Tea and Cardiovascular Health

Low magnification micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing. Masson's trichrome. Arteries have three layers (tunica intima, tunica media and tunica adventitia). These can be seen on the micrograph: Adventitia (outermost layer) = green fluffy material (collagen), Media (middle (muscular) part) = red (smooth muscle actin), Intima (inner part, in contact with the blood) = green (collagen) with some red (smooth muscle actin). Features of atherosclerosis seen on the micrograph: The tunica intima is severely thickened; it measures up to approximately 1/3 of a millimetre. Normally, it is one cell layer thick (approximately 10 micrometres). There is fragmentation of the internal elastic lamina (a very thin black wavy layer) between the intima and media. There is a partial duplication of the internal elastic lamina. There is smooth muscle infiltration of the intima (from the media), i.e. red staining of the intima. There is significant luminal narrowing. The section of the artery shown has only 25-35% of the cross-sectional area it once had; the artery's original lumen was approximately where the double layer of elastin is seen (the internal elastic lamina). Features that may be seen in atherosclerosis but are not evident in the micrograph: Calcifications. Cholesterol crystals.

This is the picture of the wall of the blood vessel of a patient with cardiovascular disease. The dark blue part is the thickened accumulation of fatty deposits on the weakened wall of the blood vessel (in lighter blue-green). You can see that the passage for blood is what remains in the non-coloured area, which is now less than one-third in diameter of the original.

More people die of heart diseases in developed countries than of anything else (1). The second killer is stroke and other cerebrovascular diseases. It seems that quite a large number of us have not been taking care of this most hard-working of our systems and it is giving us signs.

A diagrammatic drawing showing how the inner lining of the blood vessel becomes dysfunctional due to accummulation of oxidized blood lipids. Atherosclerosis causes major diseases in our circulatory system, such as strokes and heart attack. Tea drinking helps to decrease the amount of such lipids.

A diagrammatic drawing showing how the inner lining of the blood vessel becomes dysfunctional due to accumulation of oxidized blood lipids. Atherosclerosis causes major diseases in our circulatory system, such as strokes and heart attack. Tea drinking helps to decrease the amount of such lipids.

The reminder of a healthy life style has already somewhat become a cliché so I am not repeating it here. Sometimes I do myself skip exercises and stay up late, indulge my taste buds for that seductive dessert or get irritated over trivial mishaps, though I have long been that age that I’d better stay on that healthy route. However, I always keep drinking my tea.

Those nasty free-radicals

The reason tea can be promoting cardiovascular health is its anti-oxidative characteristic. Tea flavonoids, such as theaflavins in finer black teas and the more potent tea catechins which are most abundant in green teas, are able to inhibit nasty free radicals from corrupting our cells, tissues and systems. These free radicals form in our body as we are exposed to contaminants, pathogens, and in the very processes of metabolism and aging themselves.

Flavonoids prevent these free radicals from oxidizing Low Density Lipoprotein (LDL, often labelled as the “bad” cholesterol). When LDL is oxidized, it becomes a viscous substance and tends to adhere to the inner wall of the blood vessel, causing the passage of the bloodstream to become narrow (i.e. atherosclerosis), and thus the condition for strokes.

Free radicals also cause blood platelets to adhere to other cells and tissues quicker, which can trigger blood clot within the blood vessel (i.e. thrombosis). Together with atherosclerosis, they are immediate antecedents to strokes. Minimizing the actions of free radicals prevents this from happening.

A glass cup with green tea

A glass cup with green tea

Drink tea: it lowers that blood lipid level

In a report published in an official journal of the American Heart Association in a 5-year study (2) following 1900 patients with history of acute myocardial infarction (i.e. heart attack), it was found that those who drank more than 2 cups of tea a day were 44% less likely to die in a recurrence. They were not even tracking the quality of tea.

Another substance of interest is statin, similar to those that are either natural extracts or synthetic used as a drug for cholesterol control, is present naturally in post-fermented teas such as puer. Although only in minute amount (3), regular drinking may render the effect accumulative. High blood lipid level can drop by an average of 22%, as shown in a small study in France where patients with the problem drank 3 cups a day (4).

44% lower risks of heart attacks

Interestingly, there is a medical understanding that every 1% drop of blood cholesterol reduces 2% of fatal heart attack risk; 22% drop in blood lipid level may agree with the American study of 44% lower risk factor for tea drinkers. This may be an interesting hint that tea from any category can be contributive to preventing mortality in cardiovascular diseases.

Tea: the Better Choice

“If you have to choose between tea or coffee it’s probably better to drink tea…” said Professor Nicolas Danchin of France, after a 7-year study of 131,401 persons on cardiovascular mortality between coffee and tea drinkers“Tea drinking lowered the risk of non-CV ( cardiovascular ) death by 24% and the trend towards lowering CV mortality was nearly significant” the scientist concluded (5). This agrees with other cohort studies in Japan, where they conclude that those who drink more tea are more less likely to die early of any causes (6).

Compared to wine, an average cup of green tea has 5 times the flavonoid contents (7) — the group of salutary substances in both beverages, and none of the health and social issues of alcohol.

A lot more study is needed for using any tea medically as a therapy. However, there is more than enough evidence showing that it really is worth the effort to develop a fine tea habit to lower the risk of this most threatening health problem.

The clear rational is, tea is an enjoyment which one can have the whole day long day after day. Even the most expensive tea is cheaper than drugs and medical treatments, even if there were no physical sufferings when one gets a cardiovascular problem. As the saying goes, an ounce of prevention is worth a pound of cure. An ounce of good tealeaves gives many cups for good health.

Here’s to a great heart!

footnotes
1. WHO data as of October 2008.
2. Tea Consumption and Mortality After Acute Myocardial Infarction, 2002, Kenneth J. Mukamal, Malcolm Maclure
3. According to a study in Taiwan*, there is between 130 ~ 513 ng/g of statin in the raw pu’er tealeaves, i.e. roughly 390 ~ 1500 ng per 3 g of tea used in each cup. The dissoluble and bio-accessible amounts have not been established. However, this is only a preliminary study in a market where the access to the range of pu’er was far from comprehensive. Representative datas are still needed to understand this aspect of the tea category. (*K Jeng et al, Effect of Microbial Fermentation on Content of Statin, GABA, and Polyphenols in Pu-Erh Tea, Journal of Agricultural and Food Chemistry 2007, 55, 8787–8792)
4. Prof Bernard Jacotot, Henri Mondor Hospital, Creteil, France. 20 patients with high blood lipid levels were served 3 times a day with Yunnan Toucha tea. Jacotot reported a significant 22% drop in blood fat levels among the patients, while a control group served with a different tea showed no change at all.
5.  European Society of Cardiology, PR: 31-Aug-2014, ESC Congress 2014
6. E Suzuki at al, Green Tea Consumption and Mortality among Japanese Elderly People: The Prospective Shizuoka Elderly Cohort, Annals of Epidemiology 2009;19:732–739. This was a research funded by the Japan Health and Labour Sciences Research Grants, Comprehensive Research on Aging and Health, and modeled after a previous study led by Dr Shinichi Kuriyama in Hokkaido in 1995-2001 following a subject group of over 51,000 individuals: the famous Ohsaki Study. Both studies have come to similar conclusion.
7. Please refer to the references and explanations in this Tea Guardian article: The Amazing Health Benefits of Tea

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