Catechins, one of the major groups of flavonoids, are bioactive compounds present in a variety of plant foods and beverages. Experimental data suggest that they might prevent chronic diseases in humans. We studied whether the intake of catechins was inversely associated with the risk of coronary heart disease death in a prospective study of postmenopausal women from Iowa. Between 1986 and 1998, 767 of 34,492 participants initially free of cardiovascular diseases died from coronary heart disease. There was a strong inverse association between the intake of (+)-catechin and (-)-epicatechin and coronary heart disease death, which was somewhat attenuated after multivariate adjustment (risk ratios from lowest to highest quintile: 1.00, 0.95, 0.97, 0.77, 0.76). This inverse association was most pronounced in women at low risk of coronary heart disease (non-smokers, free of diabetes mellitus and cardiovascular diseases). A high intake of "gallates," catechins typical of tea, was not associated with coronary heart disease death. Of the major catechin sources, apples and wine were inversely associated with coronary heart disease death. Our data suggest that preventive effects might be limited to certain types of catechins, or that these are indicators of other dietary components or a healthy lifestyle in general.