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CLC number: R743.3

On-line Access: 2012-08-01

Received: 2012-06-08

Revision Accepted: 2012-06-26

Crosschecked: 2012-06-27

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Citations:  Bibtex RefMan EndNOte GB/T7714

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Journal of Zhejiang University SCIENCE B 2012 Vol.13 No.8 P.652-662

doi: 10.1631/jzus.B1201001


Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies


Author(s):  Li Shen, Liu-guang Song, Hong Ma, Chun-na Jin, Jian-an Wang, Mei-xiang Xiang

Affiliation(s):  1.Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Cardiovascular Key Lab of Zhejiang Province, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):  xiangmx@yahoo.com

Key Words:  Tea, Stroke, Prospective studies, Dose-response meta-analysis


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Li Shen, Liu-guang Song, Hong Ma, Chun-na Jin, Jian-an Wang, Mei-xiang Xiang. Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies[J]. Journal of Zhejiang University Science B, 2012, 10(13): 652-662.

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title="Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies",
author="Li Shen, Liu-guang Song, Hong Ma, Chun-na Jin, Jian-an Wang, Mei-xiang Xiang",
journal="Journal of Zhejiang University Science B",
volume="13",
number="10",
pages="652-662",
year="2012",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1201001"
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%0 Journal Article
%T Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies
%A Li Shen
%A Liu-guang Song
%A Hong Ma
%A Chun-na Jin
%A Jian-an Wang
%A Mei-xiang Xiang
%J Journal of Zhejiang University SCIENCE B
%V 13
%N 10
%P 652-662
%@ 1673-565X
%D 2012
%I Zhejiang University Press & Springer

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T1 - Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies
A1 - Li Shen
A1 - Liu-guang Song
A1 - Hong Ma
A1 - Chun-na Jin
A1 - Jian-an Wang
A1 - Mei-xiang Xiang
J0 - Journal of Zhejiang University Science B
VL - 13
IS - 10
SP - 0
EP - 0
SN - 1673-565X
Y1 - 2012
PB - Zhejiang University Press & Springer
ER -


Abstract: 
Objective: To determine the association between tea consumption and the risk of stroke. Methods: We searched the PubMed database from January 1966 to March 2012 and reviewed reference lists of retrieved articles to identify relevant studies. Studies were included if they reported relative risks (RRs) and corresponding 95% confidence intervals (CIs) of stroke with respect to three or more categories of tea consumption. A random-effects model was used to combine the study-specific risk estimates. Results: Fourteen studies, consisting of 513804 participants with a median follow-up of 11.5 years, were included in this meta-analysis. We observed a modest but statistically significant inverse association between tea consumption and risk of stroke. An increase of three cups/d in tea consumption was associated with a 13% decreased risk of stroke (RR 0.87; 95% CI, 0.81–0.94). The decreased risk of stroke with tea consumption was consistent among most subgroups. Based on the three studies that provided results for stroke subtypes, tea consumption was also inversely associated with the risk of ischemic stroke (RR 0.76; 95% CI, 0.69–0.84), but not cerebral hemorrhage (RR 0.96; 95% CI, 0.82–1.11) or subarachnoid hemorrhage (RR 0.81; 95% CI, 0.57–1.16). Conclusions: tea consumption is associated with a decreased risk of stroke, particularly ischemic stroke. More well-designed, rigorously conducted studies are needed in order to make confident conclusions about the association between tea consumption and stroke subtypes.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Arab, L., Liu, W., Elashoff, D., 2009. Green and black tea consumption and risk of stroke: a meta-analysis. Stroke, 40(5):1786-1792.

[2]Babu, P.V., Liu, D., 2008. Green tea catechins and cardiovascular health: an update. Curr. Med. Chem., 15(18):1840-1850.

[3]Bahorun, T., Luximon-Ramma, A., Neergheen-Bhujun, V.S., Gunness, T.K., Googoolye, K., Auger, C., Crozier, A., Aruoma, O.I., 2012. The effect of black tea on risk factors of cardiovascular disease in a normal population. Prev. Med., 54(Suppl.):S98-S102.

[4]Basu, A., Sanchez, K., Leyva, M.J., Wu, M., Betts, N.M., Aston, C.E., Lyons, T.J., 2010. Green tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndrome. J. Am. Coll. Nutr., 29(1):31-40.

[5]Bidel, S., Hu, G., Qiao, Q., Jousilahti, P., Antikainen, R., Tuomilehto, J., 2006. Coffee consumption and risk of total and cardiovascular mortality among patients with type 2 diabetes. Diabetologia, 49(11):2618-2626.

[6]Cheng, T.O., 2006. All teas are not created equal: the Chinese green tea and cardiovascular health. Int. J. Cardiol., 108(3):301-308.

[7]de Koning Gans, J.M., Uiterwaal, C.S., van der Schouw, Y.T., Boer, J.M., Grobbee, D.E., Verschuren, W.M., Beulens, J.W., 2010. Tea and coffee consumption and cardiovascular morbidity and mortality. Arterioscler. Thromb. Vasc. Biol., 30(8):1665-1671.

[8]Debette, S., Courbon, D., Leone, N., Gariépy, J., Tzourio, C., Dartigues, J.F., Barberger-Gateau, P., Ritchie, K., Alpérovitch, A., Amouyel, P., et al., 2008. Tea consumption is inversely associated with carotid plaques in women. Arterioscler. Thromb. Vasc. Biol., 28(2):353-359.

[9]DerSimonian, R., Laird, N., 1986. Meta-analysis in clinical trials. Control. Clin. Trials, 7(3):177-188.

[10]Egger, M., Davey Smith, G., Schneider, M., Minder, C., 1997. Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-634.

[11]Fukino, Y., Ikeda, A., Maruyama, K., Aoki, N., Okubo, T., Iso, H., 2008. Randomized controlled trial for an effect of green tea-extract powder supplementation on glucose abnormalities. Eur. J. Clin. Nutr., 62(8):953-960.

[12]Gao, X., LaValley, M.P., Tucker, K.L., 2005. Prospective studies of dairy product and calcium intakes and prostate cancer risk: a meta-analysis. J. Natl. Cancer Inst., 97(23):1768-1777.

[13]Geleijnse, J.M., Launer, L.J., Hofman, A., Pols, H.A., Witteman, J.C., 1999. Tea flavonoids may protect against atherosclerosis: the Rotterdam Study. Arch. Intern. Med., 159(18):2170-2174.

[14]Goldstein, L.B., Bushnell, C.D., Adams, R.J., Appel, L.J., Braun, L.T., Chaturvedi, S., Creager, M.A., Culebras, A., Eckel, R.H., Hart, R.G., et al., 2011. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/ American Stroke Association. Stroke, 42(2):517-584.

[15]Graham, H.N., 1992. Green tea composition, consumption, and polyphenol chemistry. Prev. Med., 21(3):334-350.

[16]Greenland, S., Longnecker, M.P., 1992. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am. J. Epidemiol., 135(11):1301-1309.

[17]He, F.J., Nowson, C.A., MacGregor, G.A., 2006. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet, 367(9507):320-326.

[18]Higgins, J.P., Thompson, S.G., Deeks, J.J., Altman, D.G., 2003. Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-560.

[19]Hirvonen, T., Virtamo, J., Korhonen, P., Albanes, D., Pietinen, P., 2000. Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers. Stroke, 31(10):2301-2306.

[20]Hodgson, J.M., Puddey, I.B., Woodman, R.J., Mulder, T.P., Fuchs, D., Scott, K., Croft, K.D., 2012. Effects of black tea on blood pressure: a randomized controlled trial. Arch. Intern. Med., 172(2):186-188.

[21]Huxley, R., Lee, C.M., Barzi, F., Timmermeister, L., Czernichow, S., Perkovic, V., Grobbee, D.E., Batty, D., Woodward, M., 2009. Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch. Intern. Med., 169(22):2053-2063.

[22]Inami, S., Takano, M., Yamamoto, M., Murakami, D., Tajika, K., Yodogawa, K., Yokoyama, S., Ohno, N., Ohba, T., Sano, J., et al., 2007. Tea catechin consumption reduces circulating oxidized low-density lipoprotein. Int. Heart J., 48(6):725-732.

[23]Iwai, N., Ohshiro, H., Kurozawa, Y., Hosoda, T., Morita, H., Funakawa, K., Okamoto, M., Nose, T., 2002. Relationship between coffee and green tea consumption and all-cause mortality in a cohort of a rural Japanese population. J. Epidemiol., 12(3):191-198.

[24]Jing, Y., Han, G., Hu, Y., Bi, Y., Li, L., Zhu, D., 2009. Tea consumption and risk of type 2 diabetes: a meta-analysis of cohort studies. J. Gen. Intern. Med., 24(5):557-562.

[25]Keli, S.O., Hertog, M.G., Feskens, E.J., Kromhout, D., 1996. Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study. Arch. Intern. Med., 156(6):637-642.

[26]Klatsky, A.L., Armstrong, M.A., Friedman, G.D., 1993. Coffee, tea, and mortality. Ann. Epidemiol., 3(4):375-381.

[27]Kuriyama, S., Shimazu, T., Ohmori, K., Kikuchi, N., Nakaya, N., Nishino, Y., Tsubono, Y., Tsuji, I., 2006. Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: the Ohsaki study. JAMA, 296(10):1255-1265.

[28]Larsson, S.C., Mannisto, S., Virtanen, M.J., Kontto, J., Albanes, D., Virtamo, J., 2008. Coffee and tea consumption and risk of stroke subtypes in male smokers. Stroke, 39(6):1681-1687.

[29]Lee, C.D., Folsom, A.R., Blair, S.N., 2003. Physical activity and stroke risk: a meta-analysis. Stroke, 34(10):2475-2481.

[30]Leurs, L.J., Schouten, L.J., Goldbohm, R.A., van den Brandt, P.A., 2010. Total fluid and specific beverage intake and mortality due to IHD and stroke in the Netherlands Cohort Study. Br. J. Nutr., 104(8):1212-1221.

[31]Lopez-Garcia, E., Rodriguez-Artalejo, F., Rexrode, K.M., Logroscino, G., Hu, F.B., van Dam, R.M., 2009. Coffee consumption and risk of stroke in women. Circulation, 119(8):1116-1123.

[32]Mineharu, Y., Koizumi, A., Wada, Y., Iso, H., Watanabe, Y., Date, C., Yamamoto, A., Kikuchi, S., Inaba, Y., Toyoshima, H., et al., 2011. 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, 65(3):230-240.

[33]Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 339:b2535.

[34]Orsini, N., Bellocco, R., Greenland, S., 2006. Generalized least squares for trend estimation of summarized dose-response data. Stata J., 6(1):40-57.

[35]Pan, A., Sun, Q., Okereke, O.I., Rexrode, K.M., Hu, F.B., 2011. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA, 306(11):1241-1249.

[36]Peters, U., Poole, C., Arab, L., 2001. Does tea affect cardiovascular disease? A meta-analysis. Am. J. Epidemiol., 154(6):495-503.

[37]Ras, R.T., Zock, P.L., Draijer, R., 2011. Tea consumption enhances endothelial-dependent vasodilation; a meta-analysis. PLoS One, 6(3):e16974.

[38]Roger, V.L., Go, A.S., Lloyd-Jones, D.M., Benjamin, E.J., Berry, J.D., Borden, W.B., Bravata, D.M., Dai, S., Ford, E.S., Fox, C.S., et al., 2012. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation, 125(1):e2-e220.

[39]Sato, Y., Nakatsuka, H., Watanabe, T., Hisamichi, S., Shimizu, H., Fujisaku, S., Ichinowatari, Y., Ida, Y., Suda, S., Kato, K., et al., 1989. Possible contribution of green tea drinking habits to the prevention of stroke. Tohoku J. Exp. Med., 157(4):337-343.

[40]Sesso, H.D., Gaziano, J.M., Liu, S., Buring, J.E., 2003a. Flavonoid intake and the risk of cardiovascular disease in women. Am. J. Clin. Nutr., 77(6):1400-1408.

[41]Sesso, H.D., Paffenbarger, R.S.Jr., Oguma, Y., Lee, I.M., 2003b. Lack of association between tea and cardiovascular disease in college alumni. Int. J. Epidemiol., 32(4):527-533.

[42]Tanabe, N., Suzuki, H., Aizawa, Y., Seki, N., 2008. Consumption of green and roasted teas and the risk of stroke incidence: results from the Tokamachi-Nakasato cohort study in Japan. Int. J. Epidemiol., 37(5):1030-1040.

[43]WHO (World Health Organization), 2011. Ten leading causes of deaths in 2008. Available from http://gamapserver.who.int/gho/interactive_charts/mbd/cod_2008/graph.html [accessed on Apr. 8, 2012]

[44]Yang, Y.C., Lu, F.H., Wu, J.S., Wu, C.H., Chang, C.J., 2004. The protective effect of habitual tea consumption on hypertension. Arch. Intern. Med., 164(14):1534-1540.

[45]Yochum, L., Kushi, L.H., Meyer, K., Folsom, A.R., 1999. Dietary flavonoid intake and risk of cardiovascular disease in postmenopausal women. Am. J. Epidemiol., 149(10):943-949.

[46]Zheng, X.X., Xu, Y.L., Li, S.H., Liu, X.X., Hui, R., Huang, X.H., 2011. Green tea intake lowers fasting serum total and LDL cholesterol in adults: a meta-analysis of 14 randomized controlled trials. Am. J. Clin. Nutr., 94(2):601-610.

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