Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials

Abstract

Purpose

Although previous literature has reported that regular green tea consumption may improve blood pressure, the evidence from these studies is not consistent. The present study systematically reviewed randomised controlled trials and examined the effect of green tea consumption on blood pressure using meta-analysis.

Methods

Search of ProQuest, PubMed, Scopus and Cochrane Library (CENTERAL) was conducted, to identify eligible articles. Articles from 1995 to 2013 were included. A random-effect model was chosen to calculate the effect of combined trials.

Result

Thirteen studies were included in the meta-analysis. Green tea consumption significantly changed systolic blood pressure, by −2.08 mm Hg (95 % CI −3.06, −1.05), and diastolic blood pressure, by −1.71 mm Hg (95 % CI −2.86, −0.56), compared to the control. Changes in lipid profile, blood glucose and body mass index were also assessed in the meta-analysis. A significant reduction was found in total cholesterol (−0.15 mmol/L [95 % CI −0.27, −0.02]) and low-density lipoprotein cholesterol (−0.16 mmol/L [95 % CI −0.22, −0.09]). Changes in other parameters did not reach statistical significance. Subgroup analysis suggested a greater reduction in both systolic and diastolic blood pressure in studies that included participants with a baseline mean systolic blood pressure of ≥130 mm Hg, and studies involving consuming green tea as an extract.

Conclusion

The present meta-analysis suggests that green tea and its catechins may improve blood pressure, and the effect may be greater in those with systolic blood pressure ≥130 mm Hg. The meta-analysis also suggests that green tea catechins may improve total and low-density lipoprotein cholesterol.

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References

  1. 1.

    WHO (2002) World Health Organization. World Health Report 2002. Reducing risks, promoting healthy life. Geneva, Switzerland. http://wwww.hoint/whr/2002/en

  2. 2.

    WHO (2008) Global health observatory (GHO). Raised blood pressure. http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/index.html

  3. 3.

    Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS (2012) Heart disease and stroke statistics—2012 update a report from the American Heart Association. Circulation 125(1):e2–e220

    Article  Google Scholar 

  4. 4.

    Law M, Wald N, Morris J (2005) Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy. Int J Technol Assess Health Care 21(1):145. doi:10.1017/s0266462305220196

    Google Scholar 

  5. 5.

    Qureshi A, Sapkota B (2011) Blood pressure reduction in secondary stroke prevention. Continuum (Minneapolis, Minn) 17 (6 2ndary Stroke Prevention):1233

  6. 6.

    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT (2003) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42(6):1206–1252

    CAS  Article  Google Scholar 

  7. 7.

    Hooper L, Kroon PA, Rimm EB, Cohn JS, Harvey I, Le Cornu KA, Ryder JJ, Hall WL, Cassidy A (2008) Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials. Am J Clin Nutr 88(1):38–50

    CAS  Google Scholar 

  8. 8.

    Rains TM, Agarwal S, Maki KC (2011) Antiobesity effects of green tea catechins: a mechanistic review. J Nutr Biochem 22(1):1–7

    CAS  Article  Google Scholar 

  9. 9.

    Balentine DA, Wiseman SA, Bouwens LC (1997) The chemistry of tea flavonoids. Crit Rev Food Sci Nutr 37(8):693–704

    CAS  Article  Google Scholar 

  10. 10.

    Bhardwaj P, Khanna D (2013) Green tea catechins: defensive role in cardiovascular disorders. Chin J Nat Med 11(4):345–353

    CAS  Google Scholar 

  11. 11.

    Erba D, Riso P, Bordoni A, Foti P, Biagi PL, Testolin G (2005) Effectiveness of moderate green tea consumption on antioxidative status and plasma lipid profile in humans. J Nutr Biochem 16(3):144–149. doi:10.1016/j.jnutbio.2004.11.006

    CAS  Article  Google Scholar 

  12. 12.

    Maruyama K, Iso H, Sasaki S, Fukino Y (2009) The association between concentrations of green tea and blood glucose levels. J Clin Biochem Nutr 44(1):41

    Article  Google Scholar 

  13. 13.

    Mu LN, Lu QY, Yu SZ, Jiang QW, Cao W, You NC, Setiawan VW, Zhou XF, Ding BG, Wang RH (2005) Green tea drinking and multigenetic index on the risk of stomach cancer in a Chinese population. Int J Cancer 116(6):972–983

    CAS  Article  Google Scholar 

  14. 14.

    Sun C-L, Yuan J-M, Koh W-P, Mimi CY (2006) Green tea, black tea and breast cancer risk: a meta-analysis of epidemiological studies. Carcinogenesis 27(7):1310–1315

    CAS  Article  Google Scholar 

  15. 15.

    Antonello M, Montemurro D, Bolognesi M, Di Pascoli M, Piva A, Grego F, Sticchi D, Giuliani L, Garbisa S, Rossi GP (2007) Prevention of hypertension, cardiovascular damage and endothelial dysfunction with green tea extracts. Am J Hypertens 20(12):1321–1328

    CAS  Article  Google Scholar 

  16. 16.

    Nagao T, Hase T, Tokimitsu I (2007) A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity 15(6):1473–1483. doi:10.1038/oby.2007.176

    CAS  Article  Google Scholar 

  17. 17.

    Auvichayapat P, Prapochanung M, Tunkamnerdthai O, Sripanidkulchai B-O, Auvichayapat N, Thinkhamrop B, Kunhasura S, Wongpratoom S, Sinawat S, Hongprapas P (2008) Effectiveness of green tea on weight reduction in obese Thais: a randomized, controlled trial. Physiol Behav 93(3):486–491

    CAS  Article  Google Scholar 

  18. 18.

    Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269

    Article  Google Scholar 

  19. 19.

    Liberati A, Moher D, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100. doi:10.1371/journal.pmed.1000100

    Article  Google Scholar 

  20. 20.

    Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Commun Health 52(6):377–384

    CAS  Article  Google Scholar 

  21. 21.

    Cohen J (1992) A power primer. Psychol Bull 112(1):155–159. doi:10.1037/0033-2909.112.1.155

    CAS  Article  Google Scholar 

  22. 22.

    Harrison RA, Siminoski K, Vethanayagam D, Majumdar SR (2007) Osteoporosis-related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res 22(3):447–457

    Article  Google Scholar 

  23. 23.

    Higgins J, Green SP, Wiley I, Cochrane C (2008) Cochrane handbook for systematic reviews of interventions. vol Book, Whole. Wiley-Blackwell, Hoboken

    Google Scholar 

  24. 24.

    Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, Medical Research Council, UK

  25. 25.

    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188. doi:10.1016/0197-2456(86)90046-2

    CAS  Article  Google Scholar 

  26. 26.

    Kim A, Chiu A, Barone MK, Avino D, Wang F, Coleman CI, Phung OJ (2011) Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis. J Am Diet Assoc 111(11):1720–1729

    CAS  Article  Google Scholar 

  27. 27.

    Dong J-Y, Szeto IM, Makinen K, Gao Q, Wang J, Qin L-Q, Zhao Y (2013) Effect of probiotic fermented milk on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr 110(07):1188–1194

    CAS  Article  Google Scholar 

  28. 28.

    Sone T, Kuriyama S, Nakaya N, Hozawa A, Shimazu T, Nomura K, Rikimaru S, Tsuji I (2011) Randomized controlled trial for an effect of catechin-enriched green tea consumption on adiponectin and cardiovascular disease risk factors. Food Nutr Res 55:1–10. doi:10.3402/fnr.v55i0.8326

    Article  Google Scholar 

  29. 29.

    Basu A, Du M, Sanchez K, Leyva MJ, Betts NM, Blevins S, Wu M, Aston CE, Lyons TJ (2011) Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome. Nutrition 27(2):206–213. doi:10.1016/j.nut.2010.01.015

    CAS  Article  Google Scholar 

  30. 30.

    Fukino Y, Shimbo M, Aoki N, Okubo T, Iso H (2005) Randomized controlled trial for an effect of green tea consumption on insulin resistance and inflammation markers. J Nutr Sci Vitaminol (Tokyo) 51(5):335–342

    CAS  Article  Google Scholar 

  31. 31.

    Bogdanski P, Suliburska J, Szulinska M, Stepien M, Pupek-Musialik D, Jablecka A (2012) Green tea extract reduces blood pressure, inflammatory biomarkers, and oxidative stress and improves parameters associated with insulin resistance in obese, hypertensive patients. Nutr Res 32(6):421–427. doi:10.1016/j.nutres.2012.05.007

    CAS  Article  Google Scholar 

  32. 32.

    Frank J, George TW, Lodge JK, Rodriguez-Mateos AM, Spencer JP, Minihane AM, Rimbach G (2009) Daily consumption of an aqueous green tea extract supplement does not impair liver function or alter cardiovascular disease risk biomarkers in healthy men. J Nutr 139(1):58–62. doi:10.3945/jn.108.096412

    CAS  Article  Google Scholar 

  33. 33.

    Hsu CH, Liao YL, Lin SC, Tsai TH, Huang CJ, Chou P (2011) Does supplementation with green tea extract improve insulin resistance in obese type 2 diabetics? A randomized, double-blind, and placebo-controlled clinical trial. Altern Med Rev 16(2):157–163

    Article  Google Scholar 

  34. 34.

    Hsu CH, Tsai TH, Kao YH, Hwang KC, Tseng TY, Chou P (2008) Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr 27(3):363–370

    CAS  Article  Google Scholar 

  35. 35.

    Nagao T, Hase T, Tokimitsu I (2007) A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring) 15(6):1473–1483. doi:10.1038/oby.2007.176

    CAS  Article  Google Scholar 

  36. 36.

    Nantz MP, Rowe CA, Bukowski JF, Percival SS (2009) Standardized capsule of Camellia sinensis lowers cardiovascular risk factors in a randomized, double-blind, placebo-controlled study. Nutrition 25(2):147–154

    Article  Google Scholar 

  37. 37.

    Suliburska J, Bogdanski P, Szulinska M, Stepien M, Pupek-Musialik D, Jablecka A (2012) Effects of green tea supplementation on elements, total antioxidants, lipids, and glucose values in the serum of obese patients. Biol Trace Elem Res 149(3):315–322. doi:10.1007/s12011-012-9448-z

    CAS  Article  Google Scholar 

  38. 38.

    Vieira Senger AE, Schwanke CHA, Gomes I, Valle Gottlieb MG (2012) Effect of green tea (Camellia sinensis) consumption on the components of metabolic syndrome in elderly. J Nutr Health Aging 16(9):738–742. doi:10.1007/s12603-012-0081-5

    CAS  Article  Google Scholar 

  39. 39.

    Diepvens K, Kovacs EM, Nijs IM, Vogels N, Westerterp-Plantenga MS (2005) Effect of green tea on resting energy expenditure and substrate oxidation during weight loss in overweight females. Br J Nutr 94(6):1026–1034

    CAS  Article  Google Scholar 

  40. 40.

    Chantre P, Lairon D (2002) Recent findings of green tea extract AR25 (exolise) and its activity for the treatment of obesity. Phytomedicine 9(1):3–8

    CAS  Article  Google Scholar 

  41. 41.

    Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH (1995) Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 155(7):701–709. doi:10.1001/archinte.1995.00430070053006

    CAS  Article  Google Scholar 

  42. 42.

    Islam MA (2012) Cardiovascular effects of green tea catechins: progress and promise. Recent Pat Cardiovasc Drug Discov 7(2):88–99

    CAS  Article  Google Scholar 

  43. 43.

    Rastaldo R, Pagliaro P, Cappello S, Penna C, Mancardi D, Westerhof N, Losano G (2007) Nitric oxide and cardiac function. Life Sci 81(10):779–793

    CAS  Article  Google Scholar 

  44. 44.

    Gössl M, Lerman A (2006) Endothelin beyond a vasoconstrictor. Circulation 113(9):1156–1158

    Article  Google Scholar 

  45. 45.

    Collins QF, Liu H-Y, Pi J, Liu Z, Quon MJ, Cao W (2007) Epigallocatechin-3-gallate (EGCG), a green tea polyphenol, suppresses hepatic gluconeogenesis through 5′-AMP-activated protein kinase. J Biol Chem 282(41):30143–30149

    CAS  Article  Google Scholar 

  46. 46.

    Pon Anandh B, Dongmin L (2008) Green tea catechins and cardiovascular health: an update. Curr Med Chem 15(18):1840–1850. doi:10.2174/092986708785132979

    Article  Google Scholar 

  47. 47.

    Maron DJ, Lu GP, Cai NS, Wu ZG, Li YH, Chen H, Zhu JQ, Jin XJ, Wouters BC, Zhao J (2003) Cholesterol-lowering effect of a theaflavin-enriched green tea extract: a randomized controlled trial. Arch Intern Med 163(12):1448–1453

    CAS  Article  Google Scholar 

  48. 48.

    Koo SI, Noh SK (2007) Green tea as inhibitor of the intestinal absorption of lipids: potential mechanism for its lipid-lowering effect. J Nutr Biochem 18(3):179–183

    CAS  Article  Google Scholar 

  49. 49.

    Bursill CA, Abbey M, Roach PD (2007) A green tea extract lowers plasma cholesterol by inhibiting cholesterol synthesis and upregulating the LDL receptor in the cholesterol-fed rabbit. Atherosclerosis 193(1):86–93

    CAS  Article  Google Scholar 

  50. 50.

    Ikeda I, Kobayashi M, Hamada T, Tsuda K, Goto H, Imaizumi K, Nozawa A, Sugimoto A, Kakuda T (2003) Heat-epimerized tea catechins rich in gallocatechin gallate and catechin gallate are more effective to inhibit cholesterol absorption than tea catechins rich in epigallocatechin gallate and epicatechin gallate. J Agric Food Chem 51(25):7303–7307

    CAS  Article  Google Scholar 

  51. 51.

    Hsu T, Kusumoto A, Abe K, Hosoda K, Kiso Y, Wang M, Yamamoto S (2006) Polyphenol-enriched oolong tea increases fecal lipid excretion. Eur J Clin Nutr 60(11):1330–1336

    CAS  Article  Google Scholar 

  52. 52.

    Westerterp-Plantenga MS (2010) Green tea catechins, caffeine and body-weight regulation. Physiol Behav 100(1):42–46

    CAS  Article  Google Scholar 

  53. 53.

    Rains TM, Agarwal S, Maki KC (2011) Antiobesity effects of green tea catechins: a mechanistic review. J Nutr Biochem 22(1):1–7

    CAS  Article  Google Scholar 

  54. 54.

    Henning SM, Fajardo-Lira C, Lee HW, Youssefian AA, Go VL, Heber D (2003) Catechin content of 18 teas and a green tea extract supplement correlates with the antioxidant capacity. Nutr Cancer 45(2):226–235

    CAS  Article  Google Scholar 

  55. 55.

    Noordzij M, Uiterwaal CS, Arends LR, Kok FJ, Grobbee DE, Geleijnse JM (2005) Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials. J Hypertens 23(5):921–928

    CAS  Article  Google Scholar 

  56. 56.

    Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJP, Bittner V, Fruchart J-C, Treating New Targets I, Treating to New Targets I (2007) HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med 357(13):1301–1310. doi:10.1056/NEJMoa064278

    CAS  Article  Google Scholar 

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Khalesi, S., Sun, J., Buys, N. et al. Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials. Eur J Nutr 53, 1299–1311 (2014). https://doi.org/10.1007/s00394-014-0720-1

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Keywords

  • Green tea
  • Blood Pressure
  • Lipid profile
  • Systematic review
  • Meta-analysis