Review
Impact of Sugar-Sweetened Beverages on Blood Pressure

https://doi.org/10.1016/j.amjcard.2014.01.437Get rights and content

The impact of sugar-sweetened beverages (SSBs) on blood pressure (BP) has been debated, with some evidence suggesting that their increased intake is related to higher risk of developing hypertension. We conducted a systematic review exploring the relation between consumption of SSB and BP. A comprehensive search in 5 electronic databases along with a bibliography search was performed. The keywords “sugar sweetened beverages,” “sugary drinks,” “added sugars,” “blood pressure,” and “hypertension” were indexed in all combinations. Studies were included that reported the effects of intake of SSBs on BP. We excluded studies with <100 subjects and those involving subjects aged <12 years. Of 605 potentially relevant studies, a total of 12 studies (409,707 participants) met our inclusion criteria; 6 were cross sectional studies, whereas the rest were prospective cohort studies. All 12 studies showed positive relation between increased SSB intake and hypertension; however, statistical significance was reported in 10 of these studies. Of the 12 studies, 5 reported an increase in mean BP whereas 7 reported an increase in the incidence of high BP. In conclusion, our systematic review shows that the consumption of SSBs is associated with higher BP, leading to increased incidence of hypertension. Restriction on SSB consumption should be incorporated in the recommendations of lifestyle modifications for the treatment of hypertension. Interventions to reduce intake of SSBs should be an integral part of public health strategy to reduce the incidence of hypertension.

Section snippets

Methods

We searched MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Allied and Complementary Medicine Database, and PsycINFO to identify all the relevant studies up to August 2013. The detailed search strategy is explained in the Appendix. The keywords “sugar sweetened beverages,” “sugary drinks,” “added sugars,” “blood pressure,” and “hypertension” were indexed in all combinations for original reports and clinical studies including cross-sectional studies, observational studies,

Results

We identified a total of 918 reports in electronic databases. A manual search performed through the reference lists of relevant reviews and reports yielded 7 additional studies. Detailed schema is explained in preferred reporting items for systematic reviews and meta-analyses diagram (Figure 1). After deduplication and title and abstract screening of 605 reports, we retrieved 21 potential full-text reports for in-depth evaluation. On full-text review 9 of these articles were excluded for

Discussion

Overall, none of the studies showed a beneficial effect on BP from SSB consumption. In general, even by the most conservative estimate, intake of >12 fl oz of SSB per day can increase the risk of having hypertension by at least 6%, and it can increase mean SBP by a minimum of 1.8 mm Hg in roughly over 18 months. This can be very significant at a population level. In the past, a modest reduction in SBP at a population level has been proven to translate into substantial reductions in deaths from

Disclosures

The authors have no conflicts of interest to disclose.

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