Caffeinated beverage intake and the risk of heart disease mortality
in the elderly: a prospective analysis1,2
James A Greenberg, Christopher C Dunbar, Roseanne Schnoll, Rodamanthos Kokolis, Spyro Kokolis, and John Kassotis
Background: Motivated by the possibility that caffeine could ame-
liorate the effect of postprandial hypotension on a high risk of cor-
onary events and mortality in aging, we hypothesized that caffein-
ated beverage consumption decreases the risk of cardiovascular
disease (CVD) mortality in the elderly.
exhibits this protective effect.
Design: Cox regression analyses were conducted for 426 CVD
deaths that occurred during an 8.8-y follow-up in the prospective
first National Health and Nutrition Examination Survey Epidemio-
32–86 y with no history of CVD at baseline.
Results: Participants aged ?65 y with higher caffeinated beverage
intake exhibited lower relative risk of CVD and heart disease mor-
was a dose-response protective effect: the relative risk (95% CI) for
heart disease mortality was 1.00 (referent), 0.77 (0.54, 1.10), 0.68
(0.49, 0.94), and 0.47 (0.32, 0.69) for ?0.5, 0.5–2, 2–4, and ?4
servings/d, respectively (P for trend ? 0.003). A similar protective
was found only in participants who were not severely hypertensive.
No significant protective effect was found in participants aged ?65
y or in cerebrovascular disease mortality for those aged ?65 y.
tection against the risk of heart disease mortality among elderly
participants in this prospective epidemiologic analysis.
Clin Nutr 2007;85:392–8.
ease, coffee, heart disease, mortality risk
Previous epidemiologic studies of the relation between caf-
feinated beverage intake and the risk of cardiovascular disease
(CVD) have yielded conflicting results (1–3). It is possible that
the conflict is due to differences between nonelderly and elderly
persons. One study found that coffee drinking increased the risk
increasing age (4). In addition, elderly persons are more likely
sion (5, 6), which has been found to predict coronary events and
effect, which involves increases in blood pressure (BP). The
ated beverages could reduce the risk of CVD and heart disease
mortality, especially in elderly persons with low BP. A prospec-
tive survival analysis was conducted to assess the risk of CVD
erage intake and at different levels of blood pressure.
SUBJECTS AND METHODS
Data from a prospective follow-up study, the first National
Health and Nutrition Examination Survey (NHANES I) Epide-
miologic Follow-Up Study (NHEFS), were used for the study.
NHANES I, a probability sample survey of the noninstitution-
(11). The NHEFS is a follow-up study of those NHANES I
participants aged 25–74 y (n ? 14 407). NHEFS contains 4
follow-up surveys, conducted in 1982–1984, 1986, 1987, and
1992. The baseline data used in the current study were obtained
I survey and at the first follow-up survey in 1982–1984 (12).
Participants with any missing data and those with a self-
reported history of CVD in 1982–1984 were excluded from the
deaths that occurred during the subsequent follow-up, which
lasted an average of 8.8 y for censored participants.
Our procedures were in accordance with the ethical standards
of our institution’s committee on human experimentation. We
obtained approval for the use of the NHEFS data.
NY (JAG, CCD, and RS), and the Department of Cardiology, State Univer-
2Reprints not available. Address correspondence to JA Greenberg, De-
partment of Health and Nutrition Sciences, Brooklyn College of the City
University of New York, 2900 Bedford Avenue, Brooklyn, NY 11210.
Received August 3, 2006.
Accepted for publication September 20, 2006.
Am J Clin Nutr 2007;85:392–8. Printed in USA. © 2007 American Society for Nutrition
by guest on June 3, 2013
a valid basis for recommending increased consumption of caf-
feinated beverage. Our findings require confirmation in future
epidemiologic, metabolic, and clinical trial studies.
In conclusion, our analysis of the prospective NHEFS data
showed that habitual intake of caffeinated beverages provides
finding was obtained only in nonhypertensive elderly partici-
The original source of the NHEFS data is the National Center for Health
Statistics (NCHS); the Inter-University Consortium on Political and Social
Research (ICPSR) provided the data. Neither NCHSR nor ICPSR is respon-
sible for this report, which is the work of the authors, who appreciate being
able to obtain and work with the data.
of the caffeinated beverages studies; JAG conducted the statistical analyses;
JAG wrote the manuscript; and JAG, CCD, JK, RK, and SK contributed to
revisions of the manuscript. We appreciate the constructive comments of
several anonymous Journal reviewers, which helped us improve the manu-
script. None of the authors had any personal or financial conflict of interest.
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