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The Johns Hopkins Precursors Study

Michael J. Klag, MD, MPH; Nae-Yuh Wang, PhD; Lucy A. Meoni, ScM; Frederick L. Brancati, MD, MHS; Lisa A. Cooper, MD, MPH; Kung-Yee Liang, PhD; J. Hunter Young, MD, MHS; Daniel E. Ford, MD, MPH

Arch Intern Med. 2002;162:657-662.

Background  Whether the increase in blood pressure with coffee drinking seen in clinical trials persists over time and translates into an increased incidence of hypertension is not known.

Methods  We assessed coffee intake in a cohort of 1017 white male former medical students (mean age, 26 years) in graduating classes from 1948 to 1964 up to 11 times over a median follow-up of 33 years. Blood pressure and incidence of hypertension were determined annually by self-report, demonstrated to be accurate in this cohort.

Results  Consumption of 1 cup of coffee a day raised systolic blood pressure by 0.19 mm Hg (95% confidence interval, 0.02-0.35) and diastolic pressure by 0.27 mm Hg (95% confidence interval, 0.15-0.39) after adjustment for parental incidence of hypertension and time-dependent body mass index, cigarette smoking, alcohol drinking, and physical activity in analyses using generalized estimating equations. Compared with nondrinkers at baseline, coffee drinkers had a greater incidence of hypertension during follow-up (18.8% vs 28.3%; P = .03). Relative risk (95% confidence interval) of hypertension associated with drinking 5 or more cups a day was 1.35 (0.87-2.08) for baseline intake and 1.60 (1.06-2.40) for intake over follow-up. After adjustment for the variables listed above, however, these associations were not statistically significant.

Conclusion  Over many years of follow-up, coffee drinking is associated with small increases in blood pressure, but appears to play a small role in the development of hypertension.

From the Departments of Medicine (Drs Klag, Wang, Brancati, Cooper, Young, and Ford, and Ms Meoni), Epidemiology (Drs Klag, Brancati, Liang, and Ford), Health Policy and Management (Drs Klag, Cooper, and Ford), and Biostatistics (Ms Meoni and Dr Liang), The Johns Hopkins University School of Medicine and The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.

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