Abstract
BACKGROUND: Green tea and black tea have shown beneficial effects on cardiovascular health, and they are recommended for the prevention of cardiovascular disease (CVD) events. However, the impact of herbal tea on cardiovascular health remains unclear. This study aims to evaluate the potential benefits of herbal tea consumption in reducing the risk of incident CVD events in the general population. METHODS: Data for this study were derived from the Multi-Ethnic Study of Atherosclerosis (MESA). The primary outcome was incident CVD events, while secondary outcomes included all-cause and cardiovascular mortality. Cox proportional hazards regression models were used to examine the relationship between herbal tea consumption and the risk of incident CVD events. Kaplan-Meier survival curves were employed to assess the timing of incident CVD events, all-cause mortality and cardiovascular mortality. RESULTS: A total of 4711 participants were included in the analysis, with 1834 (38.9%) in the herbal tea group and 2877 (61.1%) in the control group. Over a median follow-up of 14.1 years, 547 participants (11.61%) experienced new-onset CVD events. The herbal tea group had a significantly lower incidence of new-onset CVD events (9.0% vs. 13.3%, p < 0.001), all-cause mortality (5.1% vs. 8.8%, p < 0.001), and cardiovascular mortality (1.4% vs. 2.5%, p = 0.01) compared to the control group. Multivariate Cox regression analysis revealed that herbal tea consumption was independently associated with a lower risk of incident CVD events [HR 0.83, 95% CI (0.69–0.997), p = 0.046] and all-cause mortality [HR 0.76, 95% CI (0.60–0.97), p = 0.03]. Kaplan-Meier analysis confirmed that participants in the herbal tea group had a significantly lower risk of incident CVD events, as well as lower all-cause and cardiovascular mortality. Secondary analyses indicated that moderate frequency herbal tea consumption (2 cups/month to 2 cups/week) and consistent consumption were associated with the most pronounced cardiovascular benefits. CONCLUSIONS: This study demonstrated that herbal tea consumption was associated with a lower risk of incident CVD events, as well as reduced all-cause and cardiovascular mortality. These benefits were especially evident among individuals who consumed herbal tea at a moderate frequency and maintained consistent intake over time. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12937-025-01196-4.