What question did this study set out to answer?

To evaluate the relationship between coffee consumption and the risk of developing heart failure through a systematic review and meta-analysis.

March 19, 2026Open Access

Habitual coffee consumption and risk of incident heart failure: an updated systematic review and dose-response meta-analysis of prospective cohort studies

Key Points

To evaluate the relationship between coffee consumption and the risk of developing heart failure through a systematic review and meta-analysis.
Conducted a systematic review of prospective cohort studies
Searched databases including PubMed, Embase, and Scopus
Included studies reporting hazard ratios for coffee consumption and heart failure
Used random-effects models for pooling estimates
Planned subgroup analyses based on various demographics and coffee types.
Identified 13 studies with 656,666 participants and 20,646 heart failure events
Moderate coffee consumption (2–4 cups/day) linked to a reduced heart failure risk (HR 0.925)
Suggested a J-shaped dose-response pattern with maximum benefit at 1–2 cups/day
No indication of publication bias detected
Certainty of evidence rated as low.

Abstract

Abstract Background Coffee is among the most widely consumed beverages globally, yet evidence specifically examining its association with heart failure (HF) risk remains limited. The only dedicated meta-analysis on this topic was published in 2012. We conducted an updated systematic review and dose-response meta-analysis to comprehensively evaluate the association between coffee consumption and incident HF. Methods We searched PubMed, Embase and Scopus from January 2012 through October 2025 to update the original meta-analysis. Prospective cohort studies reporting hazard ratios for coffee consumption and incident HF were included. Random-effects models were used to pool estimates. Subgroup analyses were planned to examine effects by sex, geographic region, coffee type, and population characteristics where possible. Certainty of evidence was assessed using GRADE. Results Thirteen studies comprising 656,666 participants and 20,646 HF events were identified. Pooled analysis of 7 independent cohorts demonstrated that moderate coffee consumption (2–4 cups/day) was associated with significantly reduced HF risk (HR 0.925; 95% CI 0.882–0.971; P = 0.002) with negligible heterogeneity (I²=0%). A J-shaped dose-response pattern was suggested, although the test for non-linearity was borderline significant ( P = 0.066), with maximal benefit observed at 1–2 cups/day. Within-cohort analyses indicated similar associations for caffeinated and decaffeinated coffee. No evidence of publication bias was detected (Egger’s P = 0.99). Certainty of evidence was rated as low. Conclusions This updated meta-analysis suggests moderate coffee consumption is linked to lower incident heart failure risk, though certainty is low. Associations observed within-cohort analyses were similar for caffeinated and decaffeinated coffee, indicating moderate intake may be compatible within heart-healthy dietary patterns. Review registration (PROSPERO Registration ID: CRD420251269118) Graphical abstract

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