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Coffee Consumption and Risk of Stroke: A Dose-Response Meta-Analysis of Prospective Studies
Abstract
Coffee consumption has been inconsistently associated with risk of stroke. The authors conducted a meta-analysis of prospective studies to quantitatively assess the association between coffee consumption and stroke risk. Pertinent studies were identified by searching PubMed and Embase from January 1966 through May 2011 and by reviewing the reference lists of retrieved articles. Prospective studies in which investigators reported relative risks of stroke for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Eleven prospective studies, with 10,003 cases of stroke and 479,689 participants, met the inclusion criteria. There was some evidence of a nonlinear association between coffee consumption and risk of stroke (P for nonlinearity = 0.005). Compared with no coffee consumption, the relative risks of stroke were 0.86 (95% confidence interval (95% CI): 0.78, 0.94) for 2 cups of coffee per day, 0.83 (95% CI: 0.74, 0.92) for 3-4 cups/day, 0.87 (95% CI: 0.77, 0.97) for 6 cups/day, and 0.93 (95% CI: 0.79, 1.08) for 8 cups/day. There was marginal between-study heterogeneity among study-specific trends (I₂ = 12% and I₂ = 20% for the first and second spline transformations, respectively). Findings from this meta-analysis indicate that moderate coffee consumption may be weakly inversely associated with risk of stroke.
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“These meta-analyses did not support an association between coffee consumption and a higher CVD risk, but the shape of the association remains uncertain.”
From Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose–Response Meta-Analysis of Prospective Cohort Studies (2014) · cites this paper as [15]
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“…et al. (1996) was suggested that the relative risk of suicide may be decreased by 13%; otherwise, a reduction of risk of stroke by 10–20% was observed by Larsson and Orsini (2011) and Kim et al. (2012) for every cup of coffee consumed daily, which is rich in diterpenes such as cafestol and kahweol.”
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BackgroundInfluentialSelf-citationAnalysis of diterpenes and diterpenoids
Eksi, G., Kurbanoğlu, S., & Erdem, S. A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816455-6.00009-3 · Cited by 39
Yang, Y., Liu, D.-C., Wang, Q., Long, Q., Zhao, S., Zhang, Z., Ma, Y., Wang, Z., Chen, L., & Wang, L. (2015) · Nutrition · doi:10.1016/j.nut.2015.11.013 · Cited by 38
Ward, N. C., Hodgson, J. M., Woodman, R. J., Zimmermann, D., Poquet, L., Lévèques, A., Actis‐Goretta, L., Puddey, I. B., & Croft, K. D. (2016) · Food & Function · doi:10.1039/c6fo00248j · Cited by 37
Coffee consumption and the risk of cutaneous melanoma: a meta-analysis
Wang, J., Li, X., & Zhang, D. (2015) · European Journal of Nutrition · doi:10.1007/s00394-015-1139-z · Cited by 35
“If the upper boundary of the highest category was not provided, we supposed that the boundary had the same amplitude as the contiguous category [24].”
BackgroundKempf, K., Kolb, H., Gärtner, B., Bytof, G., Stiebitz, H., Lantz, I., Lang, R., Hofmann, T. F., & Martin, S. (2014) · European Journal of Nutrition · doi:10.1007/s00394-014-0763-3 · Cited by 36
“Although there may be a transient increase of blood pressure after drinking coffee containing caffeine [36, 37], most (but not all) studies could not detect a higher risk of cardiovascular disease or stroke, or of overall mortality in habitual coffee drinkers but rather a trend in the opposite direction [37–41].”
Naylor, L. H., Zimmermann, D., Guitard-Uldry, M., Poquet, L., Lévèques, A., Eriksen, B., Rhlid, R. B., Galaffu, N., D’Urzo, C., Castro, A. D., et al. (2020) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa312 · Cited by 33
Coffee consumption and coronary artery calcium in young and middle-aged asymptomatic adults
Choi, Y., Chang, Y., Ryu, S., Cho, J., Rampal, S., Zhang, Y., Ahn, J., Lima, J. A. C., Shin, H. C., & Güallar, E. (2015) · Heart · doi:10.1136/heartjnl-2014-306663 · Cited by 33
Nonlinear dose–response relationship between radon exposure and the risk of lung cancer
Duan, P., Quan, C., Hu, C., Zhang, J., Xie, F., Hu, X., Yu, Z., Gao, B., Liu, Z., Zheng, H., et al. (2014) · European Journal of Cancer Prevention · doi:10.1097/cej.0000000000000066 · Cited by 32
Safety of coffee consumption after myocardial infarction: A systematic review and meta-analysis
Ribeiro, E., Alves, M., Costa, J. N., Ferreira, J. J., Pinto, F. J., & Caldeira, D. (2020) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2020.07.016 · Cited by 32
“, it was shown that moderate coffee consumption may be weakly inversely associated with risk of stroke [30].”
BackgroundCarrieri, P., Protopopescu, C., Marcellin, F., Rosellini, S., Wittkop, L., Esterle, L., Zucman, D., Raffi, F., Rosenthal, É., Poizot‐Martin, I., et al. (2017) · Journal of Hepatology · doi:10.1016/j.jhep.2017.08.005 · Cited by 30
How Can Diet Influence the Risk of Stroke?
Medeiros, F., Casanova, M. D. A., Fraulob, J. C., & Trindade, M. (2012) · International Journal of Hypertension · doi:10.1155/2012/763507 · Cited by 28
“A meta-analysis of 11 prospective studies of 479,689 participants, in which relative risk of stroke for three or more categories of coffee consumption was reported, has concluded that moderate coffee consumption may be weakly inversely associated with risk of stroke [18].”
BackgroundDoes Caffeine Consumption Increase the Risk of New-Onset Atrial Fibrillation?
Abdelfattah, R. S., Kamran, H., Lazar, J., & Kassotis, J. (2018) · Cardiology · doi:10.1159/000489843 · Cited by 28
Krittanawong, C., Tunhasiriwet, A., Wang, Z., Farrell, A. M., Chirapongsathorn, S., Zhang, H., Kitai, T., & Mehta, D. (2020) · European Journal of Preventive Cardiology · doi:10.1177/2047487320908385 · Cited by 29
Lee, J., Lee, J.-E., & Kim, Y. (2017) · Nutrition Journal · doi:10.1186/s12937-017-0232-y · Cited by 27
“Another meta-analysis [12] found that the association between the two was U-shaped.”
BackgroundStroke and food groups: an overview of systematic reviews and meta-analyses
Deng, C., Lu, Q., Gong, B., Li, L., Chang, L., Fu, L., & Zhao, Y. (2017) · Public Health Nutrition · doi:10.1017/s1368980017003093 · Cited by 27
“Y Y N C N Y N Y Y Y Y 7 Larsson and Orsini((27)) NA Y Y Y N Y N Y Y Y Y 8 Mellen et al.”
BackgroundInfluentialChen, Q., Wang, J., Yang, J., Jin, Z., Shi, W., Qin, Y., Yu, F., & He, J. (2014) · International Journal of Cancer · doi:10.1002/ijc.29331 · Cited by 28
“The details of the methods were described by Larsson and Orsini.26,27 The p-value for linearity was calculated by testing the null hypothesis that the coefficient of the second spline was equal to zero.”
MethodQiu, S., Cai, X., Wu, T., Sun, Z., Guo, H., Kirsten, J., Wendt, J., Steinacker, J. M., & Schümann, U. (2020) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-19-1446 · Cited by 26
The association of tea consumption and the risk and progression of prostate cancer: a meta-analysis.
Fei, X., Shen, Y., Li, X., & Guo, H. (2014) · Europe PMC (PubMed Central) · Cited by 25
Caffeine-Containing Medicines Increase the Risk of Hemorrhagic Stroke
Lee, S.-M., Choi, N., Lee, B., Cho, K., Yoon, B., & Park, B. (2013) · Stroke · doi:10.1161/strokeaha.111.674077 · Cited by 25
“association was modest and the biological mechanism remains unclear.(8) In this context, our results suggest that CCMs increased the risk of HS consistently.”
BackgroundResultInfluentialCoffee consumption and risk of heart failure in the Physicians' Health Study
Bodar, V., Chen, J., Sesso, H. D., Gaziano, J. M., & Djoussé, L. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.09.216 · Cited by 24
Coffee Consumption and Cardiovascular Health
Chrysant, S. G. (2015) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2015.05.057 · Cited by 24
Lu, X., Zhu, X., Li, G., Wu, L., Shao, L., Fan, Y., Pan, C., Wu, Y., Borné, Y., & Ke, C. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae552 · Cited by 22
Nutrition in the primary and secondary prevention of stroke
Apostolopoulou, M. I., Michalakis, K. G., Miras, A. D., Hatzitolios, A. I., & Savopoulos, C. G. (2012) · Maturitas · doi:10.1016/j.maturitas.2012.02.006 · Cited by 23
Coffee consumption and risk of nonmelanoma skin cancer: a dose–response meta-analysis
Vaseghi, G., Javanmard, S. H., Naderi, J., Eshraghi, A., Mahdavi, M., & Mansourian, M. (2016) · European Journal of Cancer Prevention · doi:10.1097/cej.0000000000000322 · Cited by 22
“Epidemiological studies have suggested that coffee may prevent cardiovascular disease, cancer-caused mortality (Crippa et al., 2014), type 2 diabetes (Jiang et al., 2014), stroke (Larsson and Orsini, 2011), prostate cancer (Lu et al., 2014), and endometrial cancer (Je et al., 2011).”
Background
Metadata
- Authors
- Larsson, S. C., & Orsini, N.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Larsson, S. C.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-09-13
- Volume
- 174
- Issue
- 9
- Pages
- 993-1001
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2106703328
- Cited by
- 196
- References
- 38
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 15 · 2023: 5 · 2022: 7 · 2021: 9 · 2020: 15 · 2019: 4 · 2018: 11 · 2017: 13 · 2016: 21 · 2015: 25 · 2014: 23 · 2013: 20 · 2012: 11
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Coffee research and impacts
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- coffee consumption, stroke risk, dose-response relationship, nonlinear relationship, caffeine, cardiovascular disease, relative risk
- MeSH terms
- Coffee, Dose-Response Relationship, Drug, Female, Humans, Male, Prospective Studies, Risk, Risk Factors, Stroke
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