Silletta Maria Giuseppina, Marchioli Roberto
Laboratorio di Epidemiologia clinica delle Malattie cardiovascolari, Consorzio Mario Negri Sud, Santa Maria Imbaro.
Recenti Prog Med. 2008 Nov;99(11):533-7.
Many epidemiological studies have addressed the effects of coffee on cardiovascular disease. Most case-control studies suggest an increased risk in high coffee consumers, whereas cohort studies indicate no clear association with cardiovascular risk. Several aspects could be considered to explain and/or reconcile these inconsistencies. Selection bias and recall bias may explain a positive association supported by case-control studies. An inadequate adjustment for many confounding factors (i.e., smoking, poor diet, sedentary lifestyle, etc.) could also affect the relationship between coffee consumption and cardiovascular risk. Moreover, coffee contains several biologically active substances that may have either beneficial or harmful effects on the cardiovascular system. The development of complete/partial tolerance to some caffeine effects in habitual drinkers adds to the complexity of coffee effects. Variation in cup size and methods of coffee preparation may also explain some conflicting results. As it is not reasonable to conduct randomized controlled trials, it is recommended that coffee consumption be moderate in healthy people and limited in individuals at high risk.
许多流行病学研究都探讨了咖啡对心血管疾病的影响。大多数病例对照研究表明，咖啡饮用量大的人群患病风险增加，而队列研究则表明咖啡与心血管疾病风险之间没有明确关联。可以从几个方面来解释和/或调和这些矛盾之处。选择偏倚和回忆偏倚可能解释了病例对照研究所支持的正相关关系。对许多混杂因素（如吸烟、不良饮食、久坐不动的生活方式等）调整不足也可能影响咖啡消费与心血管疾病风险之间的关系。此外，咖啡含有几种生物活性物质，它们可能对心血管系统产生有益或有害的影响。习惯喝咖啡的人对某些咖啡因效应产生完全/部分耐受性，这也增加了咖啡效应的复杂性。杯子大小和咖啡冲泡方法的差异也可能解释一些相互矛盾的结果。由于进行随机对照试验不合理，建议健康人群适度饮用咖啡，高危人群限制饮用。
