Coffee and Heart Health

Java. Bean water. Your morning cup of joe. No matter what you call it, you may rely on that mug of coffee to wake you up and get you going. But you may not know that coffee offers another pick-me-up. New guidance from the American Heart Association (AHA) shows that up to five cups of caffeinated coffee a day is safe for most people. Recent research suggests it may have certain heart-protective benefits, too. It may lower your risk of a wide range of heart problems. But not all cups of coffee-or caffeinated drinks-have the same effect.

"Caffeine is not a bad thing at all. But it all comes down to how you're getting your caffeine," says Santosh Menon, MD, medical director of clinical cardiology with The Christ Hospital Physicians-Heart & Vascular. "You must be able to function in life, and caffeine helps many people do that. But you should listen to your body and pay attention to how it responds to caffeine. It's important to know your limits."

What the New Guidelines Say

According to the AHA's official statement, healthy adults can consume up to 400 milligrams of caffeine every day. That's roughly the amount found in three to five 8-ounce cups of coffee. Black coffee without any cream, sugar or syrup is best.

"Based on this study that looked at years of existing research, pure black coffee is probably cardioprotective," Dr. Menon says. "This evaluation showed that it's linked to a lower risk of type 2 diabetes, heart disease, stroke, heart failure and some irregular heartbeats."

Coffee and Cholesterol: Coffee Type Matters

When you think of cholesterol, your first thoughts may go to the foods you eat. But the type of coffee you drink can also affect your cholesterol level, Dr. Menon says. According to the study, unfiltered coffees like French press or espresso can increase your level of low-density lipoprotein (LDL) cholesterol-"bad" cholesterol.

"Coffee-whether it's caffeinated or decaffeinated-contains a naturally occurring compound called cafestol," he says. "It's a substance that increases your LDL levels, potentially leading to blockages that require lipid-lowering therapies."

But if you choose filtered or instant coffee, you can avoid cafestol. The brewing process used for these types of coffee removes the compound. So, they're less likely to raise your cholesterol.

Coffee and Heart Rhythm: A Mixed Impact

Traditionally, conventional wisdom has linked caffeinated coffee to faster heart rates or irregular heart rhythms. The new AHA guidance reveals that's not always the case, Dr. Menon says.

Instead, based on patient-reported information, researchers found that drinking up to three cups of coffee daily doesn't increase your risk of atrial fibrillation. In fact, people with this condition who drank at least one cup a day saw a 39-percent drop in their atrial fibrillation risk. But that amount of caffeine may cause you to have premature ventricular contractions (PVCs). This condition, also called skipped beats, happens when your heartbeat starts in the lower chambers of your heart instead of the upper ones.

"We tend not to treat PVCs for the most part, especially in younger patients," he says. "But they are a nuisance, and caffeine can exacerbate them."

Coffee and Type 2 Diabetes: A Word About Sweeteners

Type 2 diabetes doubles your risk of developing heart disease and heart failure. When it comes to your diabetes risk, coffee consumption can be a double-edged sword. Coffee may decrease your insulin sensitivity and make it harder to control your blood sugar. But it may also help lower your diabetes risk.

Whether you add cream, sugar or syrup to your coffee may be the deciding factor, Dr. Menon says. In fact, during the research review, the AHA determined that drinking between three-and-a-half and five cups of black coffee every day can lower your type 2 diabetes risk between 20 percent and 30 percent.

"The less sugar you take in, the less sweetener you consume. Your pancreas won't have to work as hard to produce insulin," he says. "Sticking to black caffeinated coffee is linked to a lower diabetes risk. So, try to leave the creamer, the milk and all the other additives out."

Not All Caffeine Sources Are the Same: Concerns About Energy Drinks

Dr. Menon says it's important to be careful when choosing a caffeinated drink. While research shows coffee is a safe caffeine source, that's not the case for other sources like energy drinks.

"Energy drinks have a much higher concentration of caffeine and sugar. No matter how much you drink, they can increase your blood pressure and your heart rate," Dr. Menon says. "And if you already have high blood pressure, energy drinks can make the problem worse."

Additionally, other caffeine sources, like caffeine pouches or pills, aren't regulated, he says. So, they may also present cardiac risks.

How to Handle Your Coffee Consumption

There's no one-size-fits-all recommendation for coffee consumption, Dr. Menon says. This new guidance isn't a suggestion to increase your coffee intake to five cups a day. Instead, pay attention to how your body responds to caffeine and drink black or minimally sweetened coffee in moderation.

If you have difficult atrial fibrillation or a heart rhythm problem, try to cut back on the caffeine and drink more water instead," he says. "But if you're going to have three to five cups daily, spread them out throughout the day."

Dr. Menon also recommends talking with your provider about the amount of caffeine you consume and how it affects your health.

"Be honest with your provider about how much caffeine you're taking in and where it's coming from," he says. "If they know that your heart races after you drink caffeine or that your blood sugar may have gone up, they're in a better position to help you protect your heart health."

Frequently Asked Questions About Caffeine and Coffee

Q: Is 400 mg of caffeine a day safe for everyone?

A: It is safe for most healthy adults to consume up to 400 mg of caffeine every day. However, pregnant women should limit caffeine to 200-300 mg per day. People with existing heart conditions like high blood pressure should talk with their doctor before consuming caffeine. Existing research also recommends that children and adolescents avoid caffeine as much as possible.

Q: Is it possible to consume too much caffeine?

A: Caffeine overdose is rare and is almost exclusively linked to the consumption of caffeine pills and powders. If you consume more than 1 gram of caffeine, you may experience extreme anxiety and severe heart palpitations. Higher doses can be life-threatening.

Q: What is the most heart-healthy coffee brewing method?

A: Brewing methods that use paper filters, such as standard drip coffee or pour-over coffee, are the most heart-healthy. They trap cafestol, a compound that can increase your LDL cholesterol.