Coffee Consumption and Coronary Artery Calcium | Journal Scan

Study Questions:

What is the association between regular coffee consumption and the prevalence of coronary artery calcium (CAC) in a large sample of young and middle-aged asymptomatic men and women?


The cross-sectional study included 25,138 men and women without clinically evident cardiovascular disease who underwent a health screening examination in South Korea that included a validated food frequency questionnaire and a computed tomography to determine CAC scores. Tobit regression analyses were used to estimate the CAC score ratios associated with different levels of coffee consumption compared with no coffee consumption, and adjusted for potential confounders. CAC score ratios represent the ratio of the geometric means of CAC scores comparing each category of coffee consumption to the group with no coffee consumption.


The average age of study participants was 41.3 ± 7.5 years, and 83.7% were male. The prevalence of detectable CAC (CAC score >0) was 13.4% (n = 3,364), including 11.3% prevalence for CAC scores 1–100 (n = 2,832), and 2.1% prevalence for CAC scores >100 (n = 532). The mean ± standard deviation consumption of coffee was 1.8 ± 1.5 cups/day. The multivariate-adjusted CAC score ratios (95% confidence intervals) comparing coffee drinkers of <1, 1–<3, 3–<5, and ≥5 cups/day to noncoffee drinkers were 0.77 (0.49-1.19), 0.66 (0.43-1.02), 0.59 (0.38-0.93), and 0.81 (0.46-1.43), respectively (p for quadratic trend = 0.02). The association was similar in subgroups defined by age, sex, smoking status, alcohol consumption, status of obesity, diabetes, hypertension, and hypercholesterolemia.


In this large sample of men and women apparently free of clinically evident cardiovascular disease, moderate coffee consumption was associated with a lower prevalence of subclinical coronary atherosclerosis.


The results in this young and low-risk cohort are not generalizable, nor does it establish causality between coffee and reduced CAC. Further, the CAC score versus coffee consumption 10-20 years later may differ since high coffee drinkers also had higher fasting serum glucose, glycated hemoglobin, cholesterol, triglycerides, and low-density lipoprotein cholesterol, and lower high-density lipoprotein cholesterol and systolic blood pressure, and a higher consumption of total energy, red and processed meats, alcohol, and a lower consumption of fruits and vegetables.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Noninvasive Imaging, Prevention, Atherosclerotic Disease (CAD/PAD), Homozygous Familial Hypercholesterolemia, Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Diet, Hypertension, Smoking

Keywords: Atherosclerosis, Alcohol Drinking, Blood Pressure, Calcium, Cholesterol, Cholesterol, LDL, Cholesterol, HDL, Coffee, Coronary Artery Disease, Cross-Sectional Studies, Diabetes Mellitus, Dyslipidemias, Fasting, Hypercholesterolemia, Glucose, Hypertension, Lipoproteins, HDL, Lipoproteins, LDL, Middle Aged, Regression Analysis, Obesity, Prevalence, Primary Prevention, Smoking, Tomography, Triglycerides

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