Original Article

Habitual coffee consumption and office, home, and

ambulatory blood pressure: results of a 10-year
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prospective study
Fosca Quarti Trevano a,
, Sara Vela-Bernal b,
, Rita Facchetti a, Cesare Cuspidi c, Giuseppe Mancia c,
and Guido Grassi a

See related paper on page 965

habitual coffee consumption is associated with increased,

Objectives: Heterogeneous are the results of the unchanged, or reduced blood pressure (BP) values remains
published studies aimed at determining the long-term controversial. A number of intrinsic limitations of the pub-
effects of habitual coffee consumption on blood pressure lished studies are behind these uncertain information,
(BP). Specifically, no data are available on the longitudinal including the fact that with only very few exceptions
association between habitual coffee consumption and [6,16], the available data have been collected in the context
office, home and 24 h BP profile and variability. of investigations performed with a cross-sectional design,
Methods: In 1408 subjects recruited in the Pressioni Arteriose precluding any prospective information to be gathered, and
Monitorate E Loro Associazioni (PAMELA) study, followed for a all the above mentioned evaluations (including the few
10 year follow-up period and classified as coffee consumers and prospective studies) have been performed taking into ac-
nonconsumers (self-reporting), we prospectically investigated the count only clinic BP values, thus preventing to obtain data
association between habitual coffee consumption and office, on BP values outside the clinical environment. A recent
home and 24-h ambulatory BP; 24-h BP variability; and cross-sectional study by our group, however, overcame the
development of a new hypertensive state. Data were also latter limitation, analysing office as well as home and 24-h
analysed according to gender. ambulatory BP data [17].
Results: When data were adjusted for confounders The present study was designed to overcome the first
habitual coffee nonconsumers and consumers displayed limitation, providing prospective information on the asso-
similar long-term BP changes during the follow-up in ciation between habitual coffee consumption, BP, and the
office, home, and ambulatory BP. No difference was found development of a new hypertensive state, based on values
between heavy and moderate coffee consumers. collected via office, home, and ambulatory measurements.
Furthermore, also new-onset hypertension and patterns of An additional relevant evaluation was represented by the
BP variability were superimposable in coffee nonconsumers assessment of the impact of habitual coffee consumption on
and consumers, independently on confounders including 24-h BP variability, that is, a parameter, which is closely
gender, number, and characteristics of the antihypertensive related to subclinical organ damage and cardiovascular
drug treatment. events independently on absolute BP load [18]. The data
were analysed in the whole group of subjects and in two
Conclusion: The present study, which is the first
subgroups defined according to gender. The unique feature
longitudinal investigation never performed examining in a
of the study, which examines data collected in the context
prospective fashion the long-term (10 year) effects of
of the Pressioni Arteriose Monitorate E Loro Associazioni
coffee consumption on office, home, and ambulatory BP,
(PAMELA) research project, is represented by its follow-up
provides conclusive evidence that habitual coffee
duration (10 years) [19], which is the longest carried out in
consumption is associated with neutral effects on in-office
and out-of-office BP values and related variabilities. This is
the also the case for the new-onset hypertensive state. Journal of Hypertension 2024, 42:1094–1100
a
Keywords: ambulatory blood pressure, blood pressure Clinica Medica, Department of Medicine and Surgery, University Milano-Bicocca,
Milan, Italy, bCardiometabolic Risk and Diabetes Research Group, INCLIVA Biomedical
variability, clinic blood pressure, coffee, gender, home Research Institute and Internal Medicine Hospital Clinico de Valencia, Valencia, Spain
blood pressure, new hypertension and cUniversity Milano-Bicocca, Milan, Italy
Correspondence to Professor Guido Grassi, Clinica Medica, Universit
a Milano-Bicocca,
Abbreviation: BP, blood pressure via Pergolesi 33, 20052 Monza, Italy. Tel: +39 39 2333357;
e-mail: guido.grassi@unimib.it


F.Q.T. and S.V.B. contributed equally in this work.
Received 28 November 2023 Revised 24 January 2024 Accepted 20 February 2024
INTRODUCTION J Hypertens 42:1094–1100 Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc. This is an open access article distributed under the Creative

D
espite the consistent number of original investiga- Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribu-
tions and meta-analyses published during the past tion, and reproduction in any medium, provided the original work is properly cited.
two decades [1–16], whether and to what extent DOI:10.1097/HJH.0000000000003709

1094 www.jhypertension.com Volume 42  Number 6  June 2024

 Coffee consumption and BP

population studies based on both in-office and out-of-office first set of data collection [19]. In each subject, the three
BP measurements aimed at assessing the association be- office and two home BP measurements as well as the
tween habitual coffee consumption and BP. corresponding heart rate values were separately averaged.
After editing for artifacts, all ambulatory BP recordings were
METHODS analysed to obtain 24 h, average SBP and DBP, as well as
mean BP, and heart rate, the overall 24-h variability being
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Study population taken as the corresponding standard deviation around the

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The PAMELA study was performed in 3200 subjects, repre- average [18]. New-onset hypertension detected after 10 year
sentative of the population of Monza (a town near Milan, follow-up was defined as an elevation in office, home or
Italy) stratified according to sex, age (decades), and other 24 h BP (SBP and/or DBP 140/90 mmHg for office, 135/
characteristics from 25 to 74 years of age [20]. At the initial 85 mmHg for home and 130/80 mmHg for ambulatory BP)
evaluation, carried out between 1990 and 1993, participa- or new antihypertensive drug treatment [19].
tion rate was 64% and thus data were available in 2051 Information on coffee consumption were obtained via the
subjects. The demographic and clinical characteristics of administration of a questionnaire in which the number of
participants and nonparticipants, as assessed by phone caffeine-containing coffees drunk per day was considered
interviews, were similar. As described in detail elsewhere, (from 0 to 1–2 and 3 cups of coffee). Decaffeinated coffee,
after an informed consent, participants were invited to the tea, and other caffeinated drinks were not examined in the
outpatient clinic of the S. Gerardo Hospital of Monza in the present study. The caffeine content per cup of ‘expresso’
morning of a working day (Monday to Friday), following an Italian coffee, which was the most frequently consumed type
overnight fast and abstinence from alcohol and smoking of coffee by the PAMELA participants, averages 100 mg.
since the previous day [20]. The experimental protocol of
the PAMELA study and the process for obtaining informed Protocol and data analysis
consent were approved by the Institutional Review Com- Subjects were subdivided into three groups according to the
mittee of the University Milano-Bicocca. number of coffee cups drunk per day (0, 1–2, and  3 cups
of coffee). Measurements were carried out at the study entry
Measurements and 10 years later. Only subjects who maintained during the
Data collected include medical history and physical exami- follow-up the same category of coffee consumption (coffee
nation on cardiovascular risk factors (overweight, cigarette consumers/nonconsumers) underwent the present analy-
smoking habit, alcohol intake, diabetes mellitus) weight, sis. Data related to subjects’ characteristics were analysed
height, abdominal circumference, standard blood examina- by descriptive statistics. Calculations included means and
tions, office, home, and 24-h ambulatory BP [20]. Height and standard deviations of continuous variables as well as
weight were obtained to calculate BMI. In the questionnaire numbers and percentages of categorical variables. ANOVA
administered to the subjects, a specific question was related and chi-square test were applied to compare groups with
to dietary modifications during follow-up. Laboratory anal- different levels of coffee assumption. Bonferroni correction
yses included plasma glucose, total and high-density lipo- was used when two groups were compared. Repeated
protein (HDL) plasma cholesterol and plasma triglycerides measures mixed models were used to compare BP values
[20]. Glomerular filtration rate was estimated by the Chronic during time among groups with different levels of coffee
Kidney Disease EPIdemiology (CKD-EPI) equation. Low- assumption. Because age, BMI, smoking habit, HDL cho-
density lipoprotein (LDL) cholesterol was estimated accord- lesterol, estimated glomerular filtration rate values, and
ing to the Friedewald equation. Office BP was measured antihypertensive drug treatment were different among cof-
with the subject in the sitting position, using a mercury fee consumer groups, models were also adjusted for these
sphygmomanometer and taking the first and fifth Korotkoff four variables. Same analysis was separately performed in
sounds to identify systolic and diastolic values, respectively male and female individuals. In the case of antihypertensive
[20]. To assess ambulatory BP, subjects were fitted with an pharmacological treatment, additional analysis was carried
ambulatory BP monitoring device (Spacelabs 90207, Issa- out examining in the different coffee consumer groups the
quah, Washington, USA) set to obtain automated oscillo- number and type antihypertensive drugs used at baseline
metric BP and heart rate readings every 20 min over 24 h [20]. and during follow-up. New-onset office, or home or 24-h
Subjects were asked to pursue their normal activities during hypertension was calculated in subjects with normal level
the monitoring period, holding the arm still at time of the BP of blood pressure and without the use of antihypertensive
readings, going to bed not later than 11.00 p.m. and arising treatment at baseline. Odd ratios (ORs) were calculated by
not before 7.00 a.m. Subjects were also asked to self-mea- logistic regression models and they were adjusted for age,
sure BP at home, with a validated semiautomatic oscillo- sex, and relative mean blood pressure. Cups of coffee equal
metric device (Model HP 5331, Philips, Amsterdam, The to zero was used as reference group. A P value less than
Netherlands), with a cuff size appropriate to each individu- 0.05 was considered statistically significant. Statistical anal-
al’s arm circumference, at 7.00 a.m. and 7.00 p.m., using the ysis was performed by SAS System (version 9.4; SAS Insti-
arm contralateral to the one used for ambulatory monitoring tute Inc, Cary, North Carolina, USA).
[20]. Participants were again contacted from 2001 to 2003,
that is, after a mean time interval of 10.7  0.61 years, and
those willing to be re-examined were asked to attend the
RESULTS
San Gerardo University Hospital for a second set of data From the original sample of 2051 subjects, 1408 attended
collection, according to the same procedures used for the both the two surveys and reported information about coffee

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 Trevano et al.

TABLE 1. Demographic and clinical variables in the study population, subdivided in three groups according to chronic coffee consumption
reported at the study entry
Cups of coffee per day (number)
Variable 0 1–2 3
Subjects (number) 102 471 603
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Age (years) 49.4  14.5 50.7  13.6 46.9  11.8a

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Male (%) 51 48 55.2

BMI (kg/m2) 23.8  3.8 25.3  4.2b 25.4  3.8b
Physically active (%) 34.3 28 29
Alcohol drinkers (%) 39.2 55.2b 49.8
Smokers (%) 14.7 17.8 38.3b a
Serum glucose (mg/dl) 89.9  12.8 90.6  22.6 89.4  19.4
Total cholesterol (mg/dl) 222.1  37.9 221.5  42.9 224  42.3
HDL cholesterol (mg/dl) 58.1  16.6 57.4  16.3 55.0  15.5b
LDL cholesterol (mg/dl) 142.5  37.0 142.4  39.8 146.4  38.5
Triglycerides (mg/dl) 107.6  66.9 108.2  63.5 113.6  69.7
eGFR (ml/min/1.72 m2) 88.6  14.4 87  15.4 91.1  14.4a
Anti-HT treatment (%) 17.6 18.9 11.9a

Data are shown as means  standard deviation or percentages. Anti-HT, antihypertensive drug; eGFR, estimated glomerular filtration rate; HDL, high density lipoprotein; LDL, low
density lipoprotein; NS, not significant.
a
P < 0.05 vs. one to two cups of coffee per day.
b
P < 0.05 vs. 0 cups of coffee per day.

consumption. Of them 1176 remained stable at the two whereas the percentage of smokers and alcohol drinkers
surveys regarding their belonging to the category of coffee remained substantially unmodified. No substantial modifi-
nonconsumers (n ¼ 102) or consumers (n ¼ 1074). Table 1 cation of the dietary habit was reported in about 85% of
reports demographic and clinical characteristics of these participants during the follow-up.
subjects, subdivided in three groups according to the dif- Data related to office, home, and 24 h BP values adjusted
ferent levels of daily coffee consumption detected at the for confounders (age, BMI, smoking, and antihypertensive
study entry. Habitual coffee consumers three or more cups treatment) in nonconsumers and consumers at the study
per day were younger than consumers one to two cups and entry and after 10-year follow-up are shown in Fig. 1. In
displayed slightly but significantly greater BMI values. They nonconsumers and consumers, office SBP values (left up-
were also more frequent cigarette smokers. Plasma glucose, per panel) were greater at the 10-year follow-up while DBP
triglycerides, total cholesterol, LDL-cholesterol values were (left lower panel) remained substantially unchanged in all
similar in the three groups of subjects, whereas HDL-cho- groups. Both at baseline and at the 10 year evaluation, office
lesterol was significantly lower and estimated glomerular SBP values were significantly lower in consumers three
filtration rate significantly higher in coffee consumers who cups of coffee per day as compared with the other two
consume three or more cups per day. At the study entry, groups. In contrast, home and 24 h SBP and DBP values
antihypertensive drug treatment was significantly less rep- seen at the study entry and at the 10-year follow-up were
resented in coffee consumers who consume three or more not significantly different in the three groups of subjects
cups per day than in the other two groups. The modifica- (Fig. 1, middle and right panels). Office and out-of-office
tions in antihypertensive drug treatment, alcohol drinking heart rate values were similar in coffee nonconsumers and
habit, smoking, and BMI at the 10-year follow-up in non- consumers both at the study entry and at the 10-year follow-
consumers and consumers are shown in Tables 2 and 3. In up (data not shown).
all the three groups, antihypertensive treatment and use of As illustrated in Fig. 2, the incidence (upper panel) and
different classes of drugs significantly and quite homo- adjusted risk (lower panel) of new-onset office, home
geneously increased and this was the case also for BMI, and 24 h ambulatory hypertension detected after 10-year

TABLE 2. Modifications of different variables during the 10 year follow-up in the three groups of the study population of Table 1
Cups of coffee per day (number)
0 1–2 3
Variable Entry 10-year Entry 10-year Entry 10-year




Anti-HT treatment (%) 17.6 32.4 18.9 39.3 11.9 29.2

Alcohol drinkers (%) 39.2 37.3 55.2 58.4 49.8 49.8
Smokers (%) 14.7 14.7 17.8 19.3 38.3 37.0
BMI (kg/m2) 23.8  3.8 25.1  3.9
25.3  4.2 26.6  4.4
25.4  3.8 27  4.4

HDL (mg/dl) 58.1  16.6 61.8  15
57.4  16 61.9  15
55.0  15 59.0  15
eGFR (ml/min/1.72 m2) 88.6  14.4 83.3  18.1
87  15.4 80.1  18.2
91.1  14.4 84.9  17.8

Data are shown as percentage (%) values and as means  standard deviation. Asterisks (
P < 0.05) refer to the statistical significance between data collected after 10 year follow-up vs.
study entry. Anti-HT, antihypertensive drug; eGFR, estimated glomerular filtration rate; HDL, high density lipoprotein.

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 Coffee consumption and BP

TABLE 3. Modifications of antihypertensive drug treatment during the 10-year follow-up in in the three groups of the study population of
Table 1
Cups of coffee per day (number)
0 1–2 3
Variable Entry 10-year Entry 10-year Entry 10-year
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Number of anti-HT treatment [n (%)]

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0 84 (83.2%) 69 (68.3%)
382 (81.6%) 286 (60.9%)
531 (88.7%) 427 (70.9%)

1 9 (8.9%) 15 (14.9%) 45 (9.6%) 90 (19.2%) 43 (7.2%) 79 (13.1%)
2 8 (7.9%) 10 (9.9%) 31 (6.6%) 68 (14.5%) 22 (3.7%) 70 (11.6%)
3 0 (0%) 7 (6.9%) 10 (2.1%) 26 (5.5%) 3 (0.5%) 26 (4.3%)
Drug classes [n (%)]
Beta blockers 7 (6.9%) 11 (10.9%) 31 (6.6%) 62 (13.2%)
27 (4.5%) 61 (10.1%)

Calcium blockers 2 (2%) 10 (9.9%)
24 (5.1%) 50 (10.6%)
7 (1.2%) 43 (7.1%)

Diuretics 8 (7.9%) 14 (13.9%) 50 (10.7%) 73 (15.5%)
35 (5.8%) 73 (12.1%)

ACEI/sartans 6 (5.9%) 15 (14.9%)
22 (4.7%) 83 (17.7%)
21 (3.5%) 85 (14.1%)

Vasodilators 2 (2%) 1 (1%) 4 (0.9%) 8 (1.7%) 3 (0.5%) 13 (2.2%)

Data are shown as absolute numbers (n) and percentage (%) values. Asterisks (
P < 0.05) refer to the statistical significance between data collected after 10 year follow-up vs. study
entry. ACEI, angiotensin converting enzyme inhibitors; Anti-HT, antihypertensive drug.

follow-up were similar in nonconsumers and consumers, variability, expressed as 24 h standard deviation of the
one to two and more than three cups of coffee per day. average values and as residual component, were, respec-
Data related to the behaviour of different indices of BP tively, similar or slightly lower, when assessed after 10-year
variability in nonconsumers and consumers detected at the follow-up as compared with the values detected at the
entry visit and after 10 years in the three groups of subjects study entry. No significant difference was found between
of the present study are shown in Fig. 3, upper and lower coffee nonconsumers and consumers.
panels referring to systolic and diastolic values, respective- Finally, data analysis based on the gender of the partic-
ly. In all the three groups of subjects, SBP and DBP ipants did not reveal any significant difference between

Cup of coffee Cup of coffee Cup of coffee

0 1-2 ≥3 0 1-2 ≥3 0 1-2 ≥3

*
180 * 150 140
Office SBP (mmHg)

170
140
Home SBP (mmHg)

130
24h SBP (mmHg)

160
150 130
120
140 120
130 110
120 110
110 100
100
100
90 90
90
80 80 80

Cup of coffee Cup of coffee Cup of coffee

0 1-2 ≥3 0 1-2 ≥3 0 1-2 ≥3
96 90 90
Office DBP (mmHg)

94
85
24h DBP (mmHg)

85
Home DBP (mmHg)

92
90 80 80
88
86 75 75
84
82 70 70
80 65 65
78
76 60 60
FIGURE 1 Office, home and 24 h ambulatory SBP (upper panels) and DBP (lower panels) blood pressure in coffee nonconsumers (0) and in coffee consumers one to two or
at least three cups per day. Data are shown as means  standard deviation at the study entry (grey columns) and after 10 year follow-up (black columns). Asterisks refer
to the statistical significance (
P < 0.05) between groups. Data are adjusted for age, BMI, smoking habit, antihypertensive drug treatment, HDL cholesterol, and estimated
glomerular filtration rate values.

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 Trevano et al.

60 P=0.74 P=0.59 P=0.24 office, home and 24 h ambulatory BP monitoring, was

50 similar in coffee nonconsumers and consumers. Third,
New onset HT (%)

42.1 41.2
36.4
39.7
36.5
analysis of blood pressure variability data provides evi-
40
30.8
33.7 dence that 24 h SBP and DBP variabilities, both when
28.1 28.6
30 expressed as standard deviation of the average values
and as residual variability, were virtually superimposable
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20
in coffee nonconsumers and consumers at the study entry
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10 and after 10 year follow-up.

0 Taken together, these three data sets allow to conclude
Office Home 24h that habitual coffee consumption is not associated with any
New onset HT adjOR (95%CI) p-value
significant long-term BP lowering or enhancing effect, the
lower BP values detected via office measurements being of
Office 1 (ref) small magnitude, restricted to the systolic component only
1.21 (0.61-2.40) p=0.59
1.38 (0.71-2.68) p=0.35 and, more importantly, not confirmed by home or 24 h
measurements. It should be mentioned that the disagree-
ment over the results obtained via office and out-of-office
Home 1 (ref)
1.10 (0.52-2.33) p=0.80 BP measurements detected in the present study is not
1.52 (0.74-3.13) p=0.25 peculiar to coffee consumption data but common to a
number of other clinical conditions [21–22]. It may depend
24h 1 (ref) on several factors, such as the greater accuracy and repro-
1.44 (0.75-2.76) p=0.28 ducibility over time of out-of-office BP measurements as
1.39 (0.73-2.64) p=0.32 compared with the in-office ones [23]; the much greater
number of measurements on which out-of-office (particu-
0 1 2 3 4 larly 24 h ambulatory monitoring) BP evaluations are based
as compared with the small number of in-office measure-
Cups of coffee per day 0 1-2 ≥3 ments [23]; and the presence of an alerting reaction to office,
FIGURE 2 New onset of office, home, and 24 h hypertension at the 10 year fol- but not to out-of-office, BP measurements, which interferes
low-up. Data refer to normotensive subject at baseline (n ¼ 421 for office, n ¼ 422 with the correct assessment of the ‘true’ BP values [23–25].
for home and n ¼ 436 for 24 h BP measurements). Upper panel reports percentage
of new-onset hypertension. Lower panel reports odd ratios (ORs) of new-onset In a recently published study based on a cross-sectional
hypertension. Cups of coffee equal to zero is used as reference group. ORs are analysis of the first PAMELA study survey, we found that
adjusted for age, sex, and relative blood pressure. habitual coffee consumption does not appear to have any
major lowering effect on BP values particularly when they
are assessed via ambulatory or home BP monitoring [17].
men and women as far as the in-office and out-of-office The results of the present longitudinal study confirm and
blood pressure values and BP variability detected at the strengthen these findings, by providing prospective evi-
study entry and after 10 year follow-up in coffee noncon- dence that during the 10 year follow-up coffee consump-
sumers and consumers (Supplemental Table 1, http://links. tion: neither reduces nor increases clinic, home and 24 h BP;
lww.com/HJH/C428) are concerned. This was also the case does not affect the development of new hypertensive states
for heart rate, and for the of new-onset hypertension as well evaluated not only via in-office but also via out-of-office BP
(data not shown). measurements; and leaves unaltered BP variability.
Few other results of our study deserve to be briefly
DISCUSSION mentioned. First, both at the study entry and at the 10 year
follow-up, no significant gender-related difference was
The present analysis of the data collected in the frame of the found in the analysis of office, home, and 24 h BP values
PAMELA study and related to the longitudinal long-term and their corresponding variabilities in coffee nonconsum-
association between habitual coffee consumption and BP ers and consumers. Thus, our data rule out any possible
provides three novel results. First, it shows that office BP, gender-related difference in the association between coffee
both at the study entry and at the 10-year follow-up, was consumption and BP, as previously suggested [1,8,12].
slightly but significantly lower in its systolic, but not dia- Second, office, home, and 24 h heart rate values were
stolic, component in consumers who consume three or similar in coffee nonconsumers and consumers both at
more cups of coffee per day than in nonconsumers or the study entry and after 10 year follow-up, confirming
consumers who consume one to two cups daily. However, prospectically the findings previously reported by our
when home and 24 h values were taken into account, no group in a cross-sectional study [17]. Third, changes in
significant difference in BP values both at the study entry antihypertensive drug treatment occurring during the fol-
and after 10 year follow-up was detected in coffee non- low-up were homogeneous in the different coffee consum-
consumers and consumers. This was the case when data er groups and did not significantly affect the results. This
were corrected for a number of confounders, such as age, was the case also for the different classes of antihyperten-
BMI, antihypertensive drug treatment, HDL cholesterol, sive drugs used.
smoking and estimated glomerular filtration rate. Second, The present study has strengths and limitations. The
the study shows that during the prolonged follow-up also main strengths include the prospective nature of the pres-
the occurrence of new hypertensive states, evaluated via ent study, which is based on data collected during the

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 Coffee consumption and BP

Cup of coffee Cup of coffee

0 1-2 ≥3 0 1-2 ≥3

SBP Residual var (mmHg)

20 14
SBP 24h SD (mmHg) 18
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12
16
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14 10
12 8
10
8 6
6 4
4
2
2
0 0

Cup of coffee Cup of coffee

0 1-2 ≥3 0 1-2 ≥3

16 12

DBP Residual var (mmHg)

DBP 24h SD (mmHg)

14
10
12
8
10
8 6
6
4
4
2
2
0 0
FIGURE 3 Left panels: twenty-four (24 h) SBP (upper panels) and DBP (lower panels) standard deviations in the three groups of subjects of Figure 1. Right panels: residual
variability (Var) for SBP (Upper panels) and diastolic (DBP, lower panels) variables in the same groups of subjects. Data are shown as means  standard deviation at the
study entry (grey columns) and after 10 year follow-up (black columns).

longest follow-up never performed before in studies aimed ACKNOWLEDGEMENTS

at assessing the association between coffee consumption
and BP. They also include the fact that assessment of BP Conflicts of interest
values was based not only on clinic but also on home and There are no conflicts of interest.
24 h measurements, thus providing information on relation-
ships between coffee consumption, in-office, and out-of- REFERENCES
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racies in the finding. It should be emphasized, however, 1990; 8:585–590.
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blood pressure. Hypertension 1999; 33:647–652; 2. Klag MJ, Wang NY,
lished large-scale population studies on the association Meoni LA, Brancati FL, Cooper LA, Liang KY, et al. Coffee intake and
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