The evidence remains ambiguous regarding the effect of coffee on CHD (43). The association between CHD and coffee consumption has been weakened by long-term follow-up. These findings may possibly be explained by a change in the type of coffee consumed. A lipid-rich fraction from boiled coffee seems to increase serum cholesterol concentration. When boiled coffee is filtered the lipid-rich factor is retained in the filter paper and the effect on cholesterol is reduced substantially (44).

An elevated plasma concentration of total homocysteine is considered to be a risk factor for cardiovascular disease. Heavy coffee drinking has been related to high homocysteine concentrations in epidemiologic studies and one experiment in which healthy subjects drank unfiltered boiled coffee (45).

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