Title:Coffee: A Selected Overview of Beneficial or Harmful Effects on the Cardiovascular System?
Volume: 13
Issue: 5
Author(s): Thomas F. Whayne
Affiliation:
Keywords:
Cardiovascular, coffee, coronary heart disease, congestive heart failure, diabetes mellitus, myocardial infarction,
sudden cardiac death.
Abstract: With a history that began in 800 A.D., coffee is the most popular drink known and as a result,
the issues regarding its physiologic effects deserve attention. Maintaining alertness is a wellknown
benefit and in addition, the cardiovascular (CV) effects of the active compounds, which include
polyphenols and caffeine, must be considered. Genetics are relevant and where slow caffeine metabolism
is inherent, the risk of nonfatal myocardial (MI) has been shown to be increased. Overall risk for
coronary heart disease (CHD) is not supported and unless there is excessive intake, congestive heart
failure (CHF) is not adversely affected; in moderation, there may be some benefit for CHF. There is no apparent increased
risk of sudden cardiac death (SCD). Overall, there also appears to be a beneficial inverse association with all-cause mortality,
although this is not absolute for extra heavy intake. Benefit in reducing stroke also has supportive evidence. Hypertension
is not increased by coffee. Boiled and unfiltered coffee appears to increase plasma cholesterol and triglycerides
but for the overall metabolic syndrome, there appears to be benefit. There is also some evidence that paper-filtered coffee
results in an increase in some markers of inflammation. Association of coffee with arrhythmias has been a major concern
though in moderation it is not a significant overall problem. Therefore, only if a patient were to associate major arrhythmic
symptoms with coffee would cessation have to be advised. Where coffee clearly shines from a CV standpoint is in the
established decrease in onset of type 2 diabetes mellitus (DM). Any benefit or harm has always been attributed to caffeine
as the apparent major component. However, coffee contains a myriad of compounds, including polyphenols. These other
substances may be most relevant for potential benefit or harm and some of these may be partially removed or altered by
coffee preparation methods such as paper filtration. Multiple studies support this by what appears to be no CV advantage
or disadvantage for decaffeinated coffee. The bottom line on coffee, for those who enjoy the brew, is that it is a wonderful
beverage with rare associated CV disadvantage and with much to recommend it from an overall CV standpoint.
