News Author: Laurie Barclay, MD

April 25, 2006 — Coffee does not increase the risk for coronary heart disease (CHD) in men or women, according to the results of a large, prospective cohort study reported in the April 24 Rapid Access issue of Circulation.

"We found that coffee consumption was not associated with an increased risk of CHD," lead author Esther Lopez-Garcia, DrPH, from the Universidad Autonoma de Madrid in Spain, said in a news release. "This lack of effect is good news, because coffee is one of the most widely consumed beverages in the world.... The length of follow up is important because it allowed us to examine the long-term effects of coffee consumption."

The study cohort consisted of 44 005 men and 84 488 women without history of cardiovascular disease or cancer. The investigators first evaluated coffee consumption in 1986 for men and in 1980 for women and then repeatedly every 2 to 4 years. During follow-up through 2000, there were 2173 incident cases of CHD in men, including 1449 nonfatal myocardial infarctions and 724 fatal cases of CHD; and 2254 cases in women, including 1561 nonfatal myocardial infarctions and 693 fatal cases of CHD.

After adjustment for age, smoking, and other CHD risk factors, the relative risks (RRs) of CHD for men across categories of cumulative coffee consumption were 1.0 for less than 1 cup/month; 1.04 (95% confidence interval [CI], 0.91 - 1.17) for 1 cup/month to 4 cups/week; 1.02 (95% CI, 0.91 - 1.155 for 7 cups/week; 1.07 (95% CI, 0.88 - 1.31) for 2 to 3 cups/day; 0.97 (95% CI, 0.86 - 1.11) for 4 to 5 cups/day, and 0.72 (95% CI, 0.49 - 1.07) for more than 6 cups/day (P for trend = .41). For women, the corresponding RRs were 1.0, 0.97 (95% CI, 0.83 - 1.14), 1.02 (95% CI, 0.90 - 1.17), 0.84 (95% CI, 0.74 - 0.97), 0.99 (95% CI, 0.83 - 1.17), and 0.87 (95% CI, 0.68 - 1.11; P for trend = .08).

Stratification by smoking status, alcohol consumption, history of type 2 diabetes mellitus, and body mass index did not alter the findings nor did examining the most recent coffee consumption. RRs for quintiles of caffeine intake ranged from 0.97 (95% CI, 0.84 - 1.10) in the second quintile to 0.97 (85% CI, 0.84 - 1.11) in the highest quintile (P for trend = 0.82) in men and from 1.02 (0.90 - 1.16) to 0.97 (0.85 - 1.11; P for trend = 0.37) in women.

"We believe this study clearly shows there is no association between filtered coffee consumption and CHD," Dr. Lopez-Garcia says. "However, because of the modest consumption of non-filtered coffee among participants, this study does not exclude a relationship between high non-filtered consumption and increased CHD risk."

Frequent or heavy coffee consumption was strongly associated with smoking cigarettes, drinking alcohol, and using aspirin and with lower frequency of tea drinking, exercise, and use of multivitamin and vitamin E supplements. Risk for CHD was not significantly different in women who frequently drank decaffeinated coffee and in those who did not. Total cholesterol, low-density and high-density lipoprotein cholesterol levels in men and women coffee drinkers did not differ in those who drank caffeinated or decaffeinated coffee. CHD risk associated with drinking coffee did not differ in people with or without type 2 diabetes.

"We can't exclude the association between coffee consumption and the risk of CHD in small groups of people," says coauthor Rob van Dam, PhD, from Harvard University School of Public Health in Boston, Mass. "For example, a recent study suggested coffee could be detrimental in people with certain genotypes, although that finding requires confirmation."

The National Institutes of Health funded this study. Two authors have disclosed that they are supported by Ministerio de Educacion y Cultura de España, Fondo Social Europeo, and/or the American Heart Association. The authors have disclosed no financial relationships.