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Title: Associations of coffee, tea, and caffeine intake with coronary artery calcification and cardiovascular events

Author
item MILLER, P - National Institutes Of Health (NIH)
item ZHAO, DI - Johns Hopkins School Of Public Health
item FRAZIER-WOOD, ALEXIS - Children'S Nutrition Research Center (CNRC)
item MICHOS, ERIN - Johns Hopkins University School Of Medicine
item AVERILL, MICHELLE - University Of Washington
item SANDFORT, VEIT - National Institutes Of Health (NIH)
item BURKE, GREGORY - Wake Forest School Of Medicine
item POLAK, JOSEPH - Tufts University
item LIMA, JOAO - Johns Hopkins University School Of Medicine
item POST, WENDY - Johns Hopkins University School Of Medicine
item BLUMENTHAL, ROGER - Johns Hopkins University School Of Medicine
item GUALLAR, ELISEO - Johns Hopkins University School Of Medicine
item MARTIN, SETH - Johns Hopkins University School Of Medicine

Submitted to: American Journal of Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/10/2016
Publication Date: 2/1/2017
Citation: Miller, P.E., Zhao, D., Frazier-Wood, A.C., Michos, E.D., Averill, M., Sandfort, V., Burke, G.L., Polak, J.F., Lima, J.A., Post, W.S., Blumenthal, R.S., Guallar, E., Martin, S.S. 2017. Associations of coffee, tea, and caffeine intake with coronary artery calcification and cardiovascular events. American Journal of Medicine. 130(2):188-197.

Interpretive Summary: Coffee and tea are two of the most commonly consumed beverages in the world. The problem is that it is not clear if tea and coffee are good for overall health, since the association of coffee and tea intake with coronary artery calcium (a risk factor for heart disease) and major adverse cardiovascular events remains uncertain. We examined data in a group of ethnically diverse adults and found that over 5.3 years for people who regularly drank tea (>=1 cup per day) had a slower progression of coronary artery calcium compared with never drinkers. Over 11.1 years these same people also had a lower incidence of cardiovascular events. Coffee intake was not associated with coronary artery calcium progression or cardiovascular events. This research is important since it suggests that moderate tea drinking may convey some protection against the progression of coronary artery calcium and also a reduced risk for cardiovascular events.

Technical Abstract: Coffee and tea are 2 of the most commonly consumed beverages in the world. The association of coffee and tea intake with coronary artery calcium and major adverse cardiovascular events remains uncertain. We examined 6508 ethnically diverse participants with available coffee and tea data from the Multi-Ethnic Study of Atherosclerosis. Intake for each was classified as never, occasional (<1 cup per day), and regular (>=1 cup per day). A coronary artery calcium progression ratio was derived from mixed effect regression models using loge (calcium score+1) as the outcome, with coefficients exponentiated to reflect coronary artery calcium progression ratio versus the reference. Cox proportional hazards analyses were used to evaluate the association between beverage intake and incident cardiovascular events. Over a median follow-up of 5.3 years for coronary artery calcium and 11.1 years for cardiovascular events, participants who regularly drank tea (>=1 cup per day) had a slower progression of coronary artery calcium compared with never drinkers after multivariable adjustment. This correlated with a statistically significant lower incidence of cardiovascular events for >=1 cup per day tea drinkers (adjusted hazard ratio 0.71; 95% confidence interval 0.53-0.95). Compared with never coffee drinkers, regular coffee intake (>=1 cup per day) was not statistically associated with coronary artery calcium progression or cardiovascular events (adjusted hazard ratio 0.97; 95% confidence interval 0.78-1.20). Caffeine intake was marginally inversely associated with coronary artery calcium progression. Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake.