Clinical Question: Does coffee consumption increase the risk of heart disease?

Setting: Population-based

Study Design: Cohort (prospective)

Synopsis: Many patients avoid coffee, often on the advice of their physicians, because of concerns that it may increase the risk of heart disease. The largest and longest study to date on the subject combines data from the Health Professionals Follow-up Study (n= 44,005) and the Nurses’ Health Study (n = 84,488). These studies began in 1986 and 1976, respectively, and provide 14 and 20 years of follow-up.

None of the participants had coronary artery disease (CAD) at the beginning of the study. Participants reported their typical daily caffeine consumption via surveys every four years. The primary outcome was nonfatal myocardial infarction or fatal CAD before June 1, 2000. After adjusting for age, smoking, and other risk factors, the relative risks for the primary outcome among men were all between 0.72 and 1.07, and none were statistically significant. Results were similar for women. No association was found for total caffeine intake, decaffeinated coffee, or tea.

Bottom Line: There is no evidence that coffee consumption increases the likelihood of developing heart disease. (Level of evidence: 2b)