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Moderate tea consumption may be cardioprotective
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Moderate tea consumption was associated with decreased progression of coronary artery calcium and lower incidence of major adverse CV events, according to new data from the Multi-Ethnic Study of Atherosclerosis.
P. Elliott Miller Jr., MD, and colleagues analyzed 6,212 participants from MESA to determine the relationship between tea intake and coronary artery calcium (CAC) progression and incident major adverse CV events. The findings were presented at the American Heart Association’s EPI/Lifestyle Scientific Sessions in Phoenix.
P. Elliott Miller Jr.
Miller and colleagues stratified participants into five groups by tea consumption: no consumption; less than one cup per day; one cup per day; two to three cups per day; and four or more cups per day.
The outcomes of interest were CAC progression, as measured by cardiac CT, CAC volume progression, and major adverse CV events, defined as CV death, MI, stroke, angina leading to revascularization or resuscitated cardiac arrest. Median follow-up was 11.1 years for major adverse CV event outcomes and 5.3 years for outcomes related to cardiac CT.
After adjustment for demographic, dietary and clinical characteristics, the researchers found that participants who consumed one cup of tea per day had decreased progression of CAC score (HR = 0.79; 95% CI, 0.63-0.99) and CAC volume (HR = 0.8; 95% CI, 0.64-1) compared with those who reported no tea consumption. The same was true for participants who drank two or three cups per day (HR for CAC score progression = 0.63; 95% CI, 0.48-0.82; HR for CAC volume progression = 0.64; 95% CI, 0.49-0.83), according to the findings.
In addition, compared with those who never drank tea, participants who consumed one cup per day had a lower risk for incident major adverse CV events (HR = 0.65; 95% CI, 0.45-0.96).
The researchers reported no difference in any outcome between participants who did not consume tea, those who consumed less than one cup per day and those who consumed four or more cups per day.
“We found that being a moderate tea drinker was associated with decreased progression of CAC and decreased incidence of [major adverse CV events],” Miller, instructor of medicine at Johns Hopkins Hospital, and colleagues wrote in the study abstract. “Future research is needed to understand the potentially protective nature of moderate tea intake.” – by Erik Swain
Reference:
Miller PE, et al. Abstract MP24. Presented at: American Heart Association’s EPI/Lifestyle Scientific Sessions; March 1-4, 2016; Phoenix.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Robert A. Vogel, MD
Tea is the second-most-common drink in the world and I am a very robust tea drinker. We have a lot of literature that suggests that tea is relatively good for you. It’s not all consistent and the mechanism is not absolutely clear, though antioxidant effects seem to play a role. Previous research has shown that tea has positive effects on endothelial function, green tea being a little better than black tea.
In food studies, it’s as much about what you are not eating as what you are eating. Tea is a whole lot better than drinking sweetened carbonated beverages, so that may explain part of the benefit. Also, there’s the matter of all the varieties of tea: green tea, black tea, white tea, Southern sweet tea. What if you add lemon to tea? What if you add milk to tea? The British do that and it’s thought to not be very good for you because it may undo the antioxidant effect. This is a very heterogeneous intervention.
I think this particular study is problematic on a number of grounds. Mainly, whereas coronary calcium is a reasonable index of atherosclerosis, progression of coronary calcium, which was studied here, is not a very good index. For example, statins, which we agree are good for those with CHD, actually lead to a progression of coronary calcium. So you can’t use progression of coronary calcium to determine whether something is good for you or not. However, the researchers also provide event data, which are suggestive of some benefit, as other studies have shown. The greatest benefit seems to be for one cup per day, with less benefit for more, which could be a concern.
So, I don’t think this study adds a lot. The data are a little heterogeneous and the mechanism of benefit is not evident. Having said that, from all available evidence, green tea or black tea served with a bit of lemon is probably a healthy drink, with the caveat that one should not add milk or a lot of sugar. Cardiologists should encourage their patients to drink tea only if they are drinking something worse. If they are drinking a lot of water, I would not tell them to switch to tea, but if they are drinking a lot of sweetened carbonated beverages, then I absolutely would.
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