Relation between sugar‐sweetened beverage consumption and incident hypertension: a systematic review and meta‐analysis of prospective cohorts (267.4)

Background: The role of fructose‐containing sugar‐sweetened beverages (SSBs) in incident hypertension is unclear. Aims: To quantify the relation between fructose‐containing SSBs and incident hypertension, we conducted a systematic review and meta‐analysis of prospective cohorts. Methods: MEDLINE, EMBASE, CINAHL, and the Cochrane registry were searched (through August 4, 2013) for relevant prospective cohorts. We pooled risk ratios (RR) of extreme (lowest vs. highest) quantiles of intake using generic inverse variance random effects models. Heterogeneity and cohort quality were assessed. Results: Five prospective cohorts (n=240,508) with 79,584 cases of hypertension observed over 蠅3‐million person‐years were included. SSB intake ranged from none to 蠅1‐serving (200mL, 8 or 12 oz)/day. Comparing extreme quantiles, SSBs significantly increased the risk of developing hypertension by 11% (RR:1.11 [95%CI: 1.06 to 1.17]), and a positive linear dose‐response was established (β=0.0027, p<0.001). However, significant heterogeneity was observed (I²=64%, p=0.02). Limitations: Significant unexplained heterogeneity and residual confounding due to important collinearity with a Western dietary pattern. Conclusions: SSBs are associated with a small risk of developing hypertension in five cohorts. Its contribution to hypertension risk appears to be small relative to other established risk factors. Grant Funding Source : Supported by Calorie Control Council