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Coffee is associated with lower mortality, cardiovascular disease

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Drinking two to three cups of coffee daily, including ground coffee, instant coffee, or decaffeinated coffee, significantly reduces new cardiovascular disease (CVD) and mortality compared to no coffee drinking That’s what a new analysis from the UK Biobank for the future suggests.

Ground and instant coffee and, interestingly, decaffeinated coffee consumption were associated with a reduced risk of new-onset arrhythmias. atrial fibrillation.

“Our study is the first to look at differences between coffee subtypes and reveal important differences that explain some of the mechanisms by which coffee works,” said Peter M. Kistler, M.D., Alfred Hospital. and the Baker Heart and Diabetes Institute, Melbourne, Australia, said theheart.org| Medscape Cardiology.

“Daily coffee intake should not be discouraged by doctors, but rather viewed as part of a healthy diet,” Kistler said.

“This study confirms that coffee is safe and even potentially beneficial, and is consistent with most of the evidence to date,” says Karl “Chip” Raby, M.D., who was not involved in the study. said Dr. theheart.org| Medscape Cardiology.

“We don’t prescribe coffee to our patients, but for the vast majority of people who like coffee, we can encourage them to drink a few cups a day,” says Raby of the Ochsner Cardiovascular Institute in New Orleans, Louisiana. You can,’ he said.

research is publish online today European Journal of Preventive Cardiology.

Distinct cardiovascular benefits

A total of 449,563 UK Biobank participants (median age 58 years, 55% female) were free of arrhythmias or other CVDs at baseline and reported their daily coffee intake and preferred type of coffee on a questionnaire.

Over 12.5 years of follow-up, 27,809 (6.2%) of participants died.

Drinking 1 to 5 cups of ground or instant coffee daily (excluding decaffeinated coffee) significantly reduced the occurrence of arrhythmias. The lowest risk was associated with drinking 4-5 cups of ground coffee per day (hazard ratio) [HR] 0.83; 95% confidence interval, 0.76 to 0.91. P. < .0001) and 2–3 cups per day for instant coffee (HR, 0.88; 95% CI, 0.85–0.92; P. < .0001).

Regular coffee drinkers up to five cups a day were also associated with a significantly reduced risk of cardiovascular disease compared to nondrinkers.

Dramatically reduce the risk of incidents coronary artery disease (CHD) was associated with habitual coffee consumption of up to 5 cups per day, with the lowest risk of CHD in those who drank 2–3 cups of coffee per day (HR 0.89; 95% CI, 0.86). – 0.91; P. < .0001).

Coffee consumption at all levels was associated with significantly reduced risk. congestive heart failure (CCF) and ischemic strokeThe lowest risk was for those who drank two to three cups per day, with a HR of 0.83 (95% CI 0.79 to 0.87; P. < .0001) for CCF and HR, 0.84 (95% CI, 0.78 - 0.90; P. < .0001) for ischemic stroke.

All-cause mortality was significantly reduced for all coffee subtypes, with the greatest risk reduction seen at 2-3 decaffeinated cups/day (HR, 0.86; 95% CI 0.81 – 0.91; P. < .0001); ground (HR, 0.73; 95% CI, 0.69 - 0.78; P. < .0001); and instant coffee (HR, 0.89; 95% CI, 0.86 - 0.93; P. < .0001).

“Coffee consumption is associated with cardiovascular benefits and empirically should not be discontinued in people with heart rhythm disturbances or underlying cardiovascular disease,” Kistler said. theheart.org| Medscape Cardiology.

plausible mechanism

A number of mechanisms have been proposed to explain the benefits of coffee for cardiovascular disease.

caffeine Has antiarrhythmic properties adenosine “It’s the difference between the effects of decaf and full-strength coffee on inhibition of A1 and A2A receptors and thus heart rhythm disturbances,” Kistler explained.

Coffee also has vasodilatory effects, and coffee also contains antioxidant polyphenols that reduce oxidative stress and regulate metabolism.

“The explanation for the survival benefit from habitual coffee consumption remains unclear,” Kistler said.

“Putative mechanisms include improved endothelial function, circulating antioxidants, insulin Sensitivity, and reduced inflammation.Another potential mechanism involves the beneficial effects of coffee metabolic syndrome,” He said.

“Caffeine plays a role in weight loss by inhibiting intestinal fatty acid absorption and increasing the basal metabolic rate. type 2 diabetes Meritus,” added Kistler.

Unclear relationship direction

Charlotte Mills, of the University of Reading, UK, said the study “adds to a body of evidence from observational studies linking moderate coffee consumption to cardioprotection and looks promising”.

However, in observational design, “It is unclear in which direction the relationship goes. For example, does coffee make you healthier, or does an inherently healthy person consume coffee? Randomized controlled trials are needed to fully understand the relationship before it can be recommended,” Mills told the UK non-profit Science Media Centre.

Dr Annette Creedon, a nutrition scientist at the British Nutrition Foundation, said respondents who self-reported their intake at the start of the survey may have overestimated or underestimated the amount of coffee they were consuming. .

“It is therefore difficult to determine whether the results are directly related to the coffee consumption behaviors reported at the beginning of the study,” she told the Center for Science Media.

There was no funding for this research. Kistler is funded by Abbott His Medical for consulting, speaking engagements, and fellowship support from Biosense Webster. Lavie has no relevant disclosures.mills is Worked with Nestlé on coffee and health research funded by UKRI. Creedon has not reported any related financial relationships.

Eur J Prev Cardiol. Published online on September 27, 2022. full text

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