Caffeinated beverage intake and the risk of heart disease mortality in the elderly: a prospective analysis

Background: Motivated by the possibility that caffeine could ameliorate the effect of postprandial hypotension on a high risk of coronary events and mortality in aging, we hypothesized that caffeinated beverage consumption decreases the risk of cardiovascular disease (CVD) mortality in the elderly. Objective: The objective of the study was to use prospective cohort study data to test whether the consumption of caffeinated beverages exhibits this protective effect. Design: Cox regression analyses were conducted for 426 CVD deaths that occurred during an 8.8-y follow-up in the prospective first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. The analysis involved 6594 participants aged 32-86 y with no history of CVD at baseline. Results: Participants aged >= 65 y with higher caffeinated beverage intake exhibited lower relative risk of CVD and heart disease mortality than did participants with lower caffeinated beverage intake. It was a dose-response protective effect: the relative risk (95% CI) for heart disease mortality was 1.00 (referent), 0.77 (0.54, 1.10), 0.68 (0.49, 0.94), and 0.47 (0.32, 0.69) for < 0.5, 0.5-2, 2-4, and >= 4 servings/d, respectively (P for trend = 0.003). A similar protective effect was found for caffeine intake in mg/d. The protective effective was found only in participants who were not severely hypertensive. No significant protective effect was found in participants aged < 65 y or in cerebrovascular disease mortality for those aged 65 y. Conclusion: Habitual intake of caffeinated beverages provided protection against the risk of heart disease mortality among elderly participants in this prospective epidemiologic analysis.