Association of coffee consumption with atherosclerotic cardiovascular disease and all-cause mortality in adults with familial hypercholesterolemia: Results from National Health and Nutrition Examination Survey (NHANES)

Abstract

Objective

Familial hypercholesterolemia (FH) is a common inherited metabolic disorder with an elevated risk of atherosclerotic cardiovascular disease (ASCVD). The effects of coffee on FH individuals remain unclear. The aim of this study is to examine the association between coffee consumption and ASCVD and mortality in adults with clinical diagnosed FH.

Material and methods

Cross-sectional and prospective (up to December 31st, 2019) analysis of National Health and Nutrition Examination Survey (NHANES) 1999–2018. Coffee consumption was calculated by 24-hour dietary recalls. Multivariable-adjusted logistic regression and Cox analysis were performed to evaluated the relationship between coffee consumption and ASCVD and all-cause mortality.

Results

A total of 1008 FH individuals with coffee information were included and were categorized into four groups: 357 (35.42%) did not consume coffee on a regular basis, 390 (38.69%) consumed 0.5–3 cups per day, 141 (13.99%) consumed 3–5 cups per day and 120 (11.90%) ≥5 cups per day. Higher coffee or caffeine consumption was associated with elevated risk of ASCVD and heart attack. Compared to non-coffee drinkers, ≥5 cups coffee drinking was associated with higher risk of all-cause mortality (multivariate HR: 1.67, 95%CI: 1.02–2.73, P = 0.04). The risk of all-cause death increased dose-dependently along with the higher coffee or caffeine intake (P < 0.05). The results remained similar among those who excluded non-coffee drinkers.

Conclusion

Coffee consumption of up to five cups per day was associated with unfavorable ASCVD and all-cause mortality, suggesting that high coffee consumption should be avoided among patients with FH.