Coffee consumption and the risk of coronary heart disease and death

Objectives: To study prospectively the relation of coffee drinking with fat al and nonfatal coronary heart disease (CHD) and all-cause mortality and to perform a cross-sectional analysis at baseline on the association between coffee drinking and CHD risk factors, diagnosed diseases, self-reported sym ptoms, and use of medicines. Methods: The study cohort consisted of 20179 randomly selected eastern Finn ish men and women aged 30 to 59 years who participated in a cross-sectional risk factor survey in 1972, 1977, or 1982. Habitual coffee drinking, healt h behavior, major known CHD risk factors, and medical history were assessed at the baseline examination. Each subject was followed up for 10 years aft er the survey using the national hospital discharge and death registers. Mu ltivariate analyses were performed by using the Cox proportional hazards mo del. Results: In men, the risk of nonfatal myocardial infarction was not associa ted with coffee drinking. The age-adjusted association of coffee drinking w as J shaped with CHD mortality and U shaped with all-cause mortality. The h ighest CHD mortality was found among those who did not drink coffee at all (multivariate adjusted). Alsb, in women, all-cause mortality decreased by i ncreasing coffee drinking; The prevalence of smoking and the mean level of serum cholesterol increased with increasing coffee drinking. Non-coffee dri nkers more often reported a history of various diseases and symptoms, and t hey also more frequently used several drugs compared with coffee drinkers. Conclusions: Coffee drinking does not increase the risk of CHD or death. In men, slightly increased mortality from CHD and all causes in heavy coffee drinkers is largely explained by the effects of smoking and a high serum ch olesterol level.