Study Suggests Coffee Consumption Decreases Heart Failure Risk

David Kao, MD

While previous studies have linked coffee and caffeine consumption to incident arrhythmias, a new study based on pooled data from 3 large epidemiological studies indicates coffee intake was linked to a lower risk of heart failure.

A machine learning analysis of the Framingham Heart Study, the ARIC Study, and Cardiovascular Heart Study, results from the study provide clinicians with validated evidence related to the impact of coffee intake on risk of heart failure, coronary heart disease, and stroke in patients with no history of cardiovascular disease.

“The association between caffeine and heart failure risk reduction was surprising. Coffee and caffeine are often considered by the general population to be ‘bad’ for the heart because people associate them with palpitations, high blood pressure, etc. The consistent relationship between increasing caffeine consumption and decreasing heart failure risk turns that assumption on its head,” said David Kao, MD, senior investigator of the current study and medical director at the Colorado Center for Personalized Medicine at the University of Colorado School of Medicine, in a statement.

To develop a greater understanding of lifestyle and behavioral factors associated with negative impacts on cardiovascular health, Kao and colleagues from multiple institutions in the US designed the current study to assess the impact of responses related to dietary domains on incident cardiovascular disease risk in the aforementioned studies. Investigators planned to use data from the Framingham Heart Study in their primary analysis and validate these results in cohorts from the Cardiovascular Heart Study and ARIC study.

Investigators pointed out the significance of selected variables were assessed using invariable and multivariable Cox proportional hazards analysis, which were adjusted for common cardiovascular risk factors. Variables used in the analyses included red meat consumption, whole milk consumption, and coffee consumption. Outcomes of interest included time to incident CHD, HF, and stroke.

In their initial analyses, coffee consumption was the only dietary factor that was significantly associated with any of the outcomes of interest. Specifically, increased caffeinated coffee consumption was associated with a significantly reduced risk of heart failure (HR, 0.95 per cup per day [95% CI, 0.91–0.99]; P=.02) and stroke (HR, 0.94 per cup/day [95% CI, 0.89–0.99]; P=.02) but not coronary heart disease (P=.21) or cardiovascular disease (P=.59). In univariable analyses, increased coffee consumption was significantly associated with decreased risk of heart failure in the Cardiovascular Health Study (HR, 0.86 per cup/day [95% CI, 0.78–0.96]; P=.005) and the ARIC study (HR, 0.98 per cup/day [95% CI, 0.96–0.99]; P=.048).

Investigators noted multiple limitations within their study to consider before over-interpretation of results. These limitations included inability to determine type of coffee consumed and manner of brewing, potential variability in measurement for 1 cup of coffee, and inability to account for other sources of caffeine such as energy drinks, caffeinated teas, and soda.

"While unable to prove causality, it is intriguing that these three studies suggest that drinking coffee is associated with a decreased risk of heart failure and that coffee can be part of a healthy dietary pattern if consumed plain, without added sugar and high fat dairy products such as cream,” said Penny Kris-Etherton, PhD, RDN, immediate past chairperson of the American Heart Association’s Lifestyle and Cardiometabolic Health Council Leadership Committee, in the aforementioned statement.

This study, “Association Between Coffee Intake and Incident Heart Failure Risk,” was published in Circulation: Heart Failure.