Citrus fruit juice and cardiovascular disease.

Total cardiovascular disease: Data about the relation with total cardiovascular disease was provided by 3 cohorts. No associations of citrus fruit juice (10), or 100% orange juice (36) were found with CVD risk.

Coronary heart disease: Data about the relation with coronary heart disease was provided by 2 cohorts (10). No associations were found.

Stroke: Data about the relation with stroke was provided by 3 cohorts. A significant protective effect of citrus fruit juice against ischemic stroke risk was found from pooled results of 2 cohorts, but stratified analysis showed the association was found among women only (10). No association of orange juice was found with stroke mortality (17).
Effect modification: Pooled results from 2 cohorts (10) showed a significant protective effect of citrus fruit juice among non-users of multivitamin supplements (RR = 0.72).

Conclusion: A significant protective effect of citrus fruit juice against ischemic stroke risk was found from pooled results of 2 cohorts of moderate-large size, but this association was restricted to non users of vitamin supplements. Citrus fruit juice possibly protects against ischemic stroke risk among non users of vitamin supplements (- 28%). No level of consumption could be defined for this effect.