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American Journal of Epidemiology Vol. 132, No. 3: 479-488
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health

research-article

COFFEE USE PRIOR TO MYOCARDIAL INFARCTION RESTUDIED: HEAVIER INTAKE MAY INCREASE THE RISK

ARTHUR L. KLATSKY1,, GARY D. FRIEDMAN2 and MARY ANNE ARMSTRONG2

1Division of Cardiology, Department of Medicine, Kaiser Permanente Medical Center Oakland, CA
2Division of Research, Kaiser Permanente Medical Care Program Oakland, CA

Reprint requests to Dr. Arthur L. Klatsky, Division of Cardiology, Department of Medicine, Kaiser Permanente Medical Center, 280 West MacArthur Boulevard, Oakland, CA 94611

Because of conflicting evidence about the relation of coffee use to coronary artery disease, the authors conducted a new cohort study of hospitalizations among 101,774 white persons and black persons admitted to Kaiser Permanente hospitals in northern California in 1978–1986. In analyses controlled for eight covariates, use of coffee was associated with higher risk of myocardial infarction (p=0.0002). Compared with nondrinkers of coffee, the following relative risks (RRs) were found: at 1–3 cups/day, RR=1.14 (95% confidence interval (Cl) 0.91–1.42); at 4–6 cups/day, RR=1.42 (Cl 1.10–1.84), p=0.007; and at >6 cups/day, RR=1.41 (Cl 1.00–1.99), p=0.05. The relation remained significant when also controlled for blood cholesterol, blood glucose, blood pressure, and adiposity, singly or combined. Tea use was unrelated to myocardial infarction; neither coffee nor tea was related to other coronary diagnoses. Although causality remains unestablished and uncertainty remains, the authors conclude that 1) these data suggest a weak independent relation of coffee use to acute myocardial infarction, not mediated by an effect on blood cholesterol; and 2) persons at risk of myocardial infarction should consider limitation of coffee intake to <4 cups/day.

caffeine; coffee; coronary disease; myocardial infarction; risk; tea


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