By Martin S. Lipsky, MD

Chancellor, South Jordan Campus, Roseman University of Health Sciences, South Jordan, UT

SYNOPSIS: Habitual coffee consumption was inversely associated with a lower risk of cardiac arrythmia.

SOURCE: Kim EJ, Hoffmann TJ, Nah G, et al. Coffee consumption and incident tachyarrhythmias: Reported behavior, Mendelian randomization, and their interactions. JAMA Intern Med 2021; Jul 19:e213616. doi: 10.1001/jamainternmed.2021.3616. [Online ahead of print].

Coffee is one of the most widely consumed beverages; in the United States, close to two-thirds of people drink about three cups per day.1 Over the last decade, research indicating coffee may offer health benefits continues to accumulate, with evidence linking coffee consumption to lower risks for Parkinson’s disease, diabetes, cancer, and even overall mortality.2-5 On the other hand, some professional societies recommend limiting coffee because of its presumed risk of increasing cardiac arrythmia despite little evidence.6,7

To investigate the association of coffee and arrythmias, Kim et al used the UK Biobank, a database of more than 500,000 individuals who completed questionnaires, underwent physical exams, and provided biological samples. After applying exclusion criteria, they assessed 386,258 individuals with a mean age of 56 years and followed them over 3.1 years. Using the outcome measures of tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, premature atrial complexes, and premature ventricular complexes), Kim et al found that after adjusting for demographic variables, comorbid conditions, and lifestyle habits, there was a 3% lower risk of incident arrythmia for each additional cup of coffee consumed. The authors also stratified individuals by polygenic profiles related to caffeine metabolism and did not identify an association between genetically differing rates of caffeine metabolism and the risk of arrythmia. Researchers concluded more coffee consumption was associated with a lower risk of arrythmia. Genetically mediated caffeine metabolism did not affect that association.

COMMENTARY

First, let me acknowledge my bias. I am addicted to coffee, and the smell in the morning is one of life’s joys. However, I always worried about coffee’s harmful effects. I am old enough to remember when coffee was linked to pancreatic cancer, an association further research refuted.8,9 Subsequently, more evidence began accumulating, indicating that rather than harm, coffee consumption might be beneficial, presumably because of its anti-inflammatory and antioxidant effects. Still, concern about caffeine and heart arrythmias persisted, and advising those with palpitations to reduce coffee intake or switch to decaf was common practice. Now, Kim et al have provided reassurance for coffee drinkers: caffeinated coffee does not increase the risk for cardiac arrythmias. Surprisingly, the authors found more coffee consumption was associated with a lower risk of arrythmias. Their findings match other studies, which failed to connect caffeinated beverage consumption with cardiac ectopy.10

While premature to urge patients with cardiac arrythmias to start drinking coffee, this work does provide reassurance to those patients who enjoy their morning cup: such consumption is unlikely to be the cause of an arrythmia. For the millions of individuals who suffer from arrythmias and who love coffee, this is great news.

REFERENCES

  1. National Coffee Association. NCA releases Atlas of American Coffee. March 26, 2020.
  2. Qi H, Li S. Dose-response meta-analysis on coffee, tea and caffeine consumption with risk of Parkinson’s disease. Geriatr Gerontol Int 2014;14:430-439.
  3. Santos RM, Lima DR. Coffee consumption, obesity and type 2 diabetes: A mini-review. Eur J Nutr 2016;55:1345-1358.
  4. Mendes E. Coffee and cancer: What the research really shows. American Cancer Society. April 3, 2018.
  5. Ding M, Satija A, Bhupathiraju SN, et al. Association of coffee consumption with total and cause-specific mortality in 3 large prospective cohorts. Circulation 2015;132:2305-2315.
  6. Blomström-Lundqvist C, Scheinman MM, Aliot EM, et al; Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines. Circulation 2003;108:1871-1909.
  7. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 2018;138:e272-e391.
  8. MacMahon B, Yen S, Trichopoulos D, et al. Coffee and cancer of the pancreas. N Engl J Med 1981;304:630-633.
  9. Turati F, Galeone C, Edefonti V, et al. A meta-analysis of coffee consumption and pancreatic cancer. Ann Oncol 2012;23:311-318.
  10. Dixit S, Stein PK, Dewland TA, et al. Consumption of caffeinated products and cardiac ectopy. J Am Heart Assoc 2016;5:e002503.