Associations of Coffee, Tea, and Caffeine Intake with Coronary Artery Calcification and Cardiovascular Events

Am J Med. 2017 Feb;130(2):188-197.e5. doi: 10.1016/j.amjmed.2016.08.038. Epub 2016 Sep 15.


Background: Coffee and tea are 2 of the most commonly consumed beverages in the world. The association of coffee and tea intake with coronary artery calcium and major adverse cardiovascular events remains uncertain.

Methods: We examined 6508 ethnically diverse participants with available coffee and tea data from the Multi-Ethnic Study of Atherosclerosis. Intake for each was classified as never, occasional (<1 cup per day), and regular (≥1 cup per day). A coronary artery calcium progression ratio was derived from mixed effect regression models using loge(calcium score+1) as the outcome, with coefficients exponentiated to reflect coronary artery calcium progression ratio versus the reference. Cox proportional hazards analyses were used to evaluate the association between beverage intake and incident cardiovascular events.

Results: Over a median follow-up of 5.3 years for coronary artery calcium and 11.1 years for cardiovascular events, participants who regularly drank tea (≥1 cup per day) had a slower progression of coronary artery calcium compared with never drinkers after multivariable adjustment. This correlated with a statistically significant lower incidence of cardiovascular events for ≥1 cup per day tea drinkers (adjusted hazard ratio 0.71; 95% confidence interval 0.53-0.95). Compared with never coffee drinkers, regular coffee intake (≥1 cup per day) was not statistically associated with coronary artery calcium progression or cardiovascular events (adjusted hazard ratio 0.97; 95% confidence interval 0.78-1.20). Caffeine intake was marginally inversely associated with coronary artery calcium progression.

Conclusions: Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake.

Keywords: Caffeine; Cardiovascular events; Coffee; Coronary artery calcium; Tea.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Caffeine / adverse effects*
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / etiology*
  • Coffee / adverse effects*
  • Coronary Artery Disease / chemically induced
  • Coronary Artery Disease / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Surveys and Questionnaires
  • Tea / adverse effects*
  • Vascular Calcification / chemically induced
  • Vascular Calcification / etiology*


  • Coffee
  • Tea
  • Caffeine