Caffeine and coffee: effects on health and cardiovascular disease.

Caffeine is a methylxanthine whose primary biological effect is the competitive antagonism of the adenosine receptor. Its presence in coffee, tea, soda beverages, chocolate and many prescription and over-the-counter drugs makes it a commonly consumed stimulant. Coffee and/or caffeine consumption has been linked to many human diseases in epidemiologic studies. Causal relationships have been difficult to substantiate. Initial investigations, showing an association between coffee and coronary heart disease, suffer from confounding variables and have been difficult to replicate. Recent studies, showing a significant effect over long follow-up periods and with high coffee intake, have again raised the question of a role for coffee and/or caffeine consumption in the pathogenesis of atherosclerotic heart disease. Contrary to common belief, the published literature provides little evidence that coffee and/or caffeine in typical dosages increases the risk of infarction, sudden death or arrhythmia.