Coffee consumption and risk of cardiovascular events in hypertensive patients. Results from the HARVEST

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 18-45 years, screened for stage 1 hypertension. Subjects were grouped into three categories of coffee drinking, nondrinkers (none), moderate drinkers (1 to 3 cups/day) and heavy drinkers (4 or 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 12.6 years, 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.