| Summary: | Objective: To perform a dose–response meta-analysis of prospective cohort studies investigating
the association between long-term coffee intake and risk of hypertension. Methods: An online systematic
search of studies published up to November 2016 was performed. Linear and non-linear dose–response
meta-analyses were conducted; potential evidence of heterogeneity, publication bias, and confounding
effect of selected variables were investigated through sensitivity and meta-regression analyses.
Results: Seven cohorts including 205,349 individuals and 44,120 cases of hypertension were included.
In the non-linear analysis, there was a 9% significant decreased risk of hypertension per seven cups of
coffee a day, while, in the linear dose–response association, there was a 1% decreased risk of hypertension
for each additional cup of coffee per day. Among subgroups, there were significant inverse associations for
females, caffeinated coffee, and studies conducted in the US with longer follow-up. Analysis of potential
confounders revealed that smoking-related variables weakened the strength of association between coffee
consumption and risk of hypertension. Conclusions: Increased coffee consumption is associated with
a modest decrease in risk of hypertension in prospective cohort studies. Smoking status is a potential
effect modifier on the association between coffee consumption and risk of hypertension.
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