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Study Title and Description

Coffee consumption and risk of stroke in women.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on cardiovascular outcomes?
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Primary Publication Information
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TitleData
Title Coffee consumption and risk of stroke in women.
Author SC Larsson,J Virtamo,A Wolk,
Country
Year 2011
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Cardiovascular Design
Design Details
Question... Follow Up Answer Follow-up Answer
What outcome is being evaluated in this paper? Cardiovascular
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What is the objective of the study (as reported by the authors)? We investigated the association between coffee consumption and stroke incidence in the Swedish Mammography Cohort.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Coffee consumption was assessed using a self-administered foodf requency questionnaire that included 96 foods and beverages. For coffee, participants were asked to indicate how many cups of coffee per day or per week they consumed during the past year. The questionnaire did not inquire about the type of coffee consumed (eg, regular or decaffeinated coffee) because consumption of decaffeinated coffee in the Swedish population is very low. In our validation study, the Pearson correlation coefficient between the food frequency questionnaire and the mean of 4 1-week diet records was 0.6 for coffee (A. Wolk, unpublished data). Incident cases of first stroke that occurred between January 1, 1998, and December 31, 2008, were ascertained by linkage of the study cohort with the Swedish Hospital Discharge Registry, which provides almost complete coverage of the discharges. The International Classification of Diseases, 10th Revision, was used to identify stroke events. The stroke events were classified as cerebral infarction (International Classification of Diseases, 10th Revision, code I63), intracerebral hemorrhage (I61), subarachnoid hemorrhage (I60), and unspecified stroke (I64). Information on dates of death was obtained from the Swedish Cause of Death Registry.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Incidence of stroke
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List additional health endpoints (separately). 2
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List additional health endpoints (separately).3
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List additional health endpoints (separately).4
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List additional health endpoints (separately).5
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List additional health endpoints (separately).6
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Clinical, physiological, other Clinical
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What is the study design? Cohort
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description Incident cases of first stroke that occurred between January 1, 1998, and December 31, 2008, were ascertained by linkage of the study cohort with the Swedish Hospital Discharge Registry, which provides almost complete coverage of the discharges. The International Classification of Diseases, 10th Revision, was used to identify stroke events. The stroke events were classified as cerebral infarction (International Classification of Diseases, 10th Revision, code I63), intracerebral hemorrhage (I61), subarachnoid hemorrhage (I60), and unspecified stroke (I64). Information on dates of death was obtained from the Swedish Cause of Death Registry.
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Caffeine (general)
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Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other? Coffee
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Measured or self reported? Self-report
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Children, adolescents, adults, or pregnant included? Adults
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) < 1 cup/coffee per day
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) We adjusted for diabetes by stratification in the Cox model. The multivariable model included the following variables: smoking status and pack-years of smoking (never; past _20, 20 to 39, or _40 pack-years; or current _20, 20 to 39, or _40 pack-years); education (less than high school, high school, or university); body mass index (_20, 20 to 24.9, 25 to 29.9, or _30 kg/m2); total physical activity (metabolic equivalent hours/day, quartiles); self-reported history of hypertension (yes or no); aspirin use (yes or no); family history of myocardial infarction before 60 years of age (yes or no); intakes of total energy (kcal/day, continuous variable) and alcohol (nondrinkers or <3.4, 3.4 to 9.9, or >/-10.0 g/day); and quartiles of red meat, fish, fruits, and vegetables. Tests for trends across categories were conducted by modeling coffee consumption as a continuous variable using the median value of each category of coffee. We conducted stratified analyses to assess whether the association of coffee consumption with stroke risk was modified by smoking status (never/past or current), body mass index (<30 or >/-30 kg/m2), diabetes (yes or no), hypertension (yes or no), and alcohol consumption (abstainer or drinker). To test the statistical significance of interactions on a multiplicative scale, we used the log likelihood ratio test comparing the models with or without interaction terms.
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What conflicts of interest were reported? Authors reported they had none.
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Refid 21393590
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What were the sources of funding? This study was supported by research grant from the Swedish Council for Working Life and Social Research (FAS) and the Swedish Research Council for Infrastructure.
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Results & Comparisons

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