title: Coffee consumption and risk of cardiovascular events in hypertensive patients. Results from the HARVEST.
abstract: BACKGROUND
  Controversy still exists about the long-term cardiovascular effects of coffee consumption in hypertension.
  
  
  METHODS
  The predictive capacity of coffee use for cardiovascular events (CVEs) was investigated in 1204 participants from the HARVEST, a prospective cohort study of non-diabetic subjects aged 18-45years, screened for stage 1 hypertension. Subjects were grouped into three categories of coffee drinking, non-drinkers (none), moderate drinkers (1 to 3cups/day) and heavy drinkers (4or more cups/day). Multivariate Cox proportional hazards models were developed adjusting for possible confounding variables and risk factors.
  
  
  RESULTS
  During a median follow-up of 12.6years, CVEs were developed by 60 participants. CVEs were more common among coffee drinkers than abstainers (abstainers, 2.2%; moderate drinkers, 7.0%; heavy drinkers, 14.0%; p for trend=0.0003). In a multivariable Cox regression model, coffee use was a significant predictor of CVE in both coffee categories, with a hazard ratio of 2.8 (95% CI, 1.0-7.9) in moderate coffee drinkers and of 4.5 (1.4-14.2) in heavy drinkers compared to abstainers. After inclusion of change in body weight (p=ns), incident hypertension (p=0.027) and presence of diabetes/prediabetes (p=ns) at follow-up end, the association with CVE was attenuated but remained significant in heavy coffee drinkers (HR, 95% CI, 3.4, 1.04-11.3).
  
  
  CONCLUSIONS
  These data show that coffee consumption increases the risk of CVE in a linear fashion in hypertension. This association may be explained in part by the association between coffee and development of hypertension. Hypertensive patients should be discouraged from drinking coffee.
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy. Electronic address: palatini@unipd.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Palatini
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Fania
authors.affiliation: Town Hospital, San Daniele del Friuli, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Mos
authors.affiliation: Town Hospital, Cremona, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Garavelli
authors.affiliation: Town Hospital, Vittorio Veneto, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Mazzer
authors.affiliation: Town Hospital, Trento, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Cozzio
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Saladini
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Casiglia
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D003069:Coffee / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003069:Coffee
keywords: Caffeine; Cardiovascular; Coffee; Events; Hypertension