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Black tea consumption and the risk of coronary heart disease: a systematic review and meta-analysis of cohort studies.

  • 2026-05
  • Nutrition, metabolism, and cardiovascular diseases : NMCD 36(5)
    • Ze-Mu Wang
    • Xiao-Qing Lian
    • Qingqing Long
    • Bo Wu
    • Lian-Sheng Wang

Study Design

Type
Meta-Analysis
Sample size
n = 477
Population
14 studies, with 16,990 CHD cases among 958,477 participants
Methods
We searched the PubMed and EMBASE databases for studies conducted from 1966 to August 2024. Study-specific risk estimates were combined by using a random-effects model. Dose-response relationship was assessed by a 2-stage random-effects dose-response meta-analysis.

Aims

During the past four decades, the relationship between black tea consumption and coronary heart disease (CHD) risk has been assessed in numerous studies, with conflicting results. We aimed to perform a meta-analysis to systematically examine the data published on the association in cohort studies.

Data synthesis

We searched the PubMed and EMBASE databases for studies conducted from 1966 to August 2024. Study-specific risk estimates were combined by using a random-effects model. Dose-response relationship was assessed by a 2-stage random-effects dose-response meta-analysis. A total of 14 studies, with 16,990 CHD cases among 958,477 participants, were included. The overall results showed a significant 11 % reduction in CHD risk with the highest black tea consumption [summary relative risk (RR): 0.89; 95 % confidence interval (CI): 0.79, 0.99]; there was a significant heterogeneity (P = 0.007, I2 = 50.6 %). In the subgroup analysis by region, the protective effect was observed in the European, but not in the USA. We observed a nonlinear association between black tea consumption and CHD risk (P for nonlinearity = 0.0011). Compared with non-consumers, the RRs (95 % CI) of CHD across levels of black tea consumption were 0.95 (0.91, 0.99) for 2 cups/day, 0.91 (0.86, 0.96) for 4 cups/day, 0.89 (0.83, 0.95) for 6 cups/day, 0.86 (0.78, 0.96) for 8 cups/day, and 0.84 (0.72, 0.98) for 10 cups/day.

Conclusions

This meta-analysis demonstrates that black tea consumption was associated with a reduced CHD risk. Our results support recommendations for black tea consumption to the primary prevention of CHD.

Systematic review registration

PROSPERO CRD42023395469.

Research Insights

  • Black Tea→Reduced Coronary Heart Disease Risk

    overall results showed a significant 11% reduction in CHD risk with the highest black tea consumption [summary relative risk (RR): 0.89; 95% CI: 0.79, 0.99]

    Effect
    Beneficial
    Effect size
    Small
    Dose
    2, 4, 6, 8, and 10 cups per day
  • Black Tea→Reduced Risk of Coronary Heart Disease

    The overall results showed a significant 11 % reduction in CHD risk with the highest black tea consumption [summary relative risk (RR): 0.89; 95 % confidence interval (CI): 0.79, 0.99]

    Effect
    Beneficial
    Effect size
    Small
    Dose
    Highest consumption (variable across studies)
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