Coffee Intake and Serum Lipids in Men

Abstract

To the Editor.— With respect to the article on coffee intake and elevated cholesterol levels, 1 the authors should be commended for attempting to rule out stress or stressful behavioral traits as a confounding factor. While the techniques used examine such common components of this conundrum as hostility, anxiety, depression, and coronary-prone behavior, with state-of-the-art approaches, it is still difficult to define stress to a scientist's satisfaction, much less quantify it. Association never proves causation. Hypertension and cigarette smoking are also linked with coronary heart disease, but removing these risk factors has no significant influence in preventing recurrent heart attacks, as evidenced by the Multiple Risk Factor Intervention Trial and other studies. Hypertension, smoking, elevated cholesterol levels, eating rich foods, and coffee drinking may all be associated with stress or type A behavior. In contrast to the Multiple Risk Factor Intervention Trial findings, reducing stressful type A coronary-prone behavior has