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Cardiovascular disease (CVD) is a collective term used to describe conditions affecting the heart and circulation, including coronary heart disease, heart attack, and stroke. Each of these conditions can be affected by various risk factors including blood pressure, cholesterol, blood vessel dilation and homocysteine levels.
Research into coffee consumption and CVD has suggested that a moderate intake of coffee, of around 3-5 cups per day, may reduce CVD mortality risk1-9. Moderate coffee consumption can be defined as 3-5 cups per day, based on the European Food Safety Authority’s review of caffeine safety10.
Specifically in relation to coronary heart disease, many studies suggest a protective effect at intakes of approximately 3-5 cups per day with the association resembling a U-shaped curve7,11-12. Studies reviewing associations between coffee consumption and stroke have suggested that a moderate intake is associated with a reduced risk of stroke, particularly in women13-19.
Research considering the effect of coffee consumption on atrial fibrillation suggests that there is no association between coffee consumption and risk of atrial fibrillation, and moderate coffee consumption may be associated with a reduced risk20-25. The association between coffee consumption and blood pressure is unclear, with studies reporting conflicting results. The effect appears to be relatively small and not exclusively dependent on caffeine26-30.
In relation to cholesterol levels, the method of coffee preparation is the main factor to consider. Trials using filtered coffee demonstrate virtually no effect on serum cholesterol, whilst consumption of unfiltered coffee can increase serum cholesterol levels31-35. However, the effects on cholesterol levels are transient31.
Brachial artery flow-mediated dilation is a measure of endothelial dysfunction, used to evaluate cardiovascular risk. A small number of studies have shown a short-term effect of coffee consumption on reduced flow36-38. Additionally, some research has suggested that high coffee intakes increase blood homocysteine39-49. Further studies are needed before conclusions can be drawn.
Much of the research into coffee consumption and cardiovascular disease has considered the impact in healthy participants, however additional work has considered the effect in patients with specific diseases. Such research provides valuable information on coffee drinking in cases of ill health and may help to explain some of the variation in results from epidemiological studies50-59.
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 investigation60. Caffeine is unlikely to be solely responsible for the observed effects13-19,26-49.
The content in this Topic Overview was last edited in October 2017. Papers in the Latest Research section and further resources are added regularly.
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