Coffee is one of the most consumed beverages worldwide. Its chemical composition is very complex, with over 100 biologically active compounds, including caffeine, but also magnesium, phenolic compounds, trigonelline, diterpenes and lignans(1,2). The proportions of these compounds vary depending on the type of coffee beans, the filtering method, or the degree of roasting(1). Coffee consumption leads to sympathetic nervous system activation by inhibiting phosphodiesterase, increasing cytosolic calcium, and stimulating the release of catecholamines(2). Among the beneficial effects of coffee are the improvement of lipid and glucose metabolism, the improvement of intestinal microbiome, but also the antioxidant activity, with the reduction of chronic inflammation and oxidative stress in the atherosclerotic process(3). Also, caffeine is a psychostimulant, increasing the ability to concentrate and mental alertness(2).
The increase in life expectancy has led to an increase in the population’s interest in the methods of preventing cardiovascular diseases (CVDs), the most important cause of death worldwide, by changing the lifestyle. Regarding the consumption of coffee, there is a misconception, according to which it is counted among the cardiovascular risk factors. Although the 2021 European Society of Cardiology Guidelines highlighted the beneficial effects of consuming 3-4 cups of coffee/day(4) in the prevention of CVDs, a significant proportion of healthcare professionals still recommend avoiding coffee in patients with these diseases.
A recent study that followed 449563 subjects from United Kingdom, over a period of approximately 12 years, reported an inversely proportional relationship between coffee consumption and the risk of CVDs, coronary heart disease, congestive heart failure, stroke, cardio-vascular mortality and all-cause mortality(2). Also, this study grouped coffee into three main types: ground, instant, and decaffeinated coffee(2). Depending on the type of coffee, the reduction in the risk of arrhythmias was reported only for the consumption of 1-5 cups/day of ground and instant coffee, but not for the consumption of decaffeinated coffee(2). Instead, all subtypes of coffee, in dose of 2-3 cups/day led to a reduction in CVDs and all-cause mortality(2). Regarding all-cause mortality, a lower risk was identified in the group of patients who consumed 2-3 cups/day of decaffeinated coffee (p=0.0093) or instant coffee (p<0.001)(2). These data are also validated by other data from specialized literature. Kim et al. reported a 3% reduction in arrhythmia risk for each additional cup of coffee, regardless of coffee subtype(5). Other studies have reported an inversely proportional relationship between coffee consumption and the risk of CVDs, cardiovascular mortality, all-cause mortality and stroke(6,7). A meta-analysis highlighted a U-shaped relationship between coffee consumption and the risk of chronic heart failure, the strongest reduction being observed among subjects who consumed 4 cups/day(8).
In conclusion, coffee, regardless of the subtype, has proven numerous beneficial effects, reducing the risk of cardiovascular mortality, but also all-cause mortality. It is necessary to combat the false hypothesis according to which this drink is counted among cardiovascular risk factors. On the contrary, it proved to have a protective effect for CVDs. These data can improve the therapeutic management and prognosis of these patients.
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Camelia C. DIACONU