Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA.
D&V Systematic Evidence Review Consulting, LLC, Bronx, NY, USA.
Adv Nutr. 2020 Jul 1;11(4):790-814. doi: 10.1093/advances/nmaa010.
Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I2 = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P < 0.0001; I2 = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.
茶黄素被认为对心血管健康有益。本综述综合了有关饮茶与一般健康成年人患心血管疾病（CVD）和全因死亡率风险之间关系的证据。通过检索 PubMed、EMBASE、Web of Science、Cochrane 对照试验中心注册库、食品科学技术文摘和 Ovid CAB 文摘数据库，检索截至 2019 年 11 月 1 日的英文文献，包括随机试验、前瞻性队列研究和巢式病例对照（或病例队列）研究，这些研究均提供了饮茶与心血管事件（心脏或外周血管事件）、卒中事件（包括死亡率）、CVD 特异性死亡率或全因死亡率的风险数据。综合了 39 项前瞻性队列研究出版物的数据。线性荟萃回归显示，每天增加一杯（236.6 毫升）茶（估计分别为黑茶和绿茶的 280 毫克和 338 毫克总类黄酮），CVD 死亡率风险平均降低 4%，CVD 事件风险降低 2%，卒中风险降低 4%，全因死亡率降低 1.5%。亚组荟萃分析结果表明，在老年人中，CVD 死亡率（n=4；汇总调整后的 RR：0.89；95%CI：0.83，0.96；P=0.001）和全因死亡率（n=3；汇总调整后的 RR：0.92；95%CI：0.90，0.94；P < 0.0001；I2=0.3%）的关联幅度更大，且存在较大的异质性（I2=72.4%）。一般来说，偏倚风险较高的研究比偏倚风险较低的研究显示出更大的关联幅度。CVD 特异性死亡率结局的证据强度被评为低等和中等（取决于研究人群的年龄组），CVD 事件、卒中和全因死亡率结局的证据强度被评为低等。作为健康习惯性饮食模式的一部分，每日饮茶可能与成年人较低的 CVD 和全因死亡率风险相关。
