Coffee, caffeine, and cardiovascular health: navigating risks and benefits-an updated systematic review and meta-analysis.
- 2026-05-07
- BMC cardiovascular disorders 26(1)
- Eman E Shaban
- Hussam Elmelliti
- Ahmed Shaban
- Amira Shaban
- Ali Elkandow
- Mohamed Gafar Abdelrahim
- Hany A Zaki
- PubMed: 42098622
- DOI: 10.1186/s12872-026-05693-0
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 2
- Population
- 2,856,002 participants from 38 studies
- Methods
- Systematic search of five electronic databases (PubMed, Web of Science, Cochrane Library, Embase, Scopus) for records published January 2000-December 2025; inclusion criteria: studies examining coffee effects on CVD reporting HR, RR, OR; quality appraisal with Newcastle Ottawa Scale and Joanna Briggs Institute tool.
Background
The association between coffee or caffeine intake and cardiovascular diseases (CVDs) and their risk factors has been extensively researched. However, there has been conflicting evidence. Therefore, the current updated meta-analysis assessed the relationship between coffee or caffeine with CVDs, such as coronary heart diseases (CHDs), myocardial infarction (MI), heart failure (HF), stroke, cardiac arrhythmias, and CVD mortality.Methods
Five electronic databases, namely PubMed, Web of Science, Cochrane Library, Embase, and Scopus, were extensively searched for all records published between January 2000 and December 2025. Studies were included if they examined the effects of coffee on any CVD and reported the associations in terms of the hazard ratio (HR), relative risk (RR), or odds ratio (OR). Moreover, quality appraisal was conducted using the Newcastle Ottawa Scale for cohort studies and the Joanna Briggs Institute tool for case-control studies.Results
After exclusions, 38 studies involving 2,856,002 participants were reviewed and analyzed. The pooled analysis showed no significant associations between coffee consumption and total CHDs or HF, when comparing the highest and lowest coffee consumption categories (HR: 0.98; p = 0.80 and HR: 1.03; p = 0.62, respectively). In contrast, the pooled results showed a significant positive association between higher coffee consumption and the risk of developing MI (OR: 1.48; p < 0.0001). The pooled analysis also showed an inverse relationship between coffee consumption and stroke or cardiac arrhythmias (HR: 0.89; p = 0.01 and HR: 0.94; p = 0.04, respectively). Furthermore, we observed a non-linear relationship between caffeine intake and CVD mortality among hypertensive patients (HR: 0.68; p = 0.001).Conclusion
Higher coffee intake might increase the risk of MI, but can also offer protective effects against stroke and cardiac arrhythmias. Moreover, higher caffeine intake can reduce the risk of CVD mortality in hypertensive patients.Clinical trial registration
PROSPERO: CRD420251073620.Research Insights
The pooled analysis also showed an inverse relationship between coffee consumption and stroke or cardiac arrhythmias (HR: 0.89; p = 0.01 and HR: 0.94; p = 0.04, respectively).
- Effect
- Beneficial
- Effect size
- Small
The pooled analysis showed no significant associations between coffee consumption and total CHDs or HF, when comparing the highest and lowest coffee consumption categories (HR: 0.98; p = 0.80 and HR: 1.03; p = 0.62, respectively).
- Effect
- Neutral
- Effect size
- Small
the pooled results showed a significant positive association between higher coffee consumption and the risk of developing MI (OR: 1.48; p < 0.0001).
- Effect
- Harmful
- Effect size
- Moderate
The pooled analysis showed no significant associations between coffee consumption and total CHDs or HF, when comparing the highest and lowest coffee consumption categories (HR: 0.98; p = 0.80
- Effect
- Neutral
- Effect size
- Small
The pooled analysis also showed an inverse relationship between coffee consumption and stroke or cardiac arrhythmias (HR: 0.89; p = 0.01
- Effect
- Beneficial
- Effect size
- Small