Article Title
Dose Response of Sugar-sweetened Beverage Intake and Risk of Hypertension Incidence：a Meta-analysis
Abstract
Background Consuming sugar sweetened beverages is prevalent in our country, and excessive intake can induce the occurrence of several diseases. Several studies at home and abroad have reported the association between the intakes of sugar sweetened beverages and the risk of hypertension incidence, but controversy remains on the specific intake dose and the risk of developing the disease. Objective To analyze the dose-response relationship between the intakes of sugar sweetened beverages and the risk of developing hypertension. Methods A computer search of cross-sectional and prospective studies on the association between the intake of sugar sweetened beverages and the risk of developing hypertension was used in databases of CNKI, CQVIP, SinoMed, Wanfang Data, PubMed, EMBase, Cochrane Library, and Web of Science from inception to November 2021. Two reviewers independently extracted data, and evaluated the quality of included studies. Stata 16.0 was used for meta-analysis. Results Sixteen studies with 316 205 subjects were included. Meta-analysis results showed that the intake of sugary drinks increasedthe risk of developing hypertension〔OR=1.12,95%CI（1.10,1.15）,P<0.05 〕. Subgroup analyses revealed showed that a 34% higher risk of incident hypertension was associated with sugar sweetened beverage intake in Asian population [OR = 1.34, 95% CI (1.20, 1.51), P < 0.05], an 11% higher risk of incident hypertension was associated with sugar sweetened beverage intake in North American population [OR = 1.11, 95% CI (1.09, 1.14), P < 0.05], and an 82% higher risk of incident hypertension was associated with sugar sweetened beverage intake in Oceania population [OR = 1.82, 95% CI (1.04, 3.21), P < 0.05], European populations had an 18% increased risk of developing hypertension with sugar sweetened beverage intake [OR = 1.18, 95% CI (1.02, 1.36), P < 0.05]; The 43% increased risk of incident hypertension was associated for minors with sugar sweetened beverage intake [OR = 1.43, 95% CI (1.21, 1.69), P < 0.05] and the 12% increased risk of incident hypertension for adults with sugar sweetened beverage intake [OR = 1.12, 95% CI (1.09, 1.15), P < 0.05]; Individuals with normal body mass index (BMI) had a 12% higher risk of incident hypertension with sugar sweetened beverage intake [OR = 1.12, 95% CI (1.09, 1.15), P < 0.05], overweight individuals had a 17% higher risk of incident hypertension withsugar sweetened beverage intake [OR = 1.17, 95% CI (1.00, 1.38), P < 0.05], and obese individuals had a 19% higher risk of incident hypertension with sugar sweetened beverage intake [OR = 1.19, 95% CI (1.06, 1.34), P < 0.05]. The dose-response analysis resulted in a 16% increased risk of developing hypertension for each additional 1 serving of sugar sweetened beverage intake per day (i.e., 12 ounces,approximately about 340 g or 355 ml), [OR = 1.16, 95% CI (1.13, 1.18), P < 0.05]. Funnel plots of the literature showed basic symmetry, and Begg's test (z = 0.23, P > 0.05) and Egger's test (t = 1.46, P > 0.05) showed no publication bias. Conclusion Sugar sweetened beverage intake increases the risk of developing hypertension, and the risk of developing hypertension is increased by 16% for every additional intake of 1 serving of sugar sweetened beverage per day (i.e., 12 ounces, approximately 340 g or 355 ml), and controlling sugar content is important for the prevention of hypertension.
