Abstract
BackgroundStroke is a crucial health threat to adults worldwide. Despite extensive knowledge of risk-factor mitigation, no primary prevention exists for healthy people. Coffee is a widely consumed beverage globally. Health benefit of coffee for several neurological diseases has been identified; however, the association between stroke risk and coffee consumption in healthy people has not been determined. We investigated the effect of coffee on stroke risk by conducting a meta-analysis of prospective cohort studies.MethodsElectronic databases, namely PubMed, BioMed Central, Medline, and Google Scholar, were searched using terms related to stroke and coffee. Articles that described clear diagnostic criteria for stroke and details on coffee consumption were included. The reference lists of relevant articles were reviewed to identify eligible studies not shortlisted using these terms. Enrolled studies were grouped into three outcome categories: overall stroke, hemorrhagic stroke, and ischemic stroke.ResultsSeven studies were included and all of them were large-scale, long-term, follow-up cohort studies of a healthy population. Upon comparing the least-coffee-consuming groups from each study, the meta-analysis revealed a reduction in the risk of overall stroke during follow-up (hazard ratio [HR] for overall stroke = 0.922, 95% confidence interval [CI] = 0.855–0.994, P = 0.035). In studies with a clear definition of hemorrhagic and ischemic stroke, coffee consumption reduced the risk of ischemic stroke more robustly than that of hemorrhagic stroke (hemorrhagic, HR = 0.895, 95% CI = 0.824–0.972, P = .008; ischemic, HR = 0.834, 95% CI = 0.739–0.876, P < .001). No obvious dose-dependent or U-shaped effect was observed.ConclusionsCoffee consumption reduces the risk of overall stroke, especially ischemic stroke. Further investigation is required to identify beneficial components in coffee, including caffeine and phenolic acids, to develop preventive medication for stroke.
Highlights
Stroke is a leading cause of mortality globally and results in more disabilities compared with other diseases [1]
This study investigated the association between stroke risk and coffee consumption
Ischemic stroke, and hemorrhagic stroke were identified through self-reports, confirmation of medical records, or a national health care database
Summary
Stroke is a leading cause of mortality globally and results in more disabilities compared with other diseases [1]. Chan et al BMC Neurol (2021) 21:380 include age and male sex, whereas the modifiable risk factors include hypertension, diabetes mellitus, hyperlipidemia, cardiovascular diseases, sedentary lifestyle, atrial fibrillation, smoking, and alcohol consumption [3]. Despite improved knowledge and control of modifiable risk factors, the decline in stroke incidence in the twentyfirst century is unsatisfactory [4]. Studies for identifying protective factors that can reduce the risk of stroke are warranted [6]. Despite extensive knowledge of risk-factor mitiga‐ tion, no primary prevention exists for healthy people. Health benefit of coffee for several neurological diseases has been identified; the association between stroke risk and coffee consumption in healthy people has not been determined. We investigated the effect of coffee on stroke risk by conducting a meta-analysis of prospective cohort studies
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