What question did this study set out to answer?

This review aims to clarify the relationship between coffee and caffeine intake with cardiovascular diseases and risk factors.

May 9, 2026Open Access

Coffee, caffeine, and cardiovascular health: navigating risks and benefits—an updated systematic review and meta-analysis

Key Points

This review aims to clarify the relationship between coffee and caffeine intake with cardiovascular diseases and risk factors.
Conducted a meta-analysis of studies published from January 2000 to December 2025.
Included studies assessing coffee effects on cardiovascular diseases, reporting hazard ratios, relative risks, or odds ratios.
Reviewed 38 studies with 2,856,002 participants using quality appraisal tools.
No significant associations found between coffee consumption and total coronary heart diseases or heart failure (HR: 0.98, p = 0.80; HR: 1.03, p = 0.62).
Higher coffee consumption significantly increases the risk of myocardial infarction (OR: 1.48, p < 0.0001).
Inverted relationships observed between coffee consumption and stroke or cardiac arrhythmias (HR: 0.89, p = 0.01; HR: 0.94, p = 0.04).

Abstract

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. 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. 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). 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. PROSPERO: CRD420251073620.

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