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Cardiovascular health

Overview

The majority of prospective cohort studies looking at coffee consumption and cardiovascular disease do not show an overall statistically significant association with coffee, with the potential exception of a small negative association in women.
A statistically significant inverse association is observed for stroke in women. This negative association is even stronger in former smokers and non-smokers. No association is seen in smaller studies including both men and women.

No statistically significant association is seen for atrial fibrillation and caffeine consumption from coffee.

The effect of coffee consumption on blood pressure is relatively small and not exclusively dependent on caffeine. More factors appear to be involved, some having opposite effects on blood pressure.

Trials using filtered coffee demonstrate very little increase in serum cholesterol. A recent trial reports an increase in HDL-cholesterol with filtered coffee consumption. Consumption of unfiltered coffee increases serum levels of total and LDL-cholesterol.

A small number of preliminary tests on flow-mediated dilation measured in the brachial artery have shown a short-term effect of coffee consumption. Further studies are needed before conclusions about the meaning of this effect can be drawn.

There is some evidence that high intakes of coffee may increase blood homocysteine levels. However, it is still unclear whether reducing homocysteine levels leads to a reduced risk of cardiovascular disease; no causal relationship between high homocysteine levels and cardiovascular disease has been established.

The number of reported studies on patients appears to be increasing. The results of these studies should be interpreted with caution. Extrapolation of these results to healthy people is questionable. The primary value of such patient studies will be in therapy development.

The mechanisms underlying the associations between coffee consumption and reduced risk of stroke, and potential associations with risk factors for coronary heart disease, need further investigation. Caffeine is unlikely to be solely responsible for the observed effects.