Coffee subtypes associated with reduced CVD, arrhythmias, mortality
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Regular coffee intake of multiple subtypes was associated with preventing CVD, mortality and incident arrhythmias, according to a study.
“Regular coffee intake has a beneficial effect on incident arrhythmias, cardiovascular disease and mortality,” Peter Kistler, MBBS, PhD, head of clinical electrophysiology research at the Baker Heart and Diabetes Institute and head of electrophysiology at the Alfred Hospital in Melbourne, Australia, told Healio. “Coffee consumption is associated with cardiovascular benefits and should not empirically [be] discontinued in those with underlying heart rhythm disorders or cardiovascular disease. Daily coffee intake should not be discouraged by physicians, but rather considered part of a healthy diet.”
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As Healio previously reported, in the main results of a large prospective cohort study, there was a significant reduction in the incidence of arrythmia, CVD, stroke, all-cause mortality and CVD mortality in regular coffee drinkers compared with nondrinkers.
Coffee subtype consumption
For the present analysis, the researchers examined the relationships between different coffee subtypes and CVD outcomes. The subtypes included in the study were caffeinated (instant, ground) and decaffeinated. The 449,563 participants (median age, 58 years; 55% women) were grouped into categories based on daily coffee intake (0, < 1, 1, 2-3, 4-5 and > 5 cups per day) and followed for 12.5 years.
The primary outcome was the relationship between coffee subtype consumption and the incidence of arrhythmias, CVD and mortality. Secondary outcomes were the relationships between coffee subtype consumption and subcategories of arrythmia (atrial fibrillation/flutter, supraventricular tachycardia, ventricular tachycardia/ventricular fibrillation) and CVD (CHD, congestive cardiac failure, stroke).
The researchers observed that any ground coffee intake up to five cups per day was associated with reduced risk for arrhythmia, CVD and all-cause mortality. Arrhythmia risk was lowest with four to five cups per day (HR = 0.83; 95% CI, 0.76-0.91; P < .0001), all-cause mortality risk was lowest with two to three cups of ground coffee per day (HR = 0.73; 95% CI, 0.69-0.78; P < .0001) and CVD mortality was lowest with four to five cups per day (HR = 0.65; CI, 0.51-0.83; P < .0001).
There was a U-shaped relationship between instant coffee intake and CVD endpoints, with two to three cups per day associated with the lowest risk for arrythmias (HR = 0.88; 95% CI, 0.85-0.92; P < .0001), CVD (HR = 0.91; 95% CI, 0.88-0.94; P < .0001), CHD (HR = 0.91; 95% CI, 0.88-0.94; P < .0001), stroke (HR = 0.83; 95% CI 0.76-0.9; P < .0001) and all-cause mortality (HR = 0.89; 95% CI, 0.86-0.93; P < .0001), according to the researchers.
Researchers observed that decaffeinated coffee intake of two to three cups per day reduced risk for CVD (HR = 0.94; 95% CI, 0.9-0.99, P = .0093), CHD (HR = 0.94; 95% CI, 0.89-0.99; P = .0127), congestive cardiac failure (HR = 0.86; 95% CI, 0.79-0.94; P = .0004) and all-cause mortality (HR = 0.86; 95% CI, 0.8-0.91; P < .0001). The risk for CVD mortality was lowest with one to three cups per day (HR = 0.74; 95% CI, 0.61-0.89; P = .0012), according to the researchers.
Differences with arrhythmias
However, decaffeinated coffee intake only had a neutral effect on the risk for arrythmias.
“By blocking adenosine receptors, caffeinated coffee may mitigate the effects of endogenous adenosine and protect against arrhythmias,” Kistler and colleagues wrote.
“This may explain the differing effects of caffeinated vs. decaffeinated coffee on the incidence of arrhythmias.”
Further clinical research on coffee intake is necessary, according to the researchers.
“There needs to be a randomized controlled trial to determine whether people who do not drink coffee should be encouraged to do so,” Kistler told Healio.
For more information:
Peter Kistler, MBBS, PhD, can be reached at peter.kistler@baker.edu.au.
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