J Intern Med. 2026 Oct 21. doi: 10.1111/joim.70172. Online ahead of print.
ABSTRACT
BACKGROUND: Tea consumption has been associated with vascular health, but evidence regarding multidimensional tea-drinking characteristics and their joint associations with other lifestyle factors remains limited.
OBJECTIVES: To examine associations of multidimensional tea-drinking characteristics with vascular disease (VD) and assess joint associations and interactions with smoking and physical activity (PA).
METHODS: We included 485,934 participants from the China Kadoorie Biobank (CKB). Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for total VD and 12 subtypes. Dose-response relationships and joint associations and interactions of tea consumption with smoking and PA were evaluated.
RESULTS: During a mean follow-up of 9.05 years, 14,863 incident VD cases occurred. Habitual tea consumption was associated with lower total VD risk (HR = 0.888, 95%CI 0.857-0.921) and several major cardiovascular and cerebrovascular outcomes. Associations varied by tea-drinking characteristics: Black tea showed more consistent inverse associations than green tea, moderate-strength tea was associated with lower risk, whereas 'burning hot' tea was associated with higher VD risk (HR = 1.160, 95%CI 1.090-1.236). Tea intake showed non-linear dose-response associations, with the lowest estimated risk at approximately 6-8 cups/day among weekly drinkers. The combination of habitual tea consumption, non-smoking and high PA was associated with the lowest VD risk (HR = 0.548, 95%CI 0.492-0.609), with evidence of sub-additive tea-PA interaction.
CONCLUSION: Habitual tea consumption was associated with lower VD risk, with associations varying by drinking characteristics and intake level. Tea consumption combined with non-smoking and high PA was associated with the lowest risk. These findings support considering multidimensional tea-drinking and lifestyle patterns in vascular health research.
PMID:42902821 | DOI:10.1111/joim.70172