Advanced Search

Study Preview



Study Title and Description

Coffee and tea consumption are inversely associated with mortality in a multiethnic urban population.



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?
  • Comments Comments (
    0
    ) |

Primary Publication Information
  • Comments Comments (
    0
    ) |
TitleData
Title Coffee and tea consumption are inversely associated with mortality in a multiethnic urban population.
Author H Gardener,T Rundek,CB Wright,MS Elkind,RL Sacco,
Country
Year 2013
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
  • Comments Comments (
    0
    ) |
What is the objective of the study (as reported by the authors)? Coffee and tea are commonly consumed beverages. Inverse associations with mortality have been suggested for coffee and tea, but the relationships with cause-specific mortality are not well understood. We examined regular and decaffeinated coffee and tea in relation to mortality due to all causes, vascular, nonvascular, and cancer in the multi-ethnic, prospective, population-based Northern Manhattan Study.
  • Comments Comments (
    0
    ) |
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) Study population. NOMAS is a prospective cohort study designed to determine the incidence and risk factors for vascular outcomes in a multi-ethnic urban population. Study details have been published (28). Eligible participants had never been diagnosed with stroke, were >40 y old, and resided in Northern Manhattan for >/=3 mo in a household with a telephone. Participants were identified by random-digit dialing and recruited from the telephone sample to have an in-person interview and assessment. The enrollment response rate was 75% for a total of 3298 participants, with an average annual contact rate of 95%. Participants with a previous myocardial infarction (MI) (n = 201) or cancer diagnosis (n = 303) and those without information on coffee or tea consumption (n = 333) were excluded. Standardized questions were adapted from the Behavioral Risk Factor Surveillance System by the CDC regarding hypertension, diabetes, smoking, and cardiac conditions (30). Measurement of blood pressure and fasting blood specimens for glucose and lipids and the definitions of hypertension, hypercholesterolemia, diabetes, moderate-heavy physical activity, and moderate alcohol use have been described (31,32). Coffee and tea consumption. At baseline, participants were administered a modified Block National Cancer Institute FFQ by trained bilingual research assistants (33). The questionnaire contained questions regarding the average consumption of decaffeinated coffee, regular (caffeinated) coffee, and tea (hot or iced). For this study, instances of intake referred to the consumption of approximately one medium cup. The possible responses were: never or <1/mo, 1–3/mo, 1/wk, 2–4/wk, 5–6/wk, 1/d, 2–3/d, 4–5/d, and >/=6/d. Due to small sample sizes for each individual consumption category, and to make our analyses comparable to other studies, all coffee (regular and decaffeinated combined) and regular coffee were categorized as: <1/mo (reference), 1/mo to 4/wk, 5–7/wk, 2–3/d, and >/=4/d. The coffee and tea exposures were also examined as pseudo-continuous variables approximated as cups/day, assigning the middle value for each questionnaire response category. Outcomes: The primary outcome was all-cause mortality. Secondary outcomes were death due to confirmed vascular causes (stroke, MI, heart failure, pulmonary embolus, cardiac arrhythmia), death due to nonvascular causes (accident, cancer, pneumonia, chronic obstructive pulmonary disease, other pulmonary disorders, and other nonvascular causes), and death due to cancer. Deaths were classified as vascular or nonvascular based on information obtained from the family and physicians and validated with medical records and death certificates. Follow-up procedures and outcome classifications were previously detailed (34,35).
  • Comments Comments (
    0
    ) |
How many outcome-specific endpoints are evaluated? 1
  • Comments Comments (
    0
    ) |
What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Vascular death
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately). 2
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately).3
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately).4
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately).5
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately).6
  • Comments Comments (
    0
    ) |
Clinical, physiological, other Clinical
  • Comments Comments (
    0
    ) |
What is the study design? Cohort
  • Comments Comments (
    0
    ) |
Randomized or Non-Randomized?
  • Comments Comments (
    0
    ) |
What were the diagnostics or methods used to measure the outcome? Objective
  • Comments Comments (
    0
    ) |
Optional: Name of Method or short description Deaths were classified as vascular or nonvascular based on information obtained from the family and physicians and validated with medical records and death certificates
  • Comments Comments (
    0
    ) |
Caffeine (general)
  • Comments Comments (
    0
    ) |
Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other? Coffee
  • Comments Comments (
    0
    ) |
Measured or self reported? Self-report
  • Comments Comments (
    0
    ) |
Children, adolescents, adults, or pregnant included? Adults
  • Comments Comments (
    0
    ) |
What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) <1/month, 1/mo to 4/wk, 5-7/wk. 2-3/day, and >/= 4/day (consumption of regular/caffeinated cups of coffee)
  • Comments Comments (
    0
    ) |
What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) We constructed Cox proportional hazards models to examine the associations between coffee (any and regular only) and tea consumption and mortality, and HRs and 95% CIs were calculated. Decaffeinated coffee alone was examined in secondary exploratory analyses. Person-time of follow-up was accrued from baseline to the end of follow-up (March, 2012), death, or loss to follow-up, whichever came first. We used the following sequence of models: 1) adjusted for demographics (age, sex, race/ethnicity, education); 2) demographics, behavioral risk factors [smoking (never, former, current), moderate heavy physical activity, moderate alcohol consumption], daily diet (total kilocalories, grams protein, total fat, saturated fat, carbohydrates), and BMI; and 3) demographics, behavioral risk factors, diet, BMI, previous cardiac disease, diabetes, hypertension, and hypercholesterolemia. In model 3, we mutually controlled for tea and coffee. We examined interactions of coffee and tea with age, sex, and race/ ethnicity in relation to each of the mortality outcomes in model 3, and stratified analyses were conducted when effect modification was suggested (P-interaction < 0.05). We observed no interaction between coffee and tea in relation to any of the mortality outcomes. Because self-reported total daily kcal <500 or >4000 might indicate inaccurate reporting of diet, we conducted sensitivity analyses excluding these participants (n = 73). In an exploratory analysis, we also examined the combined effect of coffee and tea by adding the coffee and tea cups per day and examined this exposure as a continuous variable in relation to the mortality outcomes in model 3. The proportionality assumption of the hazards was first confirmed in the Cox models. This was done by examining interactions between the coffee and tea exposures of interest with the logarithm of follow-up time in relation to the mortality outcomes in model 3. No significant interactions were found.
  • Comments Comments (
    0
    ) |
What conflicts of interest were reported? Author disclosures: H. Gardener, T. Rundek, C. B. Wright, M. S. V. Elkind, and R. L. Sacco, no conflicts of interest.
  • Comments Comments (
    0
    ) |
Refid 23784068
  • Comments Comments (
    0
    ) |
What were the sources of funding? Supported by a grant from the National Institute of Neurological Disorders and Stroke (R37 NS 29993).
  • Comments Comments (
    0
    ) |




Results & Comparisons

No Results found.