Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health, and All-Cause Mortality

James H. O'Keefe, MD; Salman K. Bhatti, MD; Harshal R. Patil, MD; James J. DiNicolantonio, PHARMD; Sean C. Lucan, MD, MPH, MS; Carl J. Lavie, MD


J Am Coll Cardiol. 2013;62(12):1043-1051. 

In This Article

Biologically Active Constituents of Coffee

Coffee is a complex beverage containing >1,000 compounds. Among the many with known biological activity are caffeine (a potent stimulant and bronchodilator), diterpene alcohols (which can increase serum cholesterol), and chlorogenic acid (one of many types of antioxidant and anti-inflammatory compounds found in coffee). Caffeine is by far the most studied compound in coffee, and this agent largely accounts for the inherently habit-forming nature of the beverage. Coffee accounts for 71% of caffeine intake among American adults (soft drinks are the primary source of caffeine for children and adolescents).[2] The caffeine content of coffee is highly variable, even when the coffee beverage is obtained from the same outlet.[3] A standard 8-oz cup of brewed coffee can contain anywhere from ~95 to 200 mg of caffeine. However, coffee is increasingly served in containers that are considerably larger (e.g., 12 to 16 oz), typically delivering 180 to 300 mg of caffeine per serving.[4] Brewed decaffeinated coffee still contains caffeine, albeit at much lower doses that usually range from 5 to 15 mg per 8 oz.

Given the focus on caffeine for much of the research around coffee, the terms caffeine and coffee are often conflated in both the biomedical literature and public perception. However, the terms are not synonymous, and the biological effects of coffee cannot be reduced to the isolated effects of the caffeine that it contains. Here we discuss the evidence of coffee's effects on cardiometabolic risk factors (i.e., hypertension [HTN], insulin resistance, dyslipidemia), CV disease (i.e., coronary heart disease [CHD], congestive heart failure [CHF], arrhythmias, and stroke), and mortality (CV and all-cause). We also discuss other potential health benefits and health risks of coffee consumption, distinguishing between data specifically on caffeine and data on coffee.