Machine learning of data from 3 well-known heart studies shows a decline in heart failure risk from drinking at least 1 cup of caffeinated coffee each day.
Similar results were not seen for individuals who consumed decaffeinated coffee, among whom the risk of heart failure rose significantly, at least in the Framingham Heart Study (FHS). For the present analysis, coffee intake was categorized into 0, 1, 2, or 3 cups daily.
“While smoking, age, and high blood pressure are among the most well-known heart disease risk factors, unidentifed risk factors for heart disease remain,” particularly for developing heart failure, said David P. Kao, MD, senior author of the study, in a statement. One of these risks factors is coffee, the benefits of which constitute an ongoing debate due to self-reported data and inconsistent diet assessment.
Dietary data from Framingham were analyzed via machine learning, through the American Heart Association’s Precision Medicine Platform, and then compared with data from the Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS)—all prospective longitudinal cohort studies. Two large plusses of the studies included in this analysis is that they all had at least 10 years of follow-up and collectively covered more than 21,000 US adults (n = 2732 from Framingham, 14925 from ARIC, and 3704 from CHS) 30 years and older.
Thirty-five common risk factors were identified by the authors as being in the top 20% for coronary heart disease (CHD), heart failure, and stroke. They further analyzed dietary factors, including whole milk, red meat, and caffeinated and decaffeinated coffee, “given their potential for behavior modification.” Of these, “coffee consumption was the only factor that remained significantly associated with any of the outcomes.”
Analyses revealed decreased risks of both heart failure and stroke with increased caffeinated coffee intake:
Similar results were not seen for CHD (P = .21) or cardiovascular disease (CVD) (P = .59).
The authors then adjusted for FHS CVD risk, and again, increased caffeinated coffee intake had a significant link to drop in heart failure risk (HR, 0.95 cup/day; 95% CI, 0.90-1.00; P = .03).
Stratifying results via univariable and multivariable analysis showed a decreased heart failure risk in CHS (HR, 0.86 cup/day; 95% CI, 0.78-0.96; P = .005) and ARIC (HR, 0.98 cup/day; 95% CI, 0.96-0.99; P = .048). After adjusting for FHS score, this association remained in CHS (HR, 0.88 cup/day; 95% CI, 0.79-0.97; P = .01), while where was a trend toward multivariable association in ARIC (HR, 0.98 cup/day; 95% CI, 0.96-1.00; P = .06).
Additional analyses of caffeinated (FHS, CHS, and ARIC) vs decaffeinated (FHS and CHS) coffee consumption and heart failure risk resulted in a significant association for greater risk in FHS (HR, 1.10 cup/day; 95% CI, 1.03-1.17; P = .004) with decaffeinated coffee intake.
The authors highlighted that whereas previous studies have focused on composite CVD outcomes, few have attempted to study caffeine intake and how it affects risk of heart failure. “This analysis expands those findings to include the relationship between decreased risk of [heart failure] and higher coffee consumption,” they noted.
“It remains possible that coffee consumption is a marker or proxy for another behavior or dietary factor that reduces heart failure,” they continued. “Consequently, intentional or prescribed increase in coffee intake for the purposes of reducing heart failure risk cannot be recommended based on our results.”
They recommend that future studies examine coffee, and caffeine, to draw a clearer link between amount consumed—because coffee is “pervasive in modern society, [but] has high potential for dietary modification”—their roles, and potential mechanisms of action as risk factors for heart failure.
Stevens LM, Linstead E, Hall JL, Kao DP. Association between coffee intake and incident heart failure risk. Circ Heart Fail. Published online February 9, 2021. doi: 10.1161/CIRCHEARTFAILURE.119.006799