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摘要: 目的 通过meta分析长期咖啡摄入与新发高血压风险的关系。方法 计算机检索中国知网、维普、万方、中国生物医学文献数据库、Pubmed、Embase、Cochrane、WOS数据库，收集与咖啡摄入对新发高血压风险相关的队列研究，检索时间为1966—2022年。由2名研究人员进行文献筛选和资料提取，必要时加入第3者，并使用ReMan 5.3进行meta分析、Stata软件进行剂量-反应分析。结果 纳入11项研究，共14个队列，通过饮食问卷评估咖啡摄入量，总样本量为64 082例，分为3组：第三高组(1.5杯/d)、第二高组(3.5杯/d)、最高组(5.5杯/d)Meta分析结果显示：平均摄入1.5杯与新发高血压无明显相关性(RR=0.99，95%CI：0.97~1.01，P=0.50)，平均摄入3.5杯与新发高血压无明显相关性(RR=0.97，95%CI：0.92~1.03，P=0.29)，平均摄入5.5杯可能会降低新发高血压的发生(RR=0.96，95%CI：0.95~0.98，P < 0.05)。剂量-反应分析显示，咖啡摄入和高血压之间存在非线性剂量-反应关联(P < 0.001)。限制性三次样条模型显示，与不摄入咖啡的个体相比，每天喝1和2杯咖啡与高血压风险无显著相关性(1杯：RR=0.99，95%CI：0.96~1.03；2杯：RR=0.98，95%CI：0.96~1.01)。与不喝咖啡相比，每天3杯、5杯和7杯的高血压风险RR分别为0.97(95%CI：0.95~0.99)、0.94(95%CI：0.91~0.97)和0.89(95%CI：0.83~0.96)。结论 咖啡摄入和新发高血压无明显的相关性。Abstract: Objective To analyze the relationship between long-term coffee intake and the risk of new-onset hypertension through meta analysis.Methods Computer search of CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, Pubmed, Embase, Cochrane, and WOS databases was conducted to collect cohort studies related to the risk of new-onset hypertension caused by coffee intake from 1966 to 2022. Two researchers conducted literature screening and data extraction, and added a third person if necessary. ReMan 5.3 was used for meta analysis and Stata software was used for dose-response analysis.Results In 11 studies, 14 cohorts were included. The total sample size of 64 082 people were evaluated by the diet questionnaire. They were divided into three groups: the third highest group(1.5 cups/day), the second highest group(3.5 cups/day), and the highest group(5.5 cups/day). The results of meta analysis showed that there was no significant correlation between the average intake of 1.5 cups and new-onset hypertension(RR=0.99, 95%CI0.97-1.01, P=0.50); There was no significant correlation between the average intake of 3.5 cups and new-onset hypertension(RR=0.97, 95%CI0.92-1.03, P=0.29); It showed that the average intake of 5.5 cups might reduce the incidence of new-onset hypertension(RR=0.96, 95%CI: 0.95-0.98, P < 0.05). The dose-response analysis showed that there was nonlinear dose-response relationship between coffee intake and hypertension(P < 0.001). The restricted cubic spline model showed that compared with individuals without coffee intake, drinking one or two cups of coffee a day had no significant correlation with the risk of hypertension(1 cup: RR=0.99, 95%CI0.96-1.03; 2 cups: RR=0.98, 95%CI0.96-1.01). Compared with no coffee, the RR of hypertension risk for 3, 5 and 7 cups of coffee per day were 0.97(95%CI0.95-0.99), 0.94(95%CI0.91-0.97) and 0.89(95%CI0.83-0.96), respectively.Conclusion There is currently no significant correlation between coffee intake and newly developed hypertension.
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Key words:
- coffee /
- hypertension /
- risks /
- blood pressure /
- meta-analysis
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图 2 第二高组与高血压关系的森林图
Figure 2. The forest plot of the association between the second highest group and hypertension
图 3 第三高组与高血压关系的森林图
Figure 3. The forest plot of the association between the third highest group and hypertension
图 4 最高组与高血压关系的森林图
Figure 4. The forest plot of the association between the highest group and hypertension
图 6 咖啡摄入量与高血压的非线性剂量-反应关系
Figure 6. Nonlinear dose-response relation between coffee intake and hypertension
表 1 纳入研究的主要特征
Table 1. Characteristics of included studies
第1作者(年份) 国家 性别 随访时间/年 中位年龄/岁 BMI/(kg/m2) 样本量(发病例数) 咖啡摄入量/(杯/d) OR/RR/HR(95%CI) NOS评分 Chei(2017) 新加坡 男/女 9.5 54.9 22.72 38 592(13 658) 1 1 8 2 0.98(0.94~1.02) 3.5 0.93(0.86~1.00) Rhee(2016) 美国 女 3 62.5 25.97 29 985(5 566) 0 1 7 2~3 0.95(0.89~1.02) ≥4 0.99(0.90~1.08) Grosso(2015) 波兰 男/女 5 56.2/55.2 26.6/26.3 2 725(1 735) 1 1 7 1~2 0.86(0.68~1.07) 3~4 0.75(0.58~0.95) >4 1.58(0.85~0.64) WinkelmayerⅠ(2005) 美国 女 12 55.4 24.8 53 175(19 364) < 1 1 6 1 1.06(1.01~1.10) 2~3 1.00(0.97~1.04) 4~5 0.93(0.88~0.99) ≥6 0.88(0.80~0.98) WinkelmayerⅡ(2005) 美国 女 12 36 24.3 87 369(13 468) < 1 1 6 1 1.06(1.01~1.13) 2~3 1.00(0.95~1.04) 4~5 0.91(0.84~0.98) Miranda(2020) 巴西 男/女 3.9 54.5 25.5 29 985(8 780) 0 1 8 1 1.00(0.93~1.08) 2~3 0.95(0.89~1.02) ≥4 0.99(0.90~1.08) Navarro(2017) 西班牙 男/女 10.1 35.7 23.1 13 369(1 750) 0 1 7 < 1 0.90(0.77~1.04) 1 0.93(0.81~1.08) 2 0.86(0.75~0.99) Uiterwaal(2007) 荷兰 男 11 40.7 25.34 2 297(493) 0~3 1 7 3~6 1.08(0.79~1.47) >6 1.03(0.72~1.46) Uiterwaal(2007) 荷兰 女 11 40.1 24.63 2 892(463) 0~3 1 7 3~6 0.83(0.64~1.07) >6 0.67(0.46~0.98) Hu(2007) 芬兰 男/女 13.2 43.56 23.84 24 710(2 505) 0~1 1 7 2~3 1.27(1.07~1.51) 4~5 1.20(1.01~1.42) 6~7 1.21(1.01~1.44) >8 1.13(0.94~1.36) Palatini(2016) 意大利 男/女 12.6 33.1 25.4 1 240(783) 0 1 7 1~3 1.2(0.99~1.4) >3 1.5(1.1~1.9) Klag(2002) 美国 男 33 26.3 23.1 1 017(281) 0 1 6 1~2 1.24(0.87~1.77) 3~4 1.49(1.01~2.20) ≥5 1.07(0.67~1.69) Tan(2021) 韩国 男 5 53.7 22.55 3 897(964) 0 1 7 1 0.79(0.60~1.04) 1~3 0.87(0.67~1.14) >3 0.86(0.63~1.15) Tan(2021) 韩国 女 5 52.6 21.57 10 725(1 522) 0 1 7 1 0.89(0.74~1.06) 1~3 1.15(0.96~1.37) >3 1.59(1.26，2.00) 
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表 2 咖啡摄入量对高血压风险影响的亚组分析
Table 2. Subgroup analysis of the impact of coffee intake on the risk of hypertension
亚组 纳入研究/项 RR(95%CI) P I2/% 组间I2/% 性别 男+女 6 0.99(0.88~1.10) 0.8 88 0 女 5 0.99(0.92~1.06) 0.72 77 男 3 1.03(0.80~1.33) 0.81 78 年龄 >50岁 7 0.95(0.91~0.99) 0.03 54 68.8 ≤50岁 7 1.07(0.95~1.21) 0.27 78 诊断标准 客观评价 10 0.97(0.91~1.04) 0.43 70 0 自我报告 4 1.01(0.92~1.10) 0.88 80 地域 亚洲 2 0.96(0.93~0.99) 0.009 0 57.1 美洲 5 1.00(0.98~1.03) 0.8 79 欧洲 6 0.97(0.91~1.03) 0.35 79
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