Coffee consumption and cardiovascular disease risk

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A number of meta-analyses have reviewed the associations between coffee consumption and cardiovascular disease (CVD) overall, with many concluding that there is no association between coffee drinking and an increased risk of CVD1-7. Some studies have suggested that the association can be illustrated with a ‘U-shaped curve’ with the greatest protection seen at a moderate intake of coffee (3-5 cups per day). The lowest CVD mortality risk is seen at an intake of approximately 3 cups of coffee per day, with a percentage risk reduction of up to 21%5-8.

  • A 2012 systematic review and a dose-response meta-analysis of prospective studies observed a statistically significant J-shaped relationship between coffee and heart failure. Compared to those who did not drink coffee, the strongest inverse association was seen at 4 cups per day, with a potentially higher risk reported at higher levels of consumption. There was no indication that the relationship between coffee and heart failure risk varied by sex or by baseline history of myocardial infarction or diabetes1.
  • A 2013 review on coffee consumption and mortality, with over a million participants, suggested a significant inverse association between coffee consumption and CVD mortality risk, especially in women. Intakes of coffee at 3-5 cups per day showed the most significant protective effect, whilst quantities over 5 cups per day were associated with a smaller reduction in total mortality2.
  • However, a 2013 large American cohort study of over 2,500 CVD deaths suggested a positive association between coffee consumption and all-cause mortality in men, and also in men and women below 55 years of age. The authors advised that younger people should avoid heavy coffee consumption, cautioning that the finding should be assessed in other populations3.
  • A 2013 meta-analysis of well-controlled prospective studies suggested that coffee consumption was not associated with risk of coronary heart disease, weakly associated with a lower risk of stroke and heart failure, and not associated with a higher risk of fatal cardiovascular events. Overall, the authors concluded that for most healthy people, moderate coffee consumption is unlikely to adversely affect cardiovascular health4.
  • Two 2014 meta-analyses suggest an association between coffee consumption and CVD risk, proposing a ‘U-shaped’ pattern whereby optimal protective effects were achieved with 3-5 cups of coffee per day. According to these two studies, the greatest risk reduction may be seen at 3 cups of coffee per day, with a reduced CVD mortality risk at 21%5,6.
  • A 2017 review of observational studies and meta-analyses concluded that habitual consumption of 3-5 cups of coffee per day is associated with a 15% reduction in the risk of CVD, and higher consumption has not been linked to elevated CVD risk7.
  • A 2018 report concluded that habitual coffee consumption is associated with lower risks for cardiovascular death and a variety of adverse CV outcomes, including coronary heart disease, congestive heart failure, and stroke, whilst coffee’s effects on arrhythmias and hypertension are neutral. Habitual intake of 3-4 cups of coffee appears to be safe and is associated with the most robust beneficial effects8.
  • A 2018 review of the cardiovascular effects of caffeinated beverages concluded that a moderate intake of coffee and tea may be beneficial for a range of cardiovascular conditions including coronary artery disease, heart failure and arrhythmias9.

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