Cardiovascular Health

This is a study that I think a lot of us have been waiting for. When I say a lot of us, I’m referring to us coffee drinkers. Granted, we all know what it does for us, but we don’t know if what it does for us is actually healthy. Until, officially, now.

I know my addiction first started when I used to drink it with my grandmother (Nan). It was more coffee-milk or should I say milk with a little bit of coffee and a bunch of sugar.  I was 7 years old and the seed was planted.  It was primarily a weekend affair but 50 years later I remember it as if was last weekend. Currently my addiction starts with two double espressos every morning, followed by a cup of coffee when I get to work. It’s what helped me get through medical school as well as other trials and tribulations of my life.

The American Heart Association presented a scientific statement “Caffeine and Cardiovascular Disease“ which was published online July 20, 2026 in the journal Circulation.  It was a major, recent review drawing widespread coverage that produced evidence (primarily large observational, cohort studies, plus limited randomized trial data) and concluded that moderate coffee/caffeine intake is generally safe for most adults and associated with potential heart related benefits.  What is “moderate coffee intake” you ask?

It found that up to 400 mg of caffeine per day (roughly 3 to 5, eight ounce cups of black, caffeinated coffee, or 2-3 double espresso’s or 4-6 single espresso’s (why go with one when you can have two:) Even added sugar, syrups or creamers could be included. This amount of coffee was found to be generally safe for most healthy adults and does not appear to increase overall cardiovascular risk.  I would say it would be healthier to avoid the sugar, syrup or creamers as these are unnecessary calories but whatever taste allows you to take this precious elixir in is what I would recommend. “You gotta do what you gotta do“.

Modern coffee intake has been linked to observational data to lower risk of coronary heart, disease, stroke, heart, failure, atrial fibrillation, hypertension, and type two diabetes, as well as all cause mortality and multiple long-term cohorts. The benefits appear stronger with plain (especially paper filtered or instant) coffee.  Believe it or not, French press, some espresso or Turkish preparations retain Cafestol, which can raise LDL cholesterol and may offset some of the benefits.  Cafestol is a natural substance (diterpenoid) found primarily in the oils of coffee beans, especially Arabica beans.  Cafestol is considered the most potent dietary compound known for elevating serum cholesterol and particularly LDL (Bad) cholesterol but only by ~ 5%.  It counts for the majority of the lipid raising effect of unfiltered coffee. It does this by suppressing bile acid synthesis, (reducing cholesterol excretion) and can down regulate LDL receptors. The presence in coffee depends heavily on the brewing method. High levels appear in  unfiltered coffees such as French press, Turkish/Greek, boiled/Scandinavian and some espresso preparations. So filtered copy is best because the paper filter traps the substance. Instant coffee has none as well but then again, it’s instant coffee .

Randomized trial data, including the DECAF trial, (which was another study that examined the effects of caffeinated coffee consumption on atrial fibrillation recurrence, which was conducted between November 2021 and December 2024. The final follow up for the study concluded in June 5, 2025) indicated caffeinated coffee may reduce atrial fibrillation recurrence risk, although it can increase premature ventricular contractions, in some people.  The statement emphasizes that most evidence is observation, randomized trial data remain limited, and individual tolerance varies. Two double espresso for one may present different symptoms for another.

The findings for coffee should not be extrapolated to high dose, energy drinks, or pure, caffeine supplements (which lack the same protective signals and can raise blood pressure or arrhythmia risk).  Remember, coffee is a natural substance and the beans carry added benefits. It is considered a whole food and has been found to be extremely beneficial for our microbiome.

This AHA statement is the highest profile recent synthesis linking coffee to heart benefits. Other 2025–2026 cohort analysis papers report broadly consistent moderate intake associations.  So drink up my friends but be careful if you already have difficulty sleeping so keep it to just the mornings if you can.  “Coffee, the favorite drink of the civilized world”-Thomas Jefferson.    “Want to hear a really dark joke? Decaf”-Unknown.  

Doug

 

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