Coffee consumption and total mortality: a meta-analysis of twenty prospective cohort studies

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Abstract

Coffee consumption has been shown to be associated with various health outcomes, but no comprehensive review and meta-analysis of the association between coffee consumption and total mortality has been conducted. To quantitatively assess this association, we conducted a meta-analysis of prospective cohort studies. Eligible studies were identified by searching the PubMed and EMBASE databases for all articles published through June 2013 and reviewing the reference lists of the retrieved articles. Pooled relative risks (RR) with 95 % CI were calculated using a random-effects model. We identified twenty studies of coffee consumption and total mortality, including 129 538 cases of deaths among the 973 904 participants. The RR of total mortality for the high v. low category of coffee consumption was 0·86 (95 % CI 0·80, 0·92). The pooled RR for studies using ≥ 2–4 cups/d as a cut-off for the high category was similar to that for studies using ≥ 5–9 cups/d as the cut-off. By geographical region, the inverse association tended to be stronger for the eight studies conducted in Europe (RR 0·78, 95 % CI 0·70, 0·88) and three studies carried out in Japan (RR 0·82, 95 % CI 0·73, 0·92) than for the nine studies conducted in the USA (RR 0·92, 95 % CI 0·84, 1·00). The inverse association was similar for men (RR 0·81, 95 % CI 0·73, 0·90) and women (RR 0·84, 95 % CI 0·79, 0·89). A weak, but significant, inverse association was found with moderate coffee consumption (1–2 cups/d; RR 0·92, 95 % CI 0·87, 0·98). High decaffeinated coffee consumption was also found to be associated with a lower risk of death, but the data are limited. Our findings indicate that coffee consumption is associated with a reduced risk of total mortality.

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Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials.

Marlies Noordzij, Cuno Uiterwaal, Lidia Arends … (2005)

Coffee is a widely consumed beverage and small health effects of substances in coffee may have large public health consequences. It has been suggested that caffeine in coffee increases the risk of hypertension. We performed a meta-analysis of randomized controlled trials of coffee or caffeine and blood pressure (BP). BP trials of coffee or caffeine published between January 1966 and January 2003 were identified through literature databases and manual search. A total of 16 studies with a randomized, controlled design and at least 7 days of intervention was selected, comprising 25 strata and 1010 subjects. Two persons independently obtained data on sample size, type and duration of intervention, changes in BP and heart rate (HR), and subjects' characteristics for each trial. Meta-analysis was performed using a random-effects model. A significant rise of 2.04 mmHg [95% confidence interval (CI), 1.10-2.99] in systolic BP and 0.73 mmHg (95% CI, 0.14-1.31) in diastolic BP was found after pooling of coffee and caffeine trials. When coffee trials (n = 18, median intake: 725 ml/day) and caffeine trials (n = 7, median dose: 410 mg/day) were analysed separately, BP elevations appeared to be larger for caffeine [systolic: 4.16 mmHg (2.13-6.20); diastolic: 2.41 mmHg (0.98-3.84)] than for coffee [systolic: 1.22 mmHg (0.52-1.92) and diastolic: 0.49 mmHg (-0.06-1.04)]. Effects on HR were negligible. Regular caffeine intake increases BP. When ingested through coffee, however, the blood pressure effect of caffeine is small.

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Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women's Health Study.

Lene Andersen, David R Jacobs, Monica H Carlsen … (2006)

Coffee is the major source of dietary antioxidants. The association between coffee consumption and risk of death from diseases associated with inflammatory or oxidative stress has not been studied. We studied the relation of coffee drinking with total mortality and mortality attributed to cardiovascular disease, cancer, and other diseases with a major inflammatory component. A total of 41,836 postmenopausal women aged 55-69 y at baseline were followed for 15 y. After exclusions for cardiovascular disease, cancer, diabetes, colitis, and liver cirrhosis at baseline, 27,312 participants remained, resulting in 410,235 person-years of follow-up and 4265 deaths. The major outcome measure was disease-specific mortality. In the fully adjusted model, similar to the relation of coffee intake to total mortality, the hazard ratio of death attributed to cardiovascular disease was 0.76 (95% CI: 0.64, 0.91) for consumption of 1-3 cups/d, 0.81 (95% CI: 0.66, 0.99) for 4-5 cups/d, and 0.87 (95% CI: 0.69, 1.09) for > or =6 cups/d. The hazard ratio for death from other inflammatory diseases was 0.72 (95% CI: 0.55, 0.93) for consumption of 1-3 cups/d, 0.67 (95% CI: 0.50, 0.90) for 4-5 cups/d, and 0.68 (95% CI: 0.49, 0.94) for > or =6 cups/d. Consumption of coffee, a major source of dietary antioxidants, may inhibit inflammation and thereby reduce the risk of cardiovascular and other inflammatory diseases in postmenopausal women.

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The blood pressure-lowering effect and safety of chlorogenic acid from green coffee bean extract in essential hypertension.

Wataru Okawa, Y Kajihara, Tatsuya Kusaura … (2006)

Chlorogenic acids (CGA) in green coffee bean extract (GCE) reduce blood pressure in spontaneously hypertensive rats and humans. The authors examined the blood pressure-lowering effect and safety of CGA in patients with mild hypertension through a placebo-controlled, randomized clinical trial. Subjects (n = 28) were randomized to receive treatment with CGA (140 mg/day) from GCE or placebo. Blood pressure, pulse rate, body mass index, routine blood test, hematochemistry, urinalysis, and subjective symptoms were recorded throughout the study. In the CGA group, but not the placebo group, blood pressure (systolic and diastolic) decreased significantly during the ingestion period. There was no difference in body mass index and pulse rate between groups, nor were there any apparent side effects. Thus, CGA from GCE is effective in decreasing blood pressure and safe for patients with mild hypertension.