Fast Five Quiz: Coffee Health Effects

Yasmine S. Ali, MD; Helmi L. Lutsep, MD; Romesh Khardori, MD, PhD; BS Anand, MD; Stephen Soreff, MD; Elwyn C. Cabebe, MD


January 07, 2022

A recent study found that, among middle-aged individuals without heart disease, drinking as many as three cups of coffee per day was associated with a 21% lower risk for stroke, a 17% lower risk for death from cardiovascular disease, and a 12% lower risk for death from all causes (as well as more favorable cardiac MRI findings) compared with nondrinkers (< 0.5 cup per day) during a median 11-year follow-up. Among the 30,650 participants who had cardiac MRI data, the study found that, compared with not drinking coffee, both light to moderate and high coffee consumption were associated with significantly increased left and right ventricular end-systolic and end-diastolic volumes and with greater left ventricular mass (all P < .001). However, the long-term clinical significance of these findings remains unclear. Coffee consumption has also been associated with reduced levels of protein markers that are linked to cardiovascular disease, such as leptin and chitinase-3-like protein 1.

A recent study of more than 300,000 individuals found that habitual coffee drinking was not associated with a heightened risk for cardiac arrhythmias. In fact, an adjusted analysis found that coffee lowered the risk for incident arrhythmia. Over an average follow-up of 4.5 years, 16,979 participants developed an incident arrhythmia. After adjusting for demographic characteristics, comorbid conditions, and lifestyle habits, the decreased risk with each cup of coffee was similar for atrial fibrillation or flutter (hazard ratio, 0.97) and supraventricular tachycardia (hazard ratio, 0.96). Although transient, undiagnosed arrythmias may occur with high caffeine intake; recent evidence suggests that coffee does not increase risk for persistent, diagnosed arrythmias.

Routine coffee consumption has not shown a dramatic effect on blood pressure. In fact, some studies suggest that it may actually result in modestly decreased hypertension risk.

Studies have shown that the effect of coffee on cholesterol is highly related to the form in which it is consumed. Unfiltered coffees (eg, French press) are known to be high in cafestol, which has been called "the most potent cholesterol-elevating compound known in the human diet." In a 2020 study, Cornelis and colleagues found that although unfiltered espresso formulations resulted in higher low-density lipoprotein cholesterol levels, this effect wasn't observed among those drinking standard ground or instant coffee.

Learn more about cardiovascular disease prevention.


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