title: Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies.
abstract: BACKGROUND
  Considerable controversy exists on the association between coffee consumption and cardiovascular disease (CVD) risk. A meta-analysis was performed to assess the dose-response relationship of long-term coffee consumption with CVD risk.
  
  
  RESULTS
  PubMed and EMBASE were searched for prospective cohort studies of the relationship between coffee consumption and CVD risk, which included coronary heart disease, stroke, heart failure, and CVD mortality. Thirty-six studies were included with 1 279 804 participants and 36 352 CVD cases. A nonlinear relationship of coffee consumption with CVD risk was identified (P for heterogeneity=0.09, P for trend <0.001, P for nonlinearity <0.001). Compared with the lowest category of coffee consumption (median, 0 cups per day), the relative risk of CVD was 0.95 (95% confidence interval, 0.87-1.03) for the highest category (median, 5 cups per day) category, 0.85 (95% confidence interval, 0.80-0.90) for the second highest category (median, 3.5 cups per day), and 0.89 (95% confidence interval, 0.84-0.94) for the third highest category (median, 1.5 cups per day). Looking at separate outcomes, coffee consumption was nonlinearly associated with both coronary heart disease (P for heterogeneity=0.001, P for trend <0.001, P for nonlinearity <0.001) and stroke (P for heterogeneity=0.07, P for trend <0.001, P for nonlinearity <0.001; P for trend differences >0.05) risks.
  
  
  CONCLUSIONS
  A nonlinear association between coffee consumption and CVD risk was observed in this meta-analysis. Moderate coffee consumption was inversely significantly associated with CVD risk, with the lowest CVD risk at 3 to 5 cups per day, and heavy coffee consumption was not associated with elevated CVD risk.
authors.affiliation: Departments of Nutrition (M.D., S.N.B., A.S., R.M.v.D., F.B.H.) and Epidemiology (F.B.H.), Harvard School of Public Health, Boston, MA; Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (R.M.v.D.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.B.H.).
authors.forename: Ming
authors.initials: M
authors.lastname: Ding
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Bhupathiraju
authors.forename: Ambika
authors.initials: A
authors.lastname: Satija
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D003069:Coffee / Q000009:adverse effects*; D003327:Coronary Disease / Q000401:mortality; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D017711:Nonlinear Dynamics; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality
chemical_list: D003069:Coffee
keywords: cardiovascular diseases; coffee; meta-analysis