Prospective Cohort Study On Tea Consumption And Risk Of Stroke And Its Subtypes Among Adults In Sichuan Province

Objective:Based on the China Kadoorie Biobank project,this research was conducted to investigate the association between tea consumption and the risk of stroke and its subtypes in adults aged 30-79 years in Sichuan Province,in order to provide evidence to support comprehensive stroke prevention and control,screening of high-risk groups,and health education and prevention in adults in Sichuan Province.Methods:The research was based on baseline data and 10.6 years of follow-up data of 55686 study participants at the Pengzhou site in Sichuan Province of the China Kadoorie Biobank project,and descriptively analysed the baseline demographic information and tea consumption behavioural characteristics.Among the 55686 individuals,patients with stroke,coronary heart disease and malignancy were excluded,and 55001 individuals were finally included in the follow-up cohort.Multi-factorial Cox proportional risk regression models were used to analyse the associations between frequency of tea consumption and average daily tea consumption and the risk of stroke,ischaemic stroke and haemorrhagic stroke,respectively.In the research,hazard ratios and 95% CI were evaluated using the follow-up time as the time scale and stratified by age group(using an age group of 5 years).Two models were fitted for each of the outcome endpoints for analysis using non-tea drinkers as the reference.Model 1 adjusted for age and sex and model 2 adjusted for age,sex,education level,marital status,annual household income,occupation,alcohol consumption,smoking,physical activity level,red meat intake,fresh fruit intake,diabetes prevalence,family history of stroke,mean systolic blood pressure and BMI.We also conducted sensitivity analysis to examine the robustness of our findings,by excluding individuals with new stroke,ischaemic stroke and haemorrhagic stroke in the two years prior to follow-up.Results:1 The largest number of study participants in the baseline survey were occasional tea drinkers,27153(48.76%),and weekly tea drinkers,18703(33.59%).Higher frequency of tea drinkers was found among men,45-60 years old,weekly smokers,weekly alcohol drinkers,relatively low education level,and those with higher annual household income.2 The cohort was followed up for a mean of 10.6 years,with a total followup of 586045.4 person-years.3410 stroke events(1958 in women and 1452 in men)occurred during the follow-up period,with an incidence density of581.9/100000 person-years,including 2715 ischaemic strokes(1617 in women and 1098 in men),with an incidence density of 463.3/100000 person-years,and haemorrhagic There were 918 strokes(457 in women and 418 in men),with an incidence density of 149.3 per 100000 person-years.The incidence density of both cases increased gradually with age.3 After adjusting for age,sex,education level,marital status,annual household income,occupation,alcohol consumption,smoking,physical activity level,red meat intake,fresh fruit intake,diabetes prevalence,family history of stroke,mean systolic blood pressure and BMI,the multifactorial Cox proportional risk regression model showed that tea consumption was the protective factor of stroke and its subtypes.Compared with non-tea drinkers,the HRs for haemorrhagic stroke were 0.81(95% CI: 0.68-0.96)and 0.69(95% CI:0.50-0.96)for the occasional and average daily tea consumption of 3.0-5.0 g/day groups,respectively,and 0.79(95% CI:0.64-0.99)and 0.75(95% CI: 0.58-0.96).4 There were sex differences in tea consumption and the risk of stroke and its subtypes.The results of the analysis stratified by sex found that the HRs for stroke in the male were 0.79(95% CI: 0.64-0.99)and 0.74(95% CI: 0.57-0.96)for the 3.0-5.0 g/day and ≥5.0 g/day groups,respectively,and 0.66(95% CI:0.49-0.89).In the female population,the HR for haemorrhagic stroke in occasional tea drinkers was 0.73(95% CI: 0.60-0.90),whereas a similar association was not observed in the male population.5 In sensitivity analyses,excluding individuals with new strokes and their subtypes two years before follow-up,the results showed that the strength of the association between tea consumption and stroke and its subtypes did not change substantially from the pre-exclusion period and the results were similar.Conclusion:1 Tea consumption is an independent protective factor for stroke,ischaemic stroke and haemorrhagic stroke.There are differences in the effect of tea consumption on the development of stroke and its subtypes by gender.The protective effect of tea consumption on ischaemic stroke is more pronounced in men,while the protective effect on haemorrhagic stroke is more pronounced in women.2 Tea consumption is a worthwhile lifestyle habit or behaviour that contributes to the prevention of stroke and its subtypes in Sichuan Province populations,and it is recommended that targeted health guidance be provided in different populations to effectively prevent the occurrence of stroke and its subtypes.