We examined the relation of coffee and alcohol consumption to the risk of coronary heart disease during a six-year period in a cohort of 7705 Japanese men living in Hawaii. The analysis was based on 294 new cases of coronary heart disease. There was a positive association between coffee intake and risk, but it became statistically insignificant when cigarette smoking was taken into account. There was a strong negative association between moderate alcohol consumption (up to 60 ml per day), mainly from beer, and the risk of nonfatal myocardial infarction and death from coronary heart disease. This association remained significant in multivariate analysis, taking into account smoking and other risk factors. The correlation of alcohol consumption with the level of α cholesterol (positive) and β cholesterol (negative) may partly account for the observed negative association between alcohol and coronary heart disease. (N Engl J Med 297:405–409, 1977) The relation of coffee and alcohol consumption to the risk of coronary heart disease has long been of interest to health professionals and lay people. Recent epidemiologic studies in the United States and other Western countries have shown conflicting results. We have been following a large cohort of Japanese migrants and their descendants living in Hawaii for the development of cardiovascular disease since 1965. In this report the levels of coffee and alcohol consumption recorded at entry examination are related to the incidence of coronary heart disease during a six-year follow-up period. Methods The Honolulu Heart Study is a prospective.
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