The role of caffeine consumption in coronary heart disease (CHD) and related conditions has long been debated. One thing that does seem clear is that if the consumption of caffeine or coffee exerts an impact on CHD, it does so within the framework of a multifactorial causal model. Family history is a particularly strong factor when CHD occurs in younger people, but is also predictive in older age groups. The genetic factors in CHD may be expressed through a variety of mechanisms, including those that underlie blood lipids, homocysteine, and C-reactive protein. Diabetes mellitus, a disorder of carbohydrate metabolism resulting from insufficient secretion or exploitation of insulin, is commonly regarded as a prime risk factor for CHD. A well-documented CHD risk factor, hypertension involves genetic and environmental factors. CHD risk is tied not only to physiological factors, but also to emotions and behaviors.