Coffee consumption appears to be inversely associated with coronary calcification in women, according to findings published in the May issue of the Arteriosclerosis, Thrombosis, and Vascular Biology. Coffee consumption appears to be inversely associated with coronary calcification in women, according to findings published in the May issue of the Arteriosclerosis, Thrombosis, and Vascular Biology.

"Dietary and lifestyle factors are implicated in the etiology of coronary heart disease (CHD)," Dr. Johanna M. Geleijnse of Wageningen University in the Netherlands and colleagues write. "Coffee is an important dietary factor, because it is one of the most widely used pharmacologically active beverages," they note.

While coffee has been studied along with various risk factors for CHD, its effect on atherosclerosis has not been examined, they note.

To investigate, the researchers evaluated the effects of coffee on coronary calcification in a population-based cohort of 1570 men and women 55 years of age or older without CHD who participated in the Rotterdam Study. A semiquantitative food frequency questionnaire was used to assess coffee intake. Electron beam CT was used to detect coronary calcification. The authors defined severe calcification was an Agatson calcium score of greater than 400.

The authors report that 28 per cent of men and 19 per cent of women smoked. Ninety-eight per cent of both men and women drank coffee. The average daily coffee consumption was higher in men than women (approximately five versus four cups per day, respectively).

The prevalence of coronary calcification was 39 per cent in men and 18 per cent in women (p < 0.001). Results of multivariable analysis revealed that coronary calcification in women was significantly reduced for moderate (> three to four cups) and high (> four cups) coffee intake, compared with a daily intake of three cups or less. The association persisted after adjusting for tea and other dietary factors. The association was not modified by smoking.

In men, an inverse association was also observed between coffee consumption and coronary calcification among men. But these findings were not significant.

"Coffee is a rich source of antioxidants, including polyphenols, and may exert a beneficial effect in the cardiovascular system," Dr. Geleijnse said in an interview with Reuters Health. "Historically, coffee was considered to have adverse effects on health," she said. "However, evidence is now accumulating that regular coffee consumption does not increase the risk of cardiovascular disease, and may prevent diabetes."

"Exceptions are boiled coffee, Turkish coffee, French coffee, and other types of coffee that are prepared without a paper filter," the author noted. "These types of coffee contain diterpenes (kahweol and cafestol) that have an adverse effect on blood cholesterol," she explained. "At present, it can be concluded that regular intake of filtered coffee has no adverse effect on health."

The authors' next step is to identify compounds in coffee that could be responsible for the protective effect against atherosclerosis and diabetes. "Coffee is a main source of phytoestrogens, especially the isoflavones daidzein, genistein, and formononetin," Dr. Geleijnse explained.

"Furthermore, it contains fair amounts of the minerals potassium and magnesium and polyphenols, which are strong antioxidants," she said. "These healthy substances may offset the potential harmful effects of caffeine."

Arterioscler Thromb Vasc Biol 2008;28:1018-1023