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Andrew Steptoe

Publications and source records attributed to Andrew Steptoe.

At least 19 recordsLinked to original sources

An Updated Polygenic Index Repository: Expanded Phenotypes, New Cohorts, and Improved Causal Inference.

Polygenic indexes (PGIs) - DNA-based predictors of individual phenotypes - have become essential tools across biomedical and social sciences. We introduce Version 2 of the Polygenic Index Repository, which expands phenotype coverage from 47 to 61, increases the number of participating datasets from 11 to 20, and adopts a more consistent and improved methodology for PGI construction. For 16 phenotypes, we leverage summary statistics from an updated GWAS meta-analysis with greater statistical power compared to the original release, thereby improving the PGI's predictive power. To improve power for family-based analyses, we provide imputed parental PGIs in all datasets with first-degree relatives and offer a framework for interpreting results from analyses that control for parental PGIs. We illustrate the utility of parental PGIs using two applications: (1) comparing PGI associations with and without parental PGI controls for all phenotypes in two Repository datasets with family data, and (2) for BMI and diastolic blood pressure, exploring the contribution of causal versus non-causal components of PGI associations to the imperfect portability of PGIs across subgroups within a genetic ancestry. Collectively, the updates enhance predictive performance, broaden the Repository's scope, and introduce novel resources that reduce confounding bias and improve interpretability.

Journal Article↗

Psychological and clinical predictors of return to work after acute coronary syndrome.

AIMS: Resumption of paid employment following acute coronary syndrome (ACS) is an important indicator of recovery, but has not been studied extensively in the modern era of acute patient care. METHODS AND RESULTS: A total of 126 patients who had worked before hospitalization for ACS were studied with measures of previous clinical history, ACS type and severity, clinical management, and sociodemographic characteristics. Depressed mood (Beck Depression Inventory) and type D personality were measured 7-10 days following admission. Among them, 101 (80.2%) had returned to work 12-13 months later. Failure to resume work was associated with cardiac factors on admission (heart failure, arrhythmia), cardiac complications during the intervening months, and depression scores during hospitalization. It was not related to age, gender, socioeconomic status, type of ACS, cardiac history, acute clinical management, or type D personality. In multivariate analysis, the likelihood of returning to work was negatively associated with depression, independently of clinical and demographic factors [adjusted odds ratio 0.90, CI 0.82-0.99, P=0.032]. CONCLUSION: Depressed mood measured soon after admission is a predictor of returning to work following ACS. The management of early depressed mood might promote the resumption of economic activity and enhance the quality of life of cardiac patients.

Adolescent↗

Trends in physical activity and sedentary behaviour in adolescence: ethnic and socioeconomic differences.

OBJECTIVE: To assess developmental trends in physical activity and sedentary behaviour in British adolescents in relation to sex, ethnicity and socioeconomic status (SES). DESIGN: A 5-year longitudinal study of a diverse cohort of students aged 11-12 years at baseline in 1999. SETTING: 36 London schools sampled using a stratified random sampling procedure. PARTICIPANTS: A total of 5863 students categorised as white, black or Asian, and stratified for SES using the Townsend Index. MAIN OUTCOME MEASURES: Number of days per week of vigorous activity leading to sweating and breathing hard. Hours of sedentary behaviour, including watching television and playing video games. Data were analysed using multilevel, linear, mixed models. RESULTS: Marked reductions in physical activity and increases in sedentary behaviour were noticed between ages 11-12 and 15-16 years. Boys were more active than girls, and the decline in physical activity was greater in girls (46% reduction) than in boys (23%). Asian students were less active than whites, and this was also true of black girls but not boys. Black students were more sedentary than white students. Levels of sedentary behaviour were greater in respondents from lower SES. Most differences between ethnic and SES groups were present at age 11 years, and did not evolve over the teenage years. CONCLUSIONS: Physical activity declines and sedentary behaviour becomes more common during adolescence. Ethnic and SES differences are observed in physical activity and sedentary behaviour in British youth that anticipate adult variations in adiposity and cardiovascular disease risk. These are largely established by age 11-12 years, so reversing these patterns requires earlier intervention.

Adolescent↗

Neuroendocrine and cardiovascular correlates of positive affect measured by ecological momentary assessment and by questionnaire.

The relationships between positive affect, salivary cortisol over the day, and cardiovascular responses to laboratory mental stress tests, were assessed in 72 healthy non-smoking men (mean age 33.6+/-8.8 years). Positive affect was measured by aggregating ecological momentary assessments (EMA) of happiness obtained at four times on each of 2 working days, and by questionnaire using the Positive and Negative Affect Schedule (PANAS). Saliva was sampled on 2 days, on waking, 30 and 60 min later, and four other times over the day. Blood pressure and heart rate responses to speech and mirror tracing tasks were measured over two sessions 4 weeks apart. Data were analysed using regression of positive affect on biology adjusting for age, body mass and negative affect, with additional adjustment for time of waking in cortisol analyses and for work stress in cardiovascular analyses. EMA positive affect was inversely associated with cortisol early in the day and with the cortisol increase after waking, controlling for age, body mass index, and negative affect (P=0.012). There was no relationship between PANAS positive affect and cortisol, or between EMA positive affect and cortisol later in the day. Diastolic pressure recovery post-stress was more rapid among participants with high positive affect (P=0.022) and with lower systolic pressure throughout the stress sessions, after controlling for covariates including negative affect. PANAS positive affect was also inversely associated with systolic pressure, but not with diastolic stress or heart rate. We conclude that positive affect is related to biological responses in the laboratory and everyday life that may be health protective. Effects were substantially stronger when positive affect was assessed by aggregating EMA samples than with questionnaire measures.

Adult↗

The effects of tea on psychophysiological stress responsivity and post-stress recovery: a randomised double-blind trial.

RATIONALE: Tea has anecdotally been associated with stress relief, but this has seldom been tested scientifically. OBJECTIVES: To investigate the effects of 6 weeks of black tea consumption, compared with matched placebo, on subjective, cardiovascular, cortisol and platelet responses to acute stress, in a parallel group double-blind randomised design. MATERIALS AND METHODS: Seventy-five healthy nonsmoking men were withdrawn from tea, coffee and caffeinated beverages for a 4-week wash-out phase during which they drank four cups per day of a caffeinated placebo. A pretreatment laboratory test session was carried out, followed by either placebo (n = 38) or active tea treatment (n = 37) for 6 weeks, then, a final test session. Cardiovascular measures were obtained before, during and after two challenging behavioural tasks, while cortisol, platelet and subjective measures were assessed before and after tasks. RESULTS: The tasks induced substantial increases in blood pressure, heart rate and subjective stress ratings, but responses did not differ between tea and placebo treatments. Platelet activation (assessed using flow cytometry) was lower following tea than placebo treatment in both baseline and post-stress samples (P < 0.005). The active tea group also showed lower post-task cortisol levels compared with placebo (P = 0.032), and a relative increase in subjective relaxation during the post-task recovery period (P = 0.036). CONCLUSIONS: Compared with placebo, 6 weeks of tea consumption leads to lower post-stress cortisol and greater subjective relaxation, together with reduced platelet activation. Black tea may have health benefits in part by aiding stress recovery.

Adaptation, Psychological↗

The effects of chronic tea intake on platelet activation and inflammation: a double-blind placebo controlled trial.

BACKGROUND: Tea drinking appears to protect against the development of coronary heart disease (CHD), but the mediating pathways are uncertain. We studied the effects of 6 weeks of black tea or placebo on platelet activation, C-reactive protein (CRP), total antioxidant status, and soluble (s) P-Selectin in a randomized double-blind trial. METHODS: Healthy non-smoking men aged 18-55 years were randomized to black tea (N=37) or placebo (N=38) following a 4-week washout period during which they drank no tea, coffee or caffeinated beverages, but consumed caffeinated placebo tea. Bloods were drawn after 6 weeks of treatment. Platelet activation was assessed by measuring leukocyte-platelet aggregates using whole blood flow cytometry. RESULTS: Following treatment, the tea group had fewer monocyte-platelet aggregates (means 5.84 versus 6.60%, P=0.027), neutrophil-platelet aggregates (P=0.017), total leukocyte-platelet aggregates (P=0.027), and lower plasma C-reactive protein (means 0.76 versus 0.97 mg/L, P=0.05) than the placebo group. There were no differences in total antioxidant status or soluble P-Selectin. CONCLUSIONS: Chronic tea consumption reduces platelet activation and plasma C-reactive protein in healthy men. Effects cannot be attributed to observer bias or lifestyle confounders. These effects of tea may contribute to sustained cardiovascular health.

Adolescent↗

Parental adiposity and cortisol awakening responses in young men and women.

A heightened cortisol awakening response (CAR) is associated with adiposity in middle-aged men, but the causal significance of this effect is not known. We hypothesised that if disturbance in cortisol secretion is involved in the development of overweight and obesity, then it might be present in normal weight adults at increased risk of obesity on account of parental adiposity. The CAR and cortisol profile over the day were measured in 33 men and 62 women aged 18-25 years. Parental adiposity was assessed with figure ratings derived from the Contour Drawing Rating Scale, and these were correlated with parental self-reported body mass index (BMI) in a subset of participants (r=0.66-0.79). In men, a positive association was observed between the CAR and their judgements of their fathers' adiposity after controlling for age, smoking status, time of waking, and the participants' own BMI; the correlation was 0.56 (P=0.008) for the cortisol increase between waking and 30 min, and 0.47 (P=0.028) for the cortisol area under the curve. The correlation between the CAR and fathers' own reported BMI and figures ratings were also significant. The relationship between parental adiposity and the CAR in women was inconsistent, and the associations between the CAR and opposite gender parental adiposity were not significant. Parental adiposity was not related to cortisol output over the rest of the day or to the slope between waking and evening in either sex. The results of this study suggest that disturbances of cortisol secretion may present before the emergence of heightened adiposity in young men at raised risk for obesity.

Adiposity↗

Sleep duration and health in young adults.

BACKGROUND: Both long and short sleep durations have been associated with negative health outcomes in middle-aged and older adults. This study assessed the relationship between sleep duration and self-rated health in young adults. METHODS: Using anonymous questionnaires, data were collected from 17 465 university students aged 17 to 30 years who were taking non-health-related courses at 27 universities in 24 countries. The response rate was greater than 90%. Sleep duration was measured by self-report; the health outcome was self-rated health; and age, sex, socioeconomic background, smoking, alcohol consumption, body mass index, physical activity, depression (Beck Depression Inventory), recent use of health services, and country of origin were included as covariates. RESULTS: Sixty-three percent of respondents slept for 7 to 8 hours; 21% were short sleepers (6%, <6 hours; 15%, 6-7 hours); and 16% were long sleepers (10%, 8-10 hours; 6%, >10 hours). Compared with the reference category (7-8 hours), the adjusted odds ratio of poor health was 1.56 (95% confidence interval [CI], 1.22-1.99) for respondents sleeping 6 to 7 hours and 1.99 (95% CI, 1.31-3.03) for those sleeping less than 6 hours. The same significant pattern was seen when the results were analyzed separately by sex. When respondents from Japan, Korea, and Thailand (characterized by relatively short sleep durations) were excluded, the adjusted odds ratios were 1.33 (95% CI 1.03-1.73) and 1.62 (95% CI, 1.06-2.48) for those sleeping 6 to 7 hours and less than 6 hours, respectively. There were no significant associations between self-rated health and long sleep duration. CONCLUSION: Our data suggest that short sleep may be more of a concern than long sleep in young adults.

Adolescent↗

Ten-year changes in sun protection behaviors and beliefs of young adults in 13 European countries.

OBJECTIVE: Sun protection behaviors are important to the prevention of skin cancers, but little is known about changes over time in attitudes and behavior. METHODS: Cross-sectional surveys were carried out among university students in thirteen European countries in 1990 (n = 10,241) and 2000 (n = 10,161). Sun protection behavior and beliefs about the importance of sunscreen use for health were measured. RESULTS: There was little change in the proportion of men and women who sunbathed, but use of sun protection increased over the 10-year interval from 52% to 63% in men and 80% to 87% in women. There was wide variation in sun protection use and strength of health beliefs between countries. The association between strength of beliefs and behavior was more marked in 2000 than 1990. Sun protection behavior was positively associated with the socioeconomic background of participants. CONCLUSION: The use of sunscreen increased among educated young Europeans from several countries over the 1990s, but important sex differences remain. Awareness of the risk to health of unprotected sunbathing is high, but there is scope of strengthening attitudes to sunscreen use.

Adult↗

Delayed blood pressure recovery after psychological stress is associated with carotid intima-media thickness: Whitehall psychobiology study.

OBJECTIVE: Delayed blood pressure (BP) recovery after psychological stress is associated with low socioeconomic status (SES) and prospectively with increases in clinic BP. We tested whether poststress BP recovery was related to carotid atherosclerosis. METHODS AND RESULTS: Psychophysiological stress testing was performed with a healthy subgroup of the Whitehall II epidemiological cohort, and recovery systolic BP was monitored 40 to 45 minutes after stressful behavioral tasks. Carotid ultrasound scanning was conducted on 136 men and women (aged 55.3+/-2.7 years) 3 years after stress testing. Participants were divided into those whose systolic BP had returned to baseline in the recovery period (adequate recovery, n=37), and those whose BP remained elevated (delayed recovery, n=99). Systolic BP stress responses did not differ in the 2 groups. Carotid intima-media thickness (IMT) was associated with delayed recovery in lower SES (means 0.78 versus 0.65 mm) but not higher SES participants (means 0.75 versus 0.74 mm) after adjustment for age, gender, baseline systolic BP, and resting BP, smoking, body mass and fasting cholesterol at the time of ultrasound scanning (P=0.010). CONCLUSIONS: Variations in poststress recovery reflect dysfunction of biological regulatory processes, and may partly mediate psychosocial influences on cardiovascular disease.

Blood Pressure↗

The effects of depressive symptoms on cardiovascular and catecholamine responses to the induction of depressive mood.

We examined the effects of depressive symptoms on cardiovascular and catecholamine responses to the induction of different mood states. Fifty-five healthy men and women (mean age 23.4 +/- 3 years) were recruited. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale (CES-D) and participants were classified into high depressive (CES-D*16) or low depressive symptoms (CES-D < 16) groups. Following a baseline period, participants were required to complete two separate speech tasks where they were asked to recall life events that made them feel angry or depressed. The tasks were separated by a 30-min recovery period and the order was randomised between participants using a counterbalanced design. Cardiovascular function was monitored continuously using a Finometer device and saliva was collected for the assessment of 3-methoxy-phenylglycol (MHPG, the major metabolite of norephinephrine). Blood pressure (BP), heart rate, and total peripheral resistance (TPR) were significantly increased in response to both tasks (p = .001). Averaged over conditions, higher diastolic BP and higher MHPG levels were observed in high depressive symptoms participants. MHPG levels did not change in response to mood induction in the low depressive symptoms group. However, the high depression symptoms group showed significantly higher levels of MHPG during recovery from the depressed mood induction task and increased levels immediately after the anger induction task. These findings suggest depressive symptoms are associated with heightened central adrenergic activation during negative mood induction, but that the time course of responses is dependent on the type of emotion elicited.

Adult↗

Low levels of breast cancer risk awareness in young women: an international survey.

At least a fifth of breast cancer cases in Western countries are likely to be due to modifiable lifestyle factors. Previous work has found that while women in Western countries are aware that breast cancer can be hereditary, their knowledge of the influence of lifestyle is poor. This survey investigated on the awareness of breast cancer risk factors in university students from 23 countries between 1999 and 2001. Data were collected on awareness of links with heredity, alcohol use, exercise, obesity, stress, smoking and diet. Almost a third of women were not aware that any of these factors influenced breast cancer. Just 57% were aware of the genetic link and fewer than 1 in 20 women correctly identified alcohol, exercise or obesity as factors influencing breast cancer. Stress and smoking were the most commonly chosen lifestyle risk factors although current data suggest that they have little actual impact on breast cancer risk. There was considerable international variation, with highest levels of awareness in students in the United States of America (USA). Knowledge of risk in this sample was poorer than previously observed in older women. Health messages concerning cancer in general may be more relevant for this age group, because of the lower salience of breast cancer for younger women.

Adolescent↗

Acute depressed mood as a trigger of acute coronary syndromes.

BACKGROUND: Some cases of acute coronary syndrome (ACS) may be triggered by emotional states such as anger, but it is not known if acute depressed mood can act as a trigger. METHODS: 295 men and women with a verified ACS were studied. Depressed mood in the two hours before ACS symptom onset was compared with the same period 24 hours earlier (pair-matched analysis), and with usual levels of depressed mood, using case-crossover methods. RESULTS: 46 (18.2%) patients experienced depressed mood in the two hours before ACS onset. The odds of ACS following depressed mood were 2.50 (95% confidence intervals 1.05 to 6.56) in the pair-matched analysis, while the relative risk of ACS onset following depressed mood was 4.33 (95% confidence intervals 3.39 to 6.11) compared with usual levels of depressed mood. Depressed mood preceding ACS onset was more common in lower income patients (p = .032), and was associated with recent life stress, but was not related to psychiatric status. CONCLUSIONS: Acute depressed mood may elicit biological responses that contribute to ACS, including vascular endothelial dysfunction, inflammatory cytokine release and platelet activation. Acute depressed mood may trigger potentially life-threatening cardiac events.

Acute Disease↗

Association between plasma levels of heat shock protein 60 and cardiovascular disease in patients with diabetes mellitus.

AIMS: Evidence is accumulating to support the hypothesis that the release of heat shock protein (Hsp)60 into the circulation is associated with the development of coronary heart disease (CHD). As diabetes is a risk factor for CHD, it was of interest to determine Hsp60 blood levels in a cross-sectional cohort of diabetic patients, some of whom had cardiovascular disease, and relate levels to relevant biochemical markers. METHODS AND RESULTS: A total of 855 patients with T1DM or T2DM, recruited as part of the UCL Diabetes and Cardiovascular disease Study (UDACS), were assayed for plasma levels of Hsp60. Immunoreactive Hsp60 was detected in 54% of the samples, with 26% having plasma levels > 1 microg/mL. Levels of Hsp60 were higher in Caucasians than in other ethnic groupings, with 56.5% of Caucasian subjects, 37.5% of African-Caribbean subjects, and 47.1% of Indian subjects having detectable levels (P = 0.007), and with a higher proportion of non-smokers having detectable Hsp60 levels than smokers (54.9 vs. 43.5%, P = 0.01). Of note was the finding of an association between higher mean plasma levels of Hsp60 in subjects with clinically manifest cardiovascular disease and those with a history of myocardial infarction having an adjusted odds ratio of having detectable Hsp60 of 2.17 (CI 1.26-3.73). CONCLUSION: This is the first report of circulating Hsp60 levels in diabetic patients, which suggests that this secreted mitochondrial cell stress protein may be playing an unexpected role in the cardiovascular pathology associated with diabetes.

Antioxidants↗

Pathophysiological processes underlying emotional triggering of acute cardiac events.

Acute negative emotional states may act as triggers of acute coronary syndrome (ACS), but the biological mechanisms involved are not known. Heightened platelet activation and hemodynamic shear stress provoked by acute stress may contribute. Here we investigated whether patients whose ACS had been preceded by acute anger, stress, or depression would show heightened hemodynamic and platelet activation in response to psychophysiological stress testing. We studied 34 male patients an average of 15 months after they had survived a documented ACS. According to an interview conducted within 5 days of hospital admission, 14 men had experienced acute negative emotion in the 2 h before symptom onset, and 20 men had not experienced any negative emotion. Hemodynamic variables and platelet activation were monitored during performance of challenging color-word interference and public speaking tasks and over a 2-h poststress recovery period. The emotion trigger group showed significantly greater increases in monocyte-platelet, leukocyte-platelet, and neutrophil-platelet aggregate responses to stress than the nontrigger group, after adjusting for age, body mass, smoking status, and medication. Monocyte-platelet aggregates remained elevated for 30 min after stress in the emotion trigger group. The emotion trigger group also showed poststress delayed recovery of systolic pressure and cardiac output compared with the nontrigger group. These results suggest that some patients with coronary artery disease may be particularly susceptible to emotional triggering of ACS because of heightened platelet activation in response to psychological stress, coupled with impaired hemodynamic poststress recovery.

Acute Disease↗

Inflammatory and hemostatic responses to repeated mental stress: individual stability and habituation over time.

An important assumption underlying psychobiological studies relating stress reactivity with disease risk is that individuals are characterized by stable response profiles that can be reliably assessed using acute psychophysiological stress testing. Previous research has mainly focused on the stability of cardiovascular, neuroendocrine, and cellular immune responses to repeated stressors, and less attention has been given to inflammatory and platelet responses. We therefore examined both average stability and individual test-retest stability of cardiovascular, neuroendocrine, hemostatic, inflammatory, and subjective responses to mental stress over two repeated stress sessions, four weeks apart. Ninety-one healthy, non-smoking men (mean age 33.2 years) completed a 3-min speech task followed by a 5-min mirror tracing task on two separate occasions. Blood samples were taken at baseline and 10 min after the stress tasks while cardiovascular activity, saliva samples, and subjective ratings were measured repeatedly. There was significant cardiovascular and cortisol activation to the stressors and stress-induced increases in plasma C-reactive protein, von Willebrand factor antigen, and platelet activation indexed by leukocyte-platelet aggregates. The magnitude of stress responses did not differ between sessions in any variable. Significant test-retest correlations between sessions were observed for baseline and stress values of all variables (r=0.47-0.74, p<.001), but reactivity (change scores) for C-reactive protein, von Willebrand factor, cortisol, and platelet activation were not significantly correlated. Our results demonstrate that the stress-induced responses did not habituate between sessions, though the small magnitude of acute inflammatory, cortisol, and platelet responses limits the test-retest reliability of stress reactivity assessments.

Adaptation, Physiological↗

Influence of specific nutrients on progression of atherosclerosis, vascular function, haemostasis and inflammation in coronary heart disease patients: a systematic review.

Epidemiological evidence suggests that the diet influences CHD risk, although the protective effects of dietary intervention for patients in diseased states has gained less attention. Secondary care prevention strategies for patients often involves drug therapy that is expensive and can result in undesirable side effects. Therefore, it is potentially beneficial to utilise other strategies, such as diet, in the management of CHD. A systematic review was conducted to examine the effects of specific nutrients on progression of atherosclerosis, vascular function, haemostasis and inflammation in CHD patients. Results show substantial evidence for the efficacy of n-3 oils in reducing cardiovascular mortality and one mechanism may be related to the stabilisation of vulnerable atherosclerotic plaques, although the effects on progression of atherosclerosis, haemostatic activity and vascular inflammation remain equivocal. Promising data also exist for the efficacy of flavonoid-rich foods for improving endothelial function, although strong clinical endpoint evidence is lacking. The variation in the efficacy of certain nutrients in CHD patients may be explained by genetics, existing risk factors, psychosocial factors and methodological issues, although these are often not adequately taken into consideration. We conclude that there is a need to undertake more appropriately designed trials in specific clinical populations, controlling for additional lifestyle and risk factors, examining potential interactions with medications, and also establishing methods to increase compliance to dietary recommendations before specific nutrients can be widely prescribed for secondary prevention. Future research should also utilise techniques that provide a direct measure of atherosclerosis.

Coronary Artery Disease↗

Association between coffee consumption and markers of inflammation and cardiovascular function during mental stress.

BACKGROUND: Coffee is widely consumed in the Western diet and therefore has important implications for public health. Research findings pertaining to the effects of coffee consumption on cardiovascular health are conflicting, and the role of caffeine is not clear. OBJECTIVE: To examine the relationship between coffee intake, inflammation and cardiovascular function at baseline and during mental stress, both cross-sectionally and after a 4-week period of withdrawal of coffee during which intake of caffeine was maintained. METHODS: Eighty-five healthy, non-smoking men with varying coffee-drinking habits were recruited. Blood pressure, heart rate, and markers of inflammation [C-reactive protein (CRP), von Willebrand factor antigen (vWF)], were measured at baseline and during mental stress. These measures were repeated after a 4-week period of withdrawal of coffee, during which intake of caffeine was maintained. Habitual levels of coffee and caffeine consumption were assessed from a self-reported questionnaire, and saliva samples for the analysis of caffeine concentrations were collected regularly throughout the period of withdrawal, to confirm compliance. RESULTS: Multiple linear regression analysis of pre-withdrawal data, adjusted for age, body mass index and intake of tea, red wine, fruit, vegetables, oily fish and dietary supplements revealed that coffee consumption was positively related to baseline systolic blood pressure, and increased heart rate and vWF responses to mental stress. Four weeks after withdrawal of coffee, the heightened vWF and heart rate responses to stress in habitual coffee drinkers persisted, whereas baseline systolic blood pressure had decreased. Total caffeine intake was unrelated to any measures of physiological function. CONCLUSIONS: Habitual coffee consumption is associated with heightened acute vascular inflammatory responses to mental stress, although these effects are not affected by short-term abstinence from coffee. These findings suggest that the relationship between coffee and markers of cardiovascular risk may be explained by residual or unmeasured confounding factors.

Adult↗