The story goes that an ancient goat herder in Kaffa, Ethiopia, noticed his herd was more energetic when it grazed on the berries of a particular bush.
And thus began the human love affair with coffee.
Sometimes falling in and out of favor, coffee has been an integral part of the human experience throughout the ages.
The first coffeehouses, called qavheh khanehs, appeared in the Arabian Peninsula and were centers of thought and expression. The craze next moved to Europe, where the desire to shorten brewing time led to the development of the espresso (and unfortunately your pretentious friend is right, it’s not pronounced “expresso”).
U.S. soldiers returning from WWII popularized instant coffee, which fueled the average American coffee consumption to its peak of 46 gallons per year in the mid 1940’s.
And a few decades ago the growth of a big chain (you know which one I’m referring to) reintroduced many of us to stronger, freshly ground and brewed coffee.
More recently, there’s been a proliferation of smaller, more intimate shops, where your single origin Sumatra will probably come with a side of handlebar mustache.
Whether you like drip or cold brewed, espresso or double venti half sweet non-fat caramel macchiato, the question of the heart health consequences of coffee consumption is one I hear often as a New York City cardiologist.
And there are plenty of studies looking at coffee and the cardiovascular system — though all bets are off once there’s cream, sugar, or three pumps of anything involved. So what does the medical research show?
A study recently published in the journal Coronary Artery Disease compared the outcomes of heart attack survivors based on their coffee consumption, and found that coffee drinkers were less likely to die than non-drinkers, and in some cases nearly half as likely.
Because of biases inherent to these types of studies, these results have to be taken with a grain of salt (the story on salt consumption is an interesting one also).
And though there’s still quite a bit of controversy about the subject, these results are in line with most of what we know about coffee and heart health.
Acute caffeine intake is associated with a transient rise in systolic blood pressure, up to 10mm Hg, which is quite significant. This effect, however, is minimal or not observed at all in chronic coffee drinkers.
And though drinking a cup of coffee can also cause some people to feel palpitations, or an abnormal fluttering sensation in the chest, multiple studies have failed to show a link between coffee consumption and any significant heart rhythm abnormality.
There’s also concern that coffee can raise cholesterol, and there is some truth to this. Unfiltered coffee contains certain plant based lipid compounds like cafestol, which can raise LDL — the bad cholesterol.
This isn’t the case with filtered coffee, though, and there’s a large body of evidence suggesting coffee drinkers have lower rates of obesity, diabetes and depression, all of which are much more significantly associated with developing heart disease.
A large study published in the journal Circulation in 2014 looked at 1.4 million people and found that compared with those who drank 5, 1.5, or no cups of coffee, those who had on average 3.5 cups per day (keep in mind we’re talking about an 8 oz. cup) had the lowest risk of developing cardiovascular disease.
Those who drank the most did no worse than non-drinkers. Another large study from the New England Journal of Medicine in 2012 looked at over 400,000 people, and found coffee drinkers across the board had lower risk of death, including from cardiovascular causes, and that the most benefit was seen in those who drank 4-5 cups per day.
There are still a lot of unanswered questions about coffee and heart health. Are the effects predominantly related to caffeine? Or is it the anti-inflammatory and anti-oxidant compounds? What’s the sweet spot on number of cups per day?
And possibly most importantly: Who brews a better cup, Gregorys or Joe’s?
One thing the medical literature has shown is that coffee probably isn’t harmful to your cardiovascular system, and if anything may keep your ticker ticking longer.
Michael Ghalchi
Dr Michael Ghalchi is a board certified cardiologist, a researcher and published author, and is the medical director of Manhattan Cardiovascular Associates. He trained at the University of Pennsylvania and the NYU School of Medicine, where he remains on the faculty.
