Drinking coffee – particularly two to three cups a day – may be associated with a lower risk of heart disease and dangerous heart rhythms, and may be associated with living longer, according to three studies being presented at ACC.22.

Peter M. Kistler, MD, et al., used data from the UK BioBank, a large-scale prospective database with health information from over half a million people who were followed for at least 10 years. Researchers looked at varying levels of coffee consumption ranging from up to a cup to more than six cups a day and the relationship with arrhythmias, cardiovascular disease, including coronary artery disease, heart failure and stroke, and total and heart-related deaths among people both with and without cardiovascular disease.

For the first study, Kistler et al., examined data from 382,535 individuals without known cardiovascular disease to see whether coffee drinking played a role in the development of cardiovascular disease or stroke during the 10 years of follow up. Participants’ average age was 57 years and half were women. Results showed that in general, having two to three cups of coffee a day was associated with the greatest benefit, translating to a 10%-15% lower risk of developing coronary heart disease, heart failure, arrhythmias, or dying for any reason. The risk of stroke or cardiovascular-related death was lowest among people who drank one cup of coffee a day. Researchers did observe a U-shaped relationship with coffee intake and new arrhythmias. The maximum benefit was seen among people drinking two to three cups of coffee a day with less benefit seen among those drinking more or less.

A second study by Kistler et al., included 34,279 individuals who had some form of cardiovascular disease at baseline. Researchers found that coffee intake at two to three cups a day was associated with lower odds of dying vs. no coffee. In addition, consuming any amount of coffee was not associated with a higher risk of arrhythmias, including atrial fibrillation (AFib) or atrial flutter. Of the 24,111 people included in the analysis who had an arrhythmia at baseline, drinking coffee was associated with a lower risk of death and people with AFib who drank one cup of coffee a day were nearly 20% less likely to die than non-coffee drinkers.

“Clinicians generally have some apprehension about people with known cardiovascular disease or arrhythmias continuing to drink coffee, so they often err on the side of caution and advise them to stop drinking it altogether due to fears that it may trigger dangerous heart rhythms,” Kistler said. “But our study shows that regular coffee intake is safe and could be part of a healthy diet for people with heart disease.”

Although two to three cups of coffee a day seemed to be the most favorable overall, Kistler cautions that people shouldn’t increase their coffee intake, particularly if it makes them feel anxious or uncomfortable.

In a third study, Kistler et al., looked at whether there were any differences in the relationship between coffee and cardiovascular disease depending on whether someone drank instant or ground coffee or caffeinated or decaf. They found two to three cups a day to be associated with the lowest risk of arrhythmias, blockages in the heart’s arteries, stroke or heart failure regardless of whether they had ground or instant coffee. Lower rates of death were seen across all coffee types. Decaf coffee did not have favorable effects against incident arrhythmia but did reduce cardiovascular disease, with the exception of heart failure.

Kistler said the findings suggest caffeinated coffee is preferable across the board, and there are no cardiovascular benefits to choosing decaf over caffeinated coffees.

The researchers note that there are several limitations to these studies as they were unable to control for dietary factors that may play a role in cardiovascular disease, nor were they able to adjust for any creamers, milk or sugar consumed. They add that moving forward, the results should be validated in randomized trials.

ACC.22 will take place April 2-4, in Washington, DC, and virtually. Follow @ACCinTouch and #ACC22 for the latest news from the meeting.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Atherosclerotic Disease (CAD/PAD), Atrial Fibrillation/Supraventricular Arrhythmias, Diet

Keywords: ACC Annual Scientific Session, ACC22, Caffeine, Risk Factors, Randomized Controlled Trials as Topic, Arteries, Stroke, Coronary Artery Disease, Atrial Flutter, Biological Specimen Banks, Diet, Healthy, Follow-Up Studies, Cardiovascular Diseases, Atrial Fibrillation, Coffee

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