Feskens, EJ, Hollman, PC, et al. Dietary antioxidant flavonoids and risk of coronary heart disease: The Zutphen Elderly Study. Lancet 1993; 342: 10071011.
Google Scholar | Crossref | Medline | ISI
6. Hertog, MG, Sweetnam, PM, Fehily, AM, et al. Antioxidant flavonols and ischemic heart disease in a Welsh population of men: The Caerphilly Study. Am J Clin Nutr 1997; 65: 14891494.
Google Scholar | Crossref | Medline | ISI
7. Sesso, HD, Paffenbarger, RS, Oguma, Y, et al. Lack of association between tea and cardiovascular disease in college alumni. Int J Epidemiol 2003; 32: 527533.
Google Scholar | Crossref | Medline
8. Kuriyama, S, Shimazu, T, Ohmori, K, et al. Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: The Ohsaki study. JAMA 2006; 296: 12551265.
Google Scholar | Crossref | Medline | ISI
9. Iwai, N, Ohshiro, H, Kurozawa, Y, et al. Relationship between coffee and green tea consumption and all-cause mortality in a cohort of a rural Japanese population. J Epidemiol 2002; 12: 191198.
Google Scholar | Crossref | Medline
10. Kokubo, Y, Iso, H, Saito, I, et al. The impact of green tea and coffee consumption on the reduced risk of stroke incidence in Japanese population: The Japan public health center-based study cohort. Stroke 2013; 44: 13691374.
Google Scholar | Crossref | Medline
11. Odegaard, AO, Koh, WP, Yuan, JM, et al. Beverage habits and mortality in Chinese adults. J Nutr 2015; 145: 595604.
Google Scholar | Crossref | Medline
12. Li, X, Yu, C, Guo, Y, et al. Tea consumption and risk of ischaemic heart disease. Heart 2017; 103: 783789.
Google Scholar | Crossref | Medline
13. Tian, C, Huang, Q, Yang, L, et al. Green tea consumption is associated with reduced incident CHD and improved CHD-related biomarkers in the Dongfeng-Tongji cohort. Sci Rep 2016; 6: 24353.
Google Scholar | Crossref | Medline
14. Wen, W, Xiang, YB, Zheng, W, et al. The association of alcohol, tea, and other modifiable lifestyle factors with myocardial infarction and stroke in Chinese men. CVD Prev Control 2008; 3: 133140.
Google Scholar | Crossref | Medline
15. Liu, J, Liu, S, Zhou, H, et al. Association of green tea consumption with mortality from all-cause, cardiovascular disease and cancer in a Chinese cohort of 165,000 adult men. Eur J Epidemiol 2016; 31: 853865.
Google Scholar | Crossref | Medline
16. Meng, L, Chen, Sh, Zhu, Y, et al. A prospective cohort study of tea consumption and risk of cerebral hemorrhage in males. Chin J Hypertens 2014; 22: 836840.
Google Scholar
17. Zhao, LG, Li, HL, Sun, JW, et al. Green tea consumption and cause-specific mortality: Results from two prospective cohort studies in China. J Epidemiol 2017; 27: 3641.
Google Scholar | Crossref | Medline
18. Yang, X, Li, J, Hu, D, et al. Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population: The China-PAR Project (Prediction for ASCVD Risk in China). Circulation 2016; 134: 14301440.
Google Scholar | Crossref | Medline
19. Zhao D. Poisson regression adjustment of event rates and its macro procedure ADJ_POIS. In: SAS Conference Proceedings: SAS Users Group International 24, Miami Beach, Florida, 11--14 April 1999. SUGI24.
Google Scholar
20. WHO. Global recommendations on physical activity for health. World Health Organization, Geneva, Switzerland, 2010.
Google Scholar
21. Wang, SS, Lay, S, Yu, HN, et al. Dietary guidelines for Chinese residents (2016): Comments and comparisons. J Zhejiang Univ Sci B 2016; 17: 649656.
Google Scholar | Crossref | Medline
22. Wang, X, Yang, X, Li, J, et al. Impact of healthy lifestyles on cancer risk in the Chinese population. Cancer 2019; 125: 20992106.
Google Scholar | Crossref | Medline
23. Zhou, M, Wang, H, Zeng, X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019; 394: 11451158.
Google Scholar | Crossref | Medline
24. Yarmolinsky, J, Gon, G, Edwards, P. Effect of tea on blood pressure for secondary prevention of cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2015; 73: 236246.
Google Scholar | Crossref | Medline
25. Wang, Z, Chen, Z, Zhang, L, et al. Status of hypertension in China: Results from the China Hypertension Survey, 2012–2015. Circulation 2018; 137: 23442356.
Google Scholar | Crossref | Medline
26. Peluso, I, Serafini, M. Antioxidants from black and green tea: From dietary modulation of oxidative stress to pharmacological mechanisms. Br J Pharmacol 2017; 174: 11951208.
Google Scholar | Crossref | Medline
27. Grassi, D, Desideri, G, Di Giosia, P, et al. Tea, flavonoids, and cardiovascular health: Endothelial protection. Am J Clin Nutr 2013; 98: 1660s1666s.
Google Scholar | Crossref | Medline
28. Cao, SY, Zhao, CN, Gan, RY, et al. Effects and mechanisms of tea and its bioactive compounds for the prevention and treatment of cardiovascular diseases: An updated review. Antioxidants (Basel) 2019, pp. 8: 166–183.
Google Scholar | Crossref
29. Ihm, SH, Jang, SW, Kim, OR, et al. Decaffeinated green tea extract improves hypertension and insulin resistance in a rat model of metabolic syndrome. Atherosclerosis 2012; 224: 377383.
Google Scholar | Crossref | Medline
30. Vinson, JA, Dabbagh, YA. Effect of green and black tea supplementation on lipids, lipid oxidation and fibrinogen in the hamster: Mechanisms for the epidemiological benefits of tea drinking. FEBS Lett 1998; 433: 4446.
Google Scholar | Crossref | Medline
31. Zhao, Y, Asimi, S, Wu, K, et al. Black tea consumption and serum cholesterol concentration: Systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2015; 34: 612619.
Google Scholar | Crossref | Medline
32. Bianconi, V, Mannarino, MR, Sahebkar, A, et al. Cholesterol-lowering nutraceuticals affecting vascular function and cardiovascular disease risk. Curr Cardiol Rep 2018; 20: 53.
Google Scholar | Crossref | Medline

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