High coffee consumption may increase aortic diameter and risk of abdominal aortic aneurysm in smokers

An association of coffee consumption with a risk of abdominal aortic aneurysm (AAA) is unknown. We hypothesized that coffee consumption influences aortic diameter and AAA risk, with smoking status as a modifier. The study included 42,723 Swedish men and 34,921 women (age 45-83 years) with infrarenal aortic diameter (IAD) measured in 8,109 men. Over 18.7 years, 1863 AAA cases (1585 non-ruptured, 278 ruptured) were identified. Among participants with coffee consumption ≤ 5 cups/day, current smokers versus never smokers had a 3-fold higher risk of non-ruptured and ruptured AAA (HR = 3.12, 95%CI = 2.62-3.71 and HR = 2.90, 95%CI = 1.95-4.31, respectively); the risk increased with coffee consumption > 5 cups/day and was a 4-fold higher (HR = 3.89, 95%CI = 3.12-4.85) for non-ruptured and a 4.6-fold higher (HR = 4.61, 95%CI = 2.72-7.86) for ruptured AAA (P-value- multiplicative-interaction = 0.009). 160 (2.0%) screened men had an IAD ≥ 30 mm. In men drinking daily ≤ 3 cups of coffee, current smokers versus never smokers had a 4-fold (OR = 4.09, 95%CI = 1.81-9.22) higher risk of IAD ≥ 30 mm; in men with higher coffee consumption (> 3 cups/day), the risk increased 6.6-fold (OR = 6.58, 95%CI = 2.98-14.6). In ex-smokers, the corresponding ORs were 1.67 (95%CI = 0.62-4.49) and 3.27 (95%CI = 1.27-8.40), respectively. In conclusion, high coffee consumption may increase risk of AAA and infrarenal aortic diameter in smokers.