Nutritional Epidemiology (http://www.nutrition.org/cgi/content/full/134/9/2381)Coffee Drinking Is Dose-Dependently Related to the Risk of Acute Coronary Events in Middle-Aged Men1© 2004 The American Society for Nutritional Sciences J. Nutr. 134:2381-2386, September 2004Nutritional Epidemiology (http://www.nutrition.org/cgi/content/full/134/9/2381)Coffee Drinking Is Dose-Dependently Related to the Risk of Acute Coronary Events in Middle-Aged Men1 Pertti Happonen*,2, Sari Voutilainen and Jukka T. Salonen*, ,**, * Department of Public Health and General Practice and Research Institute of Public Health, University of Kuopio, Kuopio, Finland; ** Inner Savo Health Centre, Suonenjoki, Finland; and Oy Jurilab Ltd., Kuopio, Finland ABSTRACT: Heavy coffee consumption has been associated with increased coronary heart disease (CHD) risk although many studies have not observed any relation. We studied the effect of coffee consumption, assessed with a 4-d food record, on the incidence of nonfatal acutemyocardial infarction or coronary death in a cohort of 1971 men who were 42 to 60 y old and free of symptomatic CHD at baseline in 1984–1989. During a mean follow-up of 14 y, 269 participants experienced an acute coronary event. After adjustment for age, smoking, exercise ischemia, diabetes, income, and serum insulin concentration, the rate ratios (95% CIs) in daily nondrinkers and light (375 mL or less), moderate (reference level), and heavy (814 mL or more) drinkers were 0.84 (0.41–1.72), 1.22 (0.90–1.64), 1.00, and 1.43 (1.06–1.94 … the brewing method (boiling vs. filtering) (had no) impact on the risk estimates for coffee intake. In conclusion, heavy coffee consumption increasesthe short-term risk of acute myocardial infarction or coronary death, independent of the brewing method or currently recognized risk factors for CHD. BACKGROUNDIn the past 40 y, a suspected association between coffee drinking and coronary heart disease (CHD) was extensively studied but the evidence remains equivocal. A study of 45,589 men followed up for 2 y concluded that caffeinated coffee, as currently consumed by men in the United States, causes no substantial increase in the risk of CHD (1). Likewise, there was no evidence of a positive association between coffee consumption and 10-y incidence of CHD in a cohort of 85,747 middle-aged U.S. women (2). Two earlier U.S. studies, however, indicated that men drinking 5 or more cups of coffee daily had a 2-fold risk of myocardial infarction (3) or CHD (4); the risk was 3-fold among those drinking 10 cups or more (3) compared with nondrinkers. We examined the dose-response relationship of the consumption of caffeine-containing coffee with the incidence of acute myocardial infarction or death from CHD in a cohort ofmiddle-aged eastern Finnish men initially free from symptomatic
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