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Review
. 2013 Jun 18;2013(6):CD009934.
doi: 10.1002/14651858.CD009934.pub2.

Green and black tea for the primary prevention of cardiovascular disease

Louise Hartley  1 , Nadine Flowers, Jennifer Holmes, Aileen Clarke, Saverio Stranges, Lee Hooper, Karen Rees
Affiliations
Review

Green and black tea for the primary prevention of cardiovascular disease

Louise Hartley et al. Cochrane Database Syst Rev. .

Abstract

Background: There is increasing evidence that both green and black tea are beneficial for cardiovascular disease (CVD) prevention.

Objectives: To determine the effects of green and black tea on the primary prevention of CVD.

Search methods: We searched the following databases on 12 October 2012 without language restrictions: CENTRAL in The Cochrane Library, MEDLINE (OVID), EMBASE (OVID) and Web of Science (Thomson Reuters). We also searched trial registers, screened reference lists and contacted authors for additional information where necessary.

Selection criteria: Randomised controlled trials (RCTs) lasting at least three months involving healthy adults or those at high risk of CVD. Trials investigated the intake of green tea, black tea or tea extracts. The comparison group was no intervention, placebo or minimal intervention. The outcomes of interest were CVD clinical events and major CVD risk factors. Any trials involving multifactorial lifestyle interventions or focusing on weight loss were excluded to avoid confounding.

Data collection and analysis: Two review authors independently selected trials for inclusion, abstracted data and assessed the risk of bias. Trials of green tea were analysed separately from trials of black tea.

Main results: We identified 11 RCTs with a total of 821 participants, two trials awaiting classification and one ongoing trial. Seven trials examined a green tea intervention and four examined a black tea intervention. Dosage and form of both green and black tea differed between trials. The ongoing trial is examining the effects of green tea powder capsules.No studies reported cardiovascular events.Black tea was found to produce statistically significant reductions in low-density lipoprotein (LDL) cholesterol (mean difference (MD) -0.43 mmol/L, 95% confidence interval (CI) -0.56 to -0.31) and blood pressure (systolic blood pressure (SBP): MD -1.85 mmHg, 95% CI -3.21 to -0.48. Diastolic blood pressure (DBP): MD -1.27 mmHg, 95% CI -3.06 to 0.53) over six months, stable to sensitivity analysis, but only a small number of trials contributed to each analysis and studies were at risk of bias.Green tea was also found to produce statistically significant reductions in total cholesterol (MD -0.62 mmol/L, 95% CI -0.77 to -0.46), LDL cholesterol (MD -0.64 mmol/L, 95% CI -0.77 to -0.52) and blood pressure (SBP: MD -3.18 mmHg, 95% CI -5.25 to -1.11; DBP: MD -3.42, 95% CI -4.54 to -2.30), but only a small number of studies contributed to each analysis, and results were not stable to sensitivity analysis. When both tea types were analysed together they showed favourable effects on LDL cholesterol (MD -0.48 mmol/L, 95% CI -0.61 to -0.35) and blood pressure (SBP: MD -2.25 mmHg, 95% CI -3.39 to -1.11; DBP: MD -2.81 mmHg, 95% CI -3.77 to -1.86). Adverse events were measured in five trials and included a diagnosis of prostate cancer, hospitalisation for influenza, appendicitis and retinal detachment but these are unlikely to be directly attributable to the intervention.

Authors' conclusions: There are very few long-term studies to date examining green or black tea for the primary prevention of CVD. The limited evidence suggests that tea has favourable effects on CVD risk factors, but due to the small number of trials contributing to each analysis the results should be treated with some caution and further high quality trials with longer-term follow-up are needed to confirm this.

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Conflict of interest statement

None known.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
See this image and copyright information in PMC

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  • doi: 10.1002/14651858.CD009934

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References

References to studies included in this review

Bahorun 2012 {published data only}
    1. Bahorun T, Luximon‐Ramma A, Neergheen‐Bhujun VS, Gunness TK, Googoolye K, Auger C, et al. The effect of black tea on risk factors of cardiovascular disease in a normal population. Preventive Medicine 2012;54:S98‐102. - PubMed
Bahorun females 2012 {published data only}
    1. Bahorun T, Luximon‐Ramma A, Neergheen‐Bhujun VS, Gunness TK, Googoolye K, Auger C, et al. The effect of black tea on risk factors of cardiovascular disease in a normal population. Preventive Medicine 2012;54:S98‐102. - PubMed
Bahorun males 2012 {published data only}
    1. Bahorun T, Luximon‐Ramma A, Neergheen‐Bhujun VS, Gunness TK, Googoolye K, Auger C, et al. The effect of black tea on risk factors of cardiovascular disease in a normal population. Preventive Medicine 2012;54:S98‐102. - PubMed
Bogdanski 2012 {published data only}
    1. Bogdanski P, Suliburska J, Szulinska M, Stepien M, Pupek‐Musialik D, Jablecka A. Green tea extract reduces blood pressure, inflammatory bio markers, and oxidative stress and improves parameters associated with insulin resistance in obese, hypertensive patients. Nutrition Research 2012;32:421‐7. - PubMed
    1. Szulinska M, Bogdanski P, Musialik K, Suliburska J. Beneficial influence of green tea extract supplementation on blood pressure, insulin resistance, selected inflammatory markers and total antioxidant status in patients with obesity related hypertension. Obesity Facts 2012;5:197.
Fujita 2008 {published data only}
    1. Fujita H, Yamagami T. Antihypercholesterolemic effect of Chinese black tea extract in human subjects with borderline hypercholesterolemia. Nutrition Research 2008;28(7):450‐6. - PubMed
Hodgson 2012 {published data only}
    1. Hodgson JM, Puddey IB, Woodman RJ, Mulder TP, Fuchs D, Scott K, et al. Effects of black tea on blood pressure: A randomized controlled trial. Archives of Internal Medicine 2012;172(2):186‐8. - PubMed
Janjua 2009 {published data only}
    1. Janjua R, Munoz C, Gorell E, Rehmus W, Egbert B, Kern D, et al. A two‐year, double‐blind, randomized placebo‐controlled trial of oral Green tea polyphenols on the long‐term clinical and histologic appearance of photoaging skin. Dermatological Surgery 2009;35:1057‐65. - PubMed
Maron 2003 {published data only}
    1. Maron DJ, Lu GP, Cai NS, Wu ZG, Li YH, Chen H, et al. Cholesterol‐lowering effect of a theaflavin‐enriched green tea extract: a randomized controlled trial. Archives of Internal Medicine 2003;163(12):1448‐53. - PubMed
Mukamal 2007 {published data only}
    1. Mukamal KJ, MacDermott K, Vinson JA, Oyama N, Manning WJ, Mittleman MA. A 6‐month randomized pilot study of black tea and cardiovascular risk factors. American Heart Journal 2007;154(4):724.e1‐6. - PMC - PubMed
Nantz 2009 {published data only}
    1. Nantz MP, Rowe CA, Bukowski JF, Percival SS. Standardized capsule of Camellia sinensis lowers cardiovascular risk factors in a randomized, double‐blind, placebo‐controlled study. Nutrition 2009;25(2):147‐54. - PubMed
Shen 2010 {published data only}
    1. Shen CL, Chyu MC, Pence BC, Yeh JK, Zhang Y, Felton CK, et al. Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: Safety and quality of life report. BMC Complementary and Alternative Medicine 2010;10(76):1‐10. - PMC - PubMed
Smith 2010 {published data only}
    1. Smith AE, Lockwood CM, Moon JR, Kendall KL, Fukuda DH, Tobkin SE, et al. Physiological effects of caffeine, epigallocatechin‐3‐gallate, and exercise in overweight and obese women. Applied Physiology, Nutrition and Metabolism 2010;35(5):607‐16. - PubMed
Stendell‐Hollis 2010 {published data only}
    1. Stendell‐Hollis NR, Thomson CA, Thompson PA, Bea JW, Cussler EC, Hakim IA. Green tea improves metabolic biomarkers, not weight or body composition: a pilot study in overweight breast cancer survivors. Journal of Human Nutrition and Dietetics 2010;23:590‐600. - PMC - PubMed

References to studies excluded from this review

Alexopoulos 2008 {published data only}
    1. Alexopoulos N, Vlachopoulos C, Aznaouridis K, Baou K, Vasiliadou C, Pietri P, et al. The acute effect of green tea consumption on endothelial function in healthy individuals. European Journal of Cardiovascular Prevention and Rehabilitation 2008;15(3):300‐5. - PubMed
Alexopoulos 2009 {published data only}
    1. Alexopoulos N, Vlachopoulos C, Baou K, Terentes‐Printzios D, Aznaouridis K, Ioakeimidis N, et al. The short‐term effect of tea consumption on aortic stiffness and wave reflections. Journal of the American College of Cardiology 2009;53(10):A442.
Arima 2009 {published data only}
    1. Arima M, Yotsumoto Y, Nakamura T, Deuchi K, Hitomi Y, Shioya N, et al. Suppressant effect of black tea polyphenols‐enriched black tea beverage on postprandial elevation of blood triglyceride level ‐ A randomized double‐blind crossover study. Japanese Pharmacology and Therapeutics 2009;37(6):529‐836.
Auvichayapat 2008 {published data only}
    1. Auvichayapat P, Prapochanung M, Tunkamnerdthai O, Sripanidkulchai BO, Auvichayapat N, Thinkhamrop B, et al. Effectiveness of green tea on weight reduction in obese Thais: A randomized, controlled trial. Physiology and Behavior 2008;93(3):486‐91. - PubMed
Basu 2010 {published data only}
    1. Basu A, Sanchez K, Leyva MJ, Wu M, Betts NM, Aston CE, et al. Green tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndrome. Journal of the American College of Nutrition 2010;29(1):31‐40. - PubMed
Basu 2011 {published data only}
    1. Basu A, Du M, Sanchez K, Leyva MJ, Betts NM, Blevins S, et al. Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome. Nutrition 2011;27(2):206‐13. - PMC - PubMed
Batista 2009 {published data only}
    1. Batista Gde A, Cunha CL, Scartezini M, von der Heyde R, Bitencourt MG, Melo SF. Prospective double‐blind crossover study of Camellia sinensis (green tea) in dyslipidemias. Arquivos Brasileiros de Cardiologia 2009;93(2):128‐34. - PubMed
Belza 2009 {published data only}
    1. Belza A, Toubro S, Astrup A. The effect of caffeine, green tea and tyrosine on thermogenesis and energy intake. European Journal of Clinical Nutrition 2009;63(1):57‐64. - PubMed
Bingham 1997 {published data only}
    1. Bingham SS, Vorster H, Jerling JC, Magee E, Mulligan A, Runswick SA, et al. Effect of black tea drinking on blood lipids, blood pressure and aspects of bowel habit. British Journal of Nutrition 1997;78(1):41‐55. - PubMed
Brown 2011 {published data only}
    1. Brown AL, Lane J, Holyoak C, Nicol B, Mayes AE, Dadd T. Health effects of green tea catechins in overweight and obese men: a randomised controlled cross‐over trial. British Journal of Nutrition 2011;106(12):1880‐9. - PubMed
Davies 2003 {published data only}
    1. Davies MJ, Judd JT, Baer DJ, Clevidence BA, Paul DR, Edwards AJ, et al. Black tea consumption reduces total and LDL cholesterol in mildly hypercholesterolemic adults. Journal of Nutrition 2003;133:3298S‐302S. - PubMed
de Maat 2000 {published data only}
    1. Maat MP, Pijl H, Kluft C, Princen HM. Consumption of black and green tea had no effect on inflammation, haemostasis and endothelial markers in smoking healthy individuals. European Journal of Clinical Nutrition 2000;54:757‐63. - PubMed
Di Pierro 2009 {published data only}
    1. Pierro F, Menghi AB, Barreca A, Lucarelli M, Calandrelli A. Greenselect Phytosome as an adjunct to a low‐calorie diet for treatment of obesity: a clinical trial. Alternative Medicine Review 2009;14(2):154‐60. - PubMed
Eichenberger 2010 {published data only}
    1. Eichenberger P, Mettler S, Arnold M, Colombani PC. No effects of three‐week consumption of a green tea extract on time trial performance in endurance‐trained men. International Journal for Vitamin and Nutrition Research 2010;80(1):54‐64. - PubMed
Erba 2005 {published data only}
    1. Erba D, Riso P, Bordoni A, Foti P, Biagi PL, Testolin G. Effectiveness of moderate green tea consumption on antioxidative status and plasma lipid profile in humans. The Journal of Nutritional Biochemistry 2005;16:144‐9. - PubMed
Fisunoglu 2010 {published data only}
    1. Fisunoglu M, Besler HT. Effects of regular black tea consumption on the antioxidant activity. FASEB 2010;24:921.1.
Frank 2009 {published data only}
    1. Frank J, George TW, Lodge JK, Rodriguez‐Mateos AM, Spencer JPE, Minihane AM, et al. Daily consumption of an aqueous green tea extract supplement does not impair liver function or alter cardiovascular disease risk biomarkers in healthy men. Journal of Nutrition 2009;139(1):58‐62. - PubMed
Freese 1999 {published data only}
    1. Freese R, Basu S, Hietanen E, Nair J, Nakachi K, Bartsch H, et al. Green tea extract decreases plasma malondialdehyde concentration but does not affect other indicators of oxidative stress, nitric oxide production, or hemostatic factors during a high‐linoleic acid diet in healthy females. European Journal of Nutrition 1999;38:149‐57. - PubMed
Gordillo‐Bastidas 2011 {published data only}
    1. Gordillo‐Bastidas E, Yanez‐Sanchez I, Panduro A, Martinez‐Lopez E. Effect of moderate‐fat diet complemented with green tea on anthropometric and biochemical markers, and cardiovascular risk in obese patients. Diabetes and Vascular Disease Research 2011;8(1):83‐4.
Grassi 2009 {published data only}
    1. Grassi D, Mulder TP, Draijer R, Desideri G, Molhuizen HO, Ferri C. Black tea consumption dose‐dependently improves flow‐mediated dilation in healthy males. Journal of Hypertension 2009;27(4):774‐81. - PubMed
Hakim 2003 {published data only}
    1. Hakim IA, Harris RB, Brown S, Chow HH, Wiseman S, Agarwal S, et al. Effect of increased tea consumption on oxidative DNA damage among smokers: a randomized controlled study. Journal of Nutrition 2003;133(10):3303S‐9S. - PubMed
Hirata 2004 {published data only}
    1. Hirata K, Shimada K, Watanabe H, Otsuka R, Tokai K, Yoshiyama M. Black tea increases coronary flow velocity reserve in healthy male subjects. American Journal of Cardiology 2004;93(11):1384‐8. - PubMed
Hodgson 1999 {published data only}
    1. Hodgson JM, Puddey IB, Burke V, Beilin LJ, Jordan N. Effects on blood pressure of drinking green and black tea. Journal of Hypertension 1999;17(4):457‐63. - PubMed
Hodgson 2000 {published data only}
    1. Hodgson JM, Puddey IB, Croft KD, Burke V, Mori TA, Caccetta RA, et al. Acute effects of ingestion of black and green tea on lipoprotein oxidation. The American Journal of Clinical Nutrition 2000;71:1103‐7. - PubMed
Hodgson 2001 {published data only}
    1. Hodgson JM, Puddey IB, Mori TA, Burke V, Baker RI, Beilin LJ. Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans. European Journal of Clinical Nutrition 2001;55:881‐6. - PubMed
Hodgson 2002a {published data only}
    1. Hodgson JM, Puddey IB, Burke V, Watts GF, Beilin LJ. Regular ingestion of black tea improves brachial artery vasodilator function. Clinical Science 2002;102(2):195‐201. - PubMed
Hodgson 2002b {published data only}
    1. Hodgson JM, Croft KD, Mori TA, Burke V, Beilin LJ, Puddey IB. Regular ingestion of tea does not inhibit in vivo lipid peroxidation in humans. Journal of Nutrition 2002;132(1):55‐8. - PubMed
Hodgson 2002c {published data only}
    1. Hodgson JM, Puddey IB, Burke V, Beilin LJ, Mori TA, Chan SY. Acute effects of ingestion of black tea on postprandial platelet aggregation in human subjects. British Journal of Nutrition 2002;87:141‐5. - PubMed
Hodgson 2003 {published data only}
    1. Hodgson JM, Burke V, Beilin LJ, Croft KD, Puddey IB. Can black tea influence plasma total homocysteine concentrations?. American Journal of Clinical Nutrition 2003;77(4):907‐11. - PubMed
Inami 2007 {published data only}
    1. Inami S, Takano M, Yamamoto M, Murakami D, Tajika K, Yodogawa K, et al. Tea catechin consumption reduces circulating oxidized low‐density lipoprotein. International Heart Journal 2007;48(6):725‐32. - PubMed
Ishikawa 1997 {published data only}
    1. Ishikawa T, Suzukawa M, Ito T, Yoshida H, Ayaori M, Nishiwaki M, et al. Effect of tea flavonoid supplementation on the susceptibility of low‐density lipoprotein to oxidative modification. American Journal of Clinical Nutrition 1997;66(2):261‐6. - PubMed
Kurita 2010 {published data only}
    1. Kurita I, Maeda‐Yamamoto M, Tachibana H, Kamei M. Antihypertensive effect of Benifuuki tea containing O‐methylated EGCG. Journal of Agricultural & Food Chemistry 2010;58(3):1903‐8. - PubMed
Miller 2012 {published data only}
    1. Miller RJ, Jackson KG, Dadd T, Mayes AE, Brown AL, Lovegrove JA, et al. The impact of the catechol‐O‐methyltransferase genotype on vascular function and blood pressure after acute green tea ingestion. Molecular Nutrition & Food Research 2012;56(6):966‐75. - PubMed
Muroyama 2006 {published data only}
    1. Muroyama K, Yamamoto N. Evaluations of the effectiveness of tea containing thiamin, arginine, caffeine and citric acid on moderately obese subjects with visceral obesity and its safety. Japanese Pharmacology and Therapeutics 2006;34(10):1097‐105.
Nagaya 2004 {published data only}
    1. Nagaya N, Yamamoto H, Uematsu M, Itoh T, Nakagawa K, Miyazawa T. Green tea reverses endothelial dysfunction in healthy smokers. Heart 2004;90(12):1485‐6. - PMC - PubMed
Penugonda 2009 {published data only}
    1. Penugonda K, Sanchez K, Leyva M, Aston C, Lyons T, Basu A. Effect of green tea flavonoid supplementation on features of metabolic syndrome (MeS). FASEB 2009;23:S1.
Princen 1998 {published data only}
    1. Pricen HM, Duyvenvoorde W, Buytenhek R, Blonk C, Tijburg LBM, Langius JAE, et al. No effect of consumption of green and black tea on plasma lipid and antioxidant levels and on LDL oxidation in smokers. Arteriosclerosis, Thrombosis, and Vascular Biology 1998;18:833‐41. - PubMed
Quinlan 1997 {published data only}
    1. Quinlan P, Lane J, Aspinall L. Effects of hot tea, coffee and water ingestion on physiological responses and mood: The role of caffeine, water and beverage type. Psychopharmacology 1997;134(2):164‐73. - PubMed
Quinlan 2000 {published data only}
    1. Quinlan PT, Lane J, Moore KL, Aspen J, Rycroft JA, O'Brien DC. The acute physiological and mood effects of tea and coffee: the role of caffeine level. Pharmacology, Biochemistry & Behavior 2000;66(1):19‐28. - PubMed
Rakic 1996 {published data only}
    1. Rakic V, Beilin LJ, Burke V. Effect of coffee and tea drinking on postprandial hypotension in older men and women. Clinical and Experimental Pharmacology and Physiology 1996;23(6‐7):559‐63. - PubMed
Ryu 2006 {published data only}
    1. Ryu OH, Lee J, Lee KW, Kim HY, Seo JA, Kim SG, et al. Effects of green tea consumption on inflammation, insulin resistance and pulse wave velocity in type 2 diabetes patients. Diabetes Research and Clinical Practice 2006;71:833‐41. - PubMed
Schmidschonbein 1991 {published data only}
    1. Schmidschonbein H, Zollenkopf G, Michaelis P. Hemorheological effects of common drinks ‐ Comparison between mineral waters containing NaCl and drinks which are low on mineral content (Black tea, Apple tea). Nieren‐Und Hochdruckkrankheiten 1991;20(10):601‐5.
Schultz 2009 {published data only}
    1. Schultz V. Green tea extract for weight reduction? Randomized double blind study cannot confirm positive preliminary results. Zeitschrift fur Phytotherapie 2009;30(2):74‐5.
Steptoe 2007 {published data only}
    1. Steptoe A, Gibson EL, Vuononvirta R, Williams ED, Hamer M, Rycroft JA, et al. The effects of tea on psychophysiological stress responsivity and post‐stress recovery: a randomised double‐blind trial. Psychopharmacology 2007;190(1):81‐9. - PubMed
Takase 2008 {published data only}
    1. Takase H, Nagao T, Otsuka K, Meguro S, Komikado M, Tokimitsu T. Effects of long‐term ingestion of tea catechins on visceral fat accumulation and metabolic syndrome risk in women with abdominal obesity. Japanese Pharmacology and Therapeutics 2008;36(3):237‐45.
Takeshita 2008 {published data only}
    1. Takeshita M, Takashima S, Harada U, Shibata E, Hosoya N, Takase, H, et al. Effects of long‐term consumption of tea catechins‐enriched beverage with no caffeine on body composition in humans. Japanese Pharmacology and Therapeutics 2008;36(8):767‐76.
Trautwein 2010 {published data only}
    1. Trautwein EA, Du Y, Meynen E, Yan X, Wen Y, Wang H, et al. Purified black tea theaflavins and theaflavins/catechin supplements did not affect serum lipids in healthy individuals with mildly to moderately elevated cholesterol concentrations. European Journal of Nutrition 2010;49(1):27‐35. - PubMed
Unno 2005 {published data only}
    1. Unno T, Tago M, Suzuki Y, Nozawa A, Sagesaka YM, Kakuda T, et al. Effect of tea catechins on postprandial plasma lipid responses in human subjects. British Journal of Nutrition 2005;93:543‐7. - PubMed
Vlachopoulos 2006 {published data only}
    1. Vlachopoulos C, Alexopoulos N, Dima I, Aznaouridis K, Andreadou I, Stefanadis C. Acute effect of black and green tea on aortic stiffness and wave reflections. Journal of the American College of Nutrition 2006;25:216‐23. - PubMed
Wang 2010 {published data only}
    1. Wang H, Wen Y, Du Y, Yan X, Guo H, Rycroft JA, et al. Effects of catechin enriched green tea on body composition. Obesity 2010;18(4):773‐9. - PubMed
Wu 2012 {published data only}
    1. Wu AH, Spicer D, Stanczyk FZ, Tseng CC, Yang CS, Pike MC. Effect of 2‐month controlled green tea intervention on lipoprotein cholesterol, glucose, and hormone levels in healthy postmenopausal women. Cancer Prevention Research 2012;5(3):393‐402. - PMC - PubMed
Yen 2010 {published data only}
    1. Yen YH. Supplement containing Camellia sinensis (green tea) may help treat obesity. Focus on Alternative and Complementary Therapies 2010;15(1):15‐6.
Yoshikawa 2012 {published data only}
    1. Yoshikawa T, Yamada H, Matsuda K. Effects of short‐term consumption of a large amount of tea catechins on chromosomal damage, oxidative stress markers, serum lipid, folic acid, and total homocysteine levels: A randomized, double‐blind, controlled study. Japanese Journal of Clinical Pharmacology and Therapeutics 2012;43(1):9‐16.

References to studies awaiting assessment

Chen 1991 {published data only}
    1. Chen WF, Lin QC. Combined hypertensive tea in the treatment of hypertension. Chung Hsi i Chieh Ho Tsa Chih Chinese Journal of Modern Developments in Traditional Medicine 1991;11(2):100‐1. - PubMed
Lu 1997 {published data only}
    1. Lu Q, Zhang WX. Clinical observation of tea pigment on degrading hyperlipoidemia and hyperfibrinogen. Forum on Traditional Chinese Medicine 1997;12(4):36.

References to ongoing studies

Mitsuhiro Yamada 2009 {unpublished data only}
    1. Mitsuhiro Yamada . A randomized, double‐blind, placebo‐controlled study of effect of green tea on lifestyle‐related disease prevention. JPRN‐UMIN000001722: http://apps.who.int/trialsearch/trial.aspx?trialid=JPRN‐UMIN000001722 28/5/12.

Additional references

Arab 2009
    1. Arab L, Liu W, Elashoff D. Green and black tea consumption and risk of stroke: a meta‐analysis. Stroke 2009;40:1786–92. - PubMed
Begg 2007
    1. Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez A. The burden of disease and injury in Australia 2003. Cat. no. PHE 82. Canberra: AIHW 2007.
British Heart Foundation 2012
    1. British Heart Foundation 2012. Cardiovascular Disease. http://www.bhf.org.uk/heart‐health/conditions/cardiovascular‐disease.aspx (Accessed April 2012).
Brown 1993
    1. Brown CA, Bolton‐Smith C, Woodward M, Tunstall‐Pedoe H. Coffee and tea consumption and the prevalence of coronary heart disease in men and women: results from the Scottish Heart Health Study. Journal of Epidemiology and Community Health 1993;47:171‐5. - PMC - PubMed
Brown 2009
    1. Brown AL, Lane J, Coverly J, Stocks J, Jackson S, Stephen A, et al. Effects of dietary supplementation with the green tea polyphenol epigallocatechin‐3‐gallate on insulin resistance and associated metabolic risk factors: randomized controlled trial. British Journal of Nutrition 2009;101(6):886‐94. - PMC - PubMed
Corradini 2011
    1. Corradini E, Foglia P, Giansanti P, Gubbiotti R, Samperi R, Lagana A. Flavonoids: chemical properties and analytical methodologies of identification and quantitation in foods and plants. Natural Product Research 2011;25:469‐95. - PubMed
de Koning Gans 2010
    1. Koning Gans JM, Uiterwaal CS, Schouw YT, Boer JM, Grobbee DE, Verschuren WM, et al. Tea and coffee consumption and cardiovascular morbidity and mortality. Arteriosclerosis, Thrombosis, and Vascular Biology 2010;30(8):1665‐71. - PubMed
Deka 2011
    1. Deka A, Vita J. Tea and cardiovascular disease. Pharmacological Research 2011;64:136‐45. - PMC - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Ellinger 2011
    1. Ellinger S, Muller N, Stehle P, Ulrich‐Merzenich G. Consumption of green tea or green tea products: is there an evidence for antioxidant effects from controlled interventional studies?. Phytomedicine 2011;18(11):903‐15. - PubMed
Emberson 2004
    1. Emberson J, Whincup P, Morris R, Walker M, Ebrahim S. Evaluating the impact of population and high‐risk strategies for the primary prevention of cardiovascular disease. European Heart Journal 2004;25(6):484‐91. - PubMed
Gardner 2007
    1. Gardner EJ, Ruxton CHS, Leeds AR. Black tea ‐ helpful or harmful? A review of the evidence. European Journal of Clinical Nutrition 2007;61:3‐8. - PubMed
He 2011
    1. He F, Burnier M, MacGregor G. Nutrition in cardiovascular disease: salt in hypertension and heart failure. European Heart Journal 2011;32:3073‐80. - PubMed
Hertog 1997
    1. Hertog MG, Sweetnam PM, Fehily AM, Elwood PC, Kromhout D. Antioxidantflavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study. American Journal of Clinical Nutrition 1997;65:1489–94. - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of interventions Version 5.1 [updated March 2011]. The Cochrane Library, The Cochrane Collaboration (2011). Available from www.cochrane‐handbook.org.
Hooper 2008
    1. Hooper L, Kroon PA, Rimm EB, Cohn JS, Harvey I, Cornu KA, et al. Flavonoids, flavonoid‐rich foods and cardiovascular risk: a meta‐analysis of randomized controlled trials. American Journal of Clinical Nutrition 2008;88:38‐50. - PubMed
Kris‐Etherton 2002
    1. Kris‐Etherton PM, Hecker KD, Bonanome A, Coval SM, Binkoski AE, Hilpert KF, et al. Bioactive compounds in foods: their role in the prevention of cardiovascular disease and cancer. The American Journal of Medicine 2002;113(Suppl. 9B):71S‐88S. - PubMed
Kuriyama 2008
    1. Kuriyama S. The relation between green tea consumption and cardiovascular disease as evidenced by epidemiological studies. Journal of Nutrition 2008;138:1548S‐53S. - PubMed
Mackay 2004
    1. Mackay J, Manesh GA. The Atlas of Heart Disease and Stroke. Geneva: WHO 2004.
Mineharu 2010
    1. Mineharu Y, Koizumi A, Wada Y, Iso H, Watanabe Y, Date C et al. JACC study Group. Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women. Journal of Epidemiology and Community Health 2010;65:230‐40. - PubMed
Mosca 2011
    1. Mosca L, Barrett‐Connor E, Wenger NK. Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation 2011;124:2145–54. - PMC - PubMed
Nagao 2007
    1. Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity 2007;15(6):1473‐83. - PubMed
NHS 2010
    1. NHS, 2010. Atherosclerosis . http://www.nhs.uk/conditions/Atherosclerosis/Pages/Introduction.aspx#com... (Accessed April 2012).
Nüesch 2010
    1. Nüesch E, Trelle S, Reichenbach S, Rutjes AW, Tschannen B, Altman DG, et al. Small study effects in meta‐analyses of osteoarthritis trials: meta‐epidemiological study. BMJ 2010;341:c3515. - PMC - PubMed
Peters 2001
    1. Peters U, Poole C, Arab L. Does tea affect cardiovascular disease? A meta‐analysis. American Journal of Epidemiology 2001;154(6):495‐503. - PubMed
Scalbert 2005
    1. Scalbert A, Johnson IT, Saltmarsh M. Polyphenols: antioxidants and beyond. American Journal of Clinical Nutrition 2005;81(Suppl):215S–7S. - PubMed
Sesso 1999
    1. Sesso HD, Gaziano JM, Buring JE, Hennekens CH. Coffee and tea intake and the risk of myocardial infarction. American Journal of Epidemiology 1999;149(2):162–7. - PubMed
Shukla 2007
    1. Shukla Y. Tea and cancer chemoprevention. A comprehensive review. Asian Pacific Journal of Cancer Prevention 2007;8:155–6. - PubMed
Siri‐Tarino 2010
    1. Siri‐Tarino P, Sun Q, Hu F, Krauss R. Saturated fat, carbohydrate, and cardiovascular disease. American Journal of Clinical Nutrition 2010;91:502‐9. - PMC - PubMed
Spagnoli 2007
    1. Spagnoli LG, Bonanno E, Sangiorgi G, Mauriello A. Role of inflammation in atherosclerosis. Journal of Nuclear Medicine 2007;48(11):1800‐15. - PubMed
Stangl 2006
    1. Stangl V, Lorenz M, Stangl K. The role of tea and tea flavonoids in cardiovascular health. Molecular, Nutrition and Food Research 2006;50:218‐28. - PubMed
Sterne 2000
    1. Sterne JA, Gavaghan D, Egger M. Publication and related bias in meta‐analysis: power of statistical tests and prevalence in the literature. Journal of Clinical Epidemiology 2000;53:1119‐29. - PubMed
Sterne 2001
    1. Sterne JA, Egger M, Smith GD. Systematic reviews in health care:investigating and dealing with publication and other biases in meta analysis. BMJ 2001;323:101‐5. - PMC - PubMed
WHO 2011
    1. World Health Organization. Cardiovascular diseases (CVDs). September 2011; Fact Sheet Number 317.
World Health Report 2003
    1. WHO. The World health report: 2003: shaping the future. The World Health Organization. Switzerland, 2003.

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