ABSTRACT

Background and Aims:
To investigate the associations between unsweetened and sweetened coffee consumption and the risk of cardiovascular disease (CVD) and its subtypes (coronary artery disease (CAD), stroke, heart failure (HF), and atrial fibrillation (AF)).

Methods and Results:
This prospective cohort study included participants who completed ≥ 1 valid dietary questionnaire in the UK Biobank. The Cox regression with restricted cubic splines was used to assess the association between coffee intake and incident CVD and its subtypes. Genetic predisposition was estimated using the polygenic risk score (PRS). Among 131,247 coffee consumers (75.6%) with a median follow-up of 12.7 years, 18,659 new CVD cases occurred. A U-shaped relationship between unsweetened coffee intake and CVD risk was observed, with the lowest risk at 2-3 cups per day (HR, 0.85 95% CI, 0.81-0.90). No significant associations were observed between consumption of sugar-sweetened and artificially sweetened coffee and the risk of CVD. The observed protective effect of unsweetened coffee was consistent across various CVD subtypes, independent of genetic predisposition.

Conclusion:
Unsweetened coffee may play a beneficial role in CVD prevention, caution should be exercised when drinking coffee with added sugar or artificial sweeteners.

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