Data on the association between
coffee consumption and risk of
stroke are sparse. We assessed the association between
coffee consumption and the risk of
stroke over 24 years of follow-up in women.
METHODS AND RESULTS: We analyzed data from a prospective cohort of 83,076 women in the Nurses' Health Study without history of
stroke,
coronary heart disease, diabetes, or
cancer at baseline.
Coffee consumption was assessed first in 1980 and then repeatedly every 2 to 4 years, with follow-up through 2004. We documented 2280
strokes, of which 426 were hemorrhagic, 1224 were ischemic, and 630 were undetermined. In multivariable Cox regression models with adjustment for age, smoking status, body mass index, physical activity, alcohol intake, menopausal status,
hormone replacement therapy,
aspirin use, and dietary factors, the relative risks (RRs) of
stroke across categories of
coffee consumption (<1 cup per month, 1 per month to 4 per week, 5 to 7 per week, 2 to 3 per day, and >or=4 per day) were 1, 0.98 (95% CI, 0.84 to 1.15), 0.88 (95% CI, 0.77 to 1.02), 0.81 (95% CI, 0.70 to 0.95), and 0.80 (95% CI, 0.64 to 0.98) (P for trend=0.003). After further adjustment for
high blood pressure,
hypercholesterolemia, and
type 2 diabetes, the inverse association remained significant. The association was stronger among never and past smokers (RR for >or=4 cups a day versus <1 cup a month, 0.57; 95% CI, 0.39 to 0.84) than among current smokers (RR for >or=4 cups a day versus <1 cup a month, 0.97; 95% CI, 0.63 to 1.48). Other drinks containing
caffeine such as
tea and caffeinated soft drinks were not associated with
stroke. Decaffeinated
coffee was associated with a trend toward lower risk of
stroke after adjustment for caffeinated
coffee consumption (RR for >or=2 cups a day versus <1 cup a month, 0.89; 95% CI, 0.73 to 1.08; P for trend=0.05).
CONCLUSIONS: