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Up to three cups of coffee daily linked to significant health benefits — UK Biobank analysis

Up to three cups of coffee per day is associated with a lower risk of stroke, fatal heart disease, and all-cause mortality, in a population without diagnosed heart disease over 10-15 years, according to a large study presented at the European Society of Cardiology Congress 2021. Coffee may reverse some of the detrimental effects of ageing on the heart, said the lead author.

Imaging analysis indicated that compared with participants who did not drink coffee regularly, daily consumers had healthier sized and better functioning hearts.

"To our knowledge, this is the largest study to systematically assess the cardiovascular effects of regular coffee consumption in a population without diagnosed heart disease," said study author Dr Judit Simon of the Heart and Vascular Centre, Semmelweis University, Budapest, Hungary.

"Our results suggest that regular coffee consumption is safe, as even high daily intake was not associated with adverse cardiovascular outcomes and all-cause mortality after a follow-up of 10 to 15 years," she continued. "Moreover, 0.5 to 3 cups of coffee per day was independently associated with lower risks of stroke, death from cardiovascular disease, and death from any cause."

Even though coffee is among the most consumed beverages in the world, little is known about the long-term impact of regular consumption on cardiovascular health. This study investigated the association between usual coffee intake and incident heart attack, stroke and death. It included 468,629 participants of the UK Biobank with no signs of heart disease at the time of recruitment. The average age was 56.2 years and 55.8% were women.

Participants were divided into three groups according to their usual coffee intake: none (did not consume coffee on a regular basis, 22.1%), light-to- moderate (0.5 to 3 cups/day, 58.4%) and high (more than 3 cups/day, 19.5%).

The researchers estimated the association of daily coffee consumption with incident outcomes over a median follow-up of 11 years using multivariable models. The analyses were adjusted for factors that could influence the relationship including age, sex, weight, height, smoking status, physical activity, high blood pressure, diabetes, cholesterol level, socioeconomic status, and usual intake of alcohol, meat, tea, fruit and vegetables.

Compared with non-coffee drinkers, light-to-moderate consumption was associated with a 12% lower risk of all-cause death (hazard ratio [HR]=0.88, p<0.001), 17% lower risk of death from cardiovascular disease (HR=0.83, p=0.006), and 21% lower risk of incident stroke (HR=0.79; p=0.037). To examine the potential underlying mechanisms, the researchers analysed the association between daily coffee intake and heart structure and function over a median follow-up of 11 years. For this, they used data from 30,650 participants who underwent cardiac magnetic resonance imaging (MRI), which is considered the gold standard for the assessment of cardiac structure and function.

Simon said: "The imaging analysis indicated that compared with participants who did not drink coffee regularly, daily consumers had healthier sized and better functioning hearts. This was consistent with reversing the detrimental effects of ageing on the heart. Our findings suggest that coffee consumption of up to three cups per day is associated with favourable cardiovascular outcomes. While further studies are needed to explain the underlying mechanisms, the observed benefits might be partly explained by positive alterations in cardiac structure and function."

Study details

Association of daily coffee consumption with cardiovascular health – Results from the UK Biobank

J Simon , K Fung , Z Raisi-Estabragh, N Aung , MY Khanji , M Kolossvary, B Merkely, PB Munroe, NC Harvey, SK Piechnik, S Neubauer, SE Petersen, P Maurovich-Horvat.

Presented at the ESC Congress 28 August 2021

Abstract

There are conflicting reports on the association of coffee consumption with cardiovascular (CV) health. The UK Biobank is a prospective cohort study including data for half a million middle-aged individuals.

Purpose

We studied the association of daily coffee consumption with all-cause and CV mortality, and incidence of the major CV diseases in the UK Biobank. In a subgroup of participants who underwent cardiovascular magnetic resonance (CMR), we evaluated the association between regular coffee intake and cardiac structure and function parameters.

Methods

UK Biobank cohort of participants without clinically manifested heart disease at the time of recruitment were included. Regular coffee intake was categorised into three groups: zero, light-to-moderate (0.5-3 cups/day) and high (>3 cups/day) coffee drinkers. We estimated association of daily coffee consumption with incident outcomes using multivariable Cox-regression models (median follow-up of 11 years) and, in the subset with CMR data, with left and right ventricular (LV, RV) end-systolic and end-diastolic volumes, LV mass, and LV/RV stroke volume using multivariable linear regression. Models were adjusted for potential confounders and mediators, including: age, sex, non-European ethnicities, body mass index, smoking, physical activity, Townsend deprivation index, alcohol, meat, fruit and vegetable intake, hypertension, diabetes mellitus, and cholesterol level.

Results

We included 468,629 individuals (mean age 56.2±8.1 years, 44.2% male). Among them, 22.1% did not consume coffee on a regular basis, 58.4% had 0.5-3 cups per day and 19.5% had >3 cups per day. After adjustment for potential confounders and mediators, compared to non-coffee drinkers, light-to-moderate coffee drinking was associated with lower risk of all-cause mortality (HR=0.88, p<0.001), CV mortality (HR=0.83, p=0.006), and incident stroke (HR=0.79; p=0.037). CMR data were available in 30,650 participants. In multivariable analysis, compared to non-coffee drinkers, both the light-to-moderate and high coffee consuming categories, were associated with significantly increased LV and RV ventricular end-systolic (β=0.91 and 1.64 for LV and 1.10 and 1.72 for RV), end-diastolic (β=2.21 and 3.28 for LV and 2.24 and 3.35 for RV) and stroke volumes (β=1.31 and 1.64 for LV and 1.15 and 1.63 for RV), as well as greater LV mass (β=0.78 and 1.64; all p<0.001).

Conclusion

In this large study of the UK Biobank population, regular coffee consumption of up to three cups per day was associated with favourable cardiovascular outcomes, in particular, decreased all-cause and CV mortality and stroke incidence. Regular coffee consumption was also associated with a pattern of CMR metrics in keeping with the reverse of age-related cardiac alterations.

 

ESC Congress digital presentation – Association of daily coffee consumption with cardiovascular health – Results from the UK Biobank (Open access)

 

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