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

Coffee and Blood Pressure

Hypertension is a strong independent risk factor for stroke and CHD. Coffee consumption has been associated with acute increases in blood pressure (BP) in caffeine-naive people but exerts negligible effects on the long-term levels of BP in habitual coffee drinkers.[5] The acute effects of coffee are transient, and, with regular intake, tolerance develops to the hemodynamic and humoral effects of caffeine.[6] A recent meta-analysis of 10 randomized, controlled trials (RCTs) and 5 cohort studies assessed BP and the incidence of HTN in coffee consumers. Nonsignificant mean changes in systolic BP of −0.55 mm Hg (95% confidence interval [CI]: 2.46 to 1.36) and diastolic BP −0.45 mm Hg (95% CI: −1.52 to 0.61) were noted in coffee drinkers compared with the control group. Evidence analyzed from this large study showed no clinically important effects of long-term coffee consumption on BP or risk of HTN.[7] Studies and reviews done previously have also come to similar conclusions.[8] The Nurses' Health Study, with 1.4 million person-years of follow-up, demonstrated that daily intake of up to 6 cups of coffee was not associated with an increased risk of HTN.[9]

Caffeine is the major acute BP-increasing compound found in coffee, but other compounds present in coffee may counteract these acute pressor effects. A study of 15 volunteers, including 6 habitual and 9 nonhabitual coffee drinkers, demonstrated that intravenous caffeine infusion induced similar increases in muscle sympathetic activity and BP in the 2 groups. In contrast, coffee drinking increased BP in nonhabitual drinkers but not in the habitual coffee drinkers, despite comparable increases of muscle sympathetic activity and plasma caffeine levels in the 2 groups after coffee ingestion. The authors concluded that caffeine is not solely responsible for the CV effects associated with short- and long-term coffee consumption.[10]