Tea Consumption Enhances Endothelial-Dependent Vasodilation; a Meta-Analysis
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{"title"=>"Tea consumption enhances endothelial-dependent vasodilation; a meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Rouyanne T.", "last_name"=>"Ras", "scopus_author_id"=>"26029197200"}, {"first_name"=>"Peter L.", "last_name"=>"Zock", "scopus_author_id"=>"7004327933"}, {"first_name"=>"Richard", "last_name"=>"Draijer", "scopus_author_id"=>"6508270851"}], "year"=>2011, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-79952355001", "pui"=>"361390400", "doi"=>"10.1371/journal.pone.0016974", "sgr"=>"79952355001", "pmid"=>"21394199"}, "id"=>"e62483dc-4256-3bb5-87e6-634e2ccc1473", "abstract"=>"BACKGROUND:Tea consumption is associated with a lower risk of cardiovascular disease including stroke. Direct effects of tea components on the vasculature, particularly the endothelium, may partly explain this association. OBJECTIVE:We performed a meta-analysis of controlled human intervention studies on the effect of tea on flow-mediated dilation (FMD) of the brachial artery, a measurement of endothelial function, which is suggested to be associated with cardiovascular risk. METHODS:Human intervention studies were identified by systematic search of the databases Medline, Embase, Chemical Abstracts and Biosis through March 2009 and by hand-searching related articles. Studies were selected based on predefined criteria: intervention with tea as the sole experimental variable, placebo-controlled design, and no missing data on FMD outcome or its variability. A random effects model was used to calculate the pooled overall effect on FMD due to the intake of tea. The impact of various subject and treatment characteristics was investigated in the presence of heterogeneity. RESULTS:In total, 9 studies from different research groups were included with 15 relevant study arms. The overall absolute increase in FMD of tea vs. placebo was 2.6% of the arterial diameter (95% CI: 1.8-3.3%; P-value <0.001) for a median daily dose of 500 mL of tea (2-3 cups). This is a relative increase of approximately 40% compared to the average FMD of 6.3% measured under placebo or baseline conditions. There was significant heterogeneity between studies (P-value <0.001) that might partly be explained by the cuff position either distal or proximal to the area of FMD measurement. No indication for publication bias was found. CONCLUSION:Moderate consumption of tea substantially enhances endothelial-dependent vasodilation. This may provide a mechanistic explanation for the reduced risk of cardiovascular events and stroke observed among tea drinkers.", "link"=>"http://www.mendeley.com/research/tea-consumption-enhances-endothelialdependent-vasodilation-metaanalysis", "reader_count"=>40, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Researcher"=>16, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>4, "Student > Bachelor"=>9, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Researcher"=>16, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>4, "Student > Bachelor"=>9, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Agricultural and Biological Sciences"=>17, "Business, Management and Accounting"=>1, "Chemistry"=>1, "Computer Science"=>1, "Environmental Science"=>1, "Nursing and Health Professions"=>4, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>5, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Physics and Astronomy"=>1, "Psychology"=>1, "Social Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>5}, "Social Sciences"=>{"Social Sciences"=>1}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Chemistry"=>{"Chemistry"=>1}, "Neuroscience"=>{"Neuroscience"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>17}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1, "United Kingdom"=>1}, "group_count"=>1}

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  • {"files"=>["https://ndownloader.figshare.com/files/793082"], "description"=>"a<p>Duffy et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Duffy1\" target=\"_blank\">[19]</a> (both intervention arms) and Hodgson et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Hodgson2\" target=\"_blank\">[22]</a> used a respective control period for each intervention period; Grassi et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Grassi1\" target=\"_blank\">[41]</a> and Jochmann et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Jochmann1\" target=\"_blank\">[23]</a> used a single control period for all intervention periods. In case of multiple study arms, the intervention is specified between brackets.</p>b<p>Study design is R (randomized), NR (not randomized), RA (randomization assumed), PCW (placebo controlled with water), PCC (placebo controlled with caffeine), DB (double blinded), SB (single blinded), BNR (blinding not reported), OL (open label), CO (crossover), PA (parallel), dist (distal occlusion), prox (proximal occlusion).</p>c<p>For parallel studies: number in control group/number in treatment group.</p>d<p>Health status is healthy, MHC (mildly hypercholesterolemic), CAD (coronary artery disease), RTR (renal transplant recipients), CKD (chronic kidney disease).</p>e<p>The dosage of tea is expressed in mL tea per day. Only Grassi et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Grassi1\" target=\"_blank\">[41]</a> did not report the dosage of tea in such a unit and for that study, the volume of tea consumed was estimated from the concentration of flavonoids consumed per day.</p>f<p>Duration is LT (long-term/chronic) or ST (short-term/acute).</p>g<p>Mean baseline outcome (reference outcome) is the mean FMD at the end of the control period for crossover studies. For parallel studies, mean baseline outcome is the mean baseline FMD of the active treatment group. For Alexopoulos et al. <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0016974#pone.0016974-Alexopoulos1\" target=\"_blank\">[26]</a>, mean baseline outcome is the mean baseline FMD of the active treatment period (no endpoint FMD values reported).</p>h<p>Net response was calculated by subtracting the mean FMD at the end of the active treatment period from the mean FMD at the end of the control period in case of crossover studies. For parallel studies, the mean FMD change from baseline in the control group was subtracted from the mean FMD change from baseline in the active treatment group.</p><p>NA not available.</p>i<p>FMD measured with semi-automated edge-detection system.</p>", "links"=>[], "tags"=>["characteristics", "included"], "article_id"=>463457, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974.t001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overview_and_characteristics_of_included_studies_/463457", "title"=>"Overview and characteristics of included studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-04 00:57:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/793116"], "description"=>"a<p>For continuous variables, studies were divided in subgroups based on their medians: 6.4% for baseline FMD, 55 years for age, 500 mL for dose of tea, and 6.0 points for quality.</p>b<p>For type of tea, type of placebo, study duration, and cuff placement, we performed sensitivity analysis due to limited number of studies (<5) in one of the subgroups.</p>c<p>For the subgroup with short-term duration, we excluded the long-term study arms (>2 weeks) and the study arms that investigated acute upon longer-term effects.</p>d<p>Post-hoc analysis.</p>", "links"=>[], "tags"=>["fmd"], "article_id"=>463490, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974.t002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_tea_on_FMD_within_and_between_different_subgroups_/463490", "title"=>"Effect of tea on FMD within and between different subgroups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-04 00:58:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/792927"], "description"=>"<p>*One study was identified after the systematic search through March 2009.</p>", "links"=>[], "tags"=>["diagram"], "article_id"=>463303, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974.g001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_the_study_selection_procedure_/463303", "title"=>"Flow diagram of the study selection procedure.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-04 00:55:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/793030"], "description"=>"<p>The net FMD responses and 95% confidence intervals of 15 study arms from 9 studies investigating the effect of tea on FMD are shown. The dotted line indicates the pooled overall FMD effect (2.6%), in which each study arm was weighed by the inverse of its variance (1/SE<sup>2</sup>). In case of multiple study arms, the intervention is specified between brackets.</p>", "links"=>[], "tags"=>["cell biology"], "article_id"=>463403, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974.g003", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_/463403", "title"=>"Forest plot.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-04 00:56:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/396976"], "description"=>"<div><h3>Background</h3><p>Tea consumption is associated with a lower risk of cardiovascular disease including stroke. Direct effects of tea components on the vasculature, particularly the endothelium, may partly explain this association.</p> <h3>Objective</h3><p>We performed a meta-analysis of controlled human intervention studies on the effect of tea on flow-mediated dilation (FMD) of the brachial artery, a measurement of endothelial function, which is suggested to be associated with cardiovascular risk.</p> <h3>Methods</h3><p>Human intervention studies were identified by systematic search of the databases Medline, Embase, Chemical Abstracts and Biosis through March 2009 and by hand-searching related articles. Studies were selected based on predefined criteria: intervention with tea as the sole experimental variable, placebo-controlled design, and no missing data on FMD outcome or its variability. A random effects model was used to calculate the pooled overall effect on FMD due to the intake of tea. The impact of various subject and treatment characteristics was investigated in the presence of heterogeneity.</p> <h3>Results</h3><p>In total, 9 studies from different research groups were included with 15 relevant study arms. The overall absolute increase in FMD of tea vs. placebo was 2.6% of the arterial diameter (95% CI: 1.8-3.3%; P-value <0.001) for a median daily dose of 500 mL of tea (2–3 cups). This is a relative increase of approximately 40% compared to the average FMD of 6.3% measured under placebo or baseline conditions. There was significant heterogeneity between studies (P-value <0.001) that might partly be explained by the cuff position either distal or proximal to the area of FMD measurement. No indication for publication bias was found.</p> <h3>Conclusion</h3><p>Moderate consumption of tea substantially enhances endothelial-dependent vasodilation. This may provide a mechanistic explanation for the reduced risk of cardiovascular events and stroke observed among tea drinkers.</p> </div>", "links"=>[], "tags"=>["enhances", "endothelial-dependent", "meta-analysis"], "article_id"=>138418, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974", "stats"=>{"downloads"=>6, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Tea_Consumption_Enhances_Endothelial_Dependent_Vasodilation_a_Meta_Analysis/138418", "title"=>"Tea Consumption Enhances Endothelial-Dependent Vasodilation; a Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-04 02:20:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/792980"], "description"=>"<p>The net FMD responses are expressed against their respective precisions (1/SE) in 15 study arms. The net responses are scattered around the pooled overall effect of 2.6% (dotted line). In case the most extreme outlier (red circle) is excluded from the analyses, the net responses are more symmetrically scattered around the adjusted pooled overall effect of 2.4% (red dotted line).</p>", "links"=>[], "tags"=>["cell biology"], "article_id"=>463359, "categories"=>["Cell Biology"], "users"=>["Rouyanne T. Ras", "Peter L. Zock", "Richard Draijer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0016974.g002", "stats"=>{"downloads"=>17, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Funnel_plot_/463359", "title"=>"Funnel plot.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-04 00:55:59"}

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Relative Metric

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