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Coffee and Your Heart

July 2018, Townsend Letter
By Dr. Steven M. Helschien

Years ago, research studies linked coffee to dozens of diseases and disorders. Subsequent studies published by reputable sources, such as the New England Journal of Medicine, the Journal of the American Medical Association, and others, have shown significant flaws in the original research. These new studies considered factors such as smoking, excessive alcohol consumption, and lack of physical activity of participants; and the original findings were essentially reversed. Since then, the research has overwhelmingly pointed to the fact that daily coffee consumption can have a vast array of health benefits. Studies have shown that coffee is rich in antioxidants – phytochemicals, polyphenols and other nutrients that reduce inflammation by neutralizing harmful free radicals and, therefore, reduce the risk of diseases related to inflammation, including cardiovascular disease.[1]

The Healthiest Coffee
The best quality coffee yields the greatest potential health benefits. The way coffee is grown, handled, and roasted has a direct effect on its quality. Where it is grown (high altitudes are best), how it is farmed (is it organic or are pesticides used?), and whether mold or mycotoxins (toxins produced by mold) are present, all affect the quality of the coffee. The healthiest brew also requires pure, good quality water.

Coffee’s Antioxidants
Some of the powerful antioxidants found in coffee are as follows:

  • Chlorogenic Acid: A compound that plays an integral role in antioxidant, anti-inflammatory, and anti-bacterial activities in the body.
  • Quinine: An antioxidant known for its ability to kill off diseases, Quinine becomes more potent after coffee beans are roasted. It has a positive effect on blood sugar levels and boosts athletic performance.
  • Plant Phenols: Similar to the antioxidants found in berries, plant phenols are responsible for protecting the body from cellular damage, certain types of cancer, and cardiovascular disease.
  • Cafestol: An antioxidant found in decaffeinated coffee, cafestol acts as an anti-inflammatory substance in the brain and also as a modulator for bile acid in the intestines.
  • Melanoidins: Responsible for coffee’s enticing aroma when it’s roasted, melanoidin compounds are formed during the roasting process. They have anti-bacterial and anti-inflammatory properties.
  • Trigonelline: The bitter alkaloid compound found in coffee, trigonelline is responsible for coffee’s unique aroma. It has anti-bacterial properties that support oral health and help kill bacteria that cause gum disease and cavities.

The Best Cup of Antioxidants You Can Get
Two sources of rich antioxidants that you can use to boost your healthy coffee are EGCG and L-theanine. Epigallocatechin gallate (EGCG) is the major polyphenol and flavonoid in green tea. EGCG is high in antioxidants with many proven health benefits, especially for the cardiovascular system.[2] The extract, used as a supplement with coffee, produces the healthiest drink you can make. The combination of coffee and L-theanine boosts concentration, focus (it is being used to help with ADHD), creativity, memory, and relaxation. L-theanine is a non-essential amino acid that is found in the leaves of black, oolong, and green tea. The combination is a powerful antioxidant source and brain booster.

Cardiovascular Disease Statistics for the United States[3]

  •  Every 38 seconds a person dies from a heart attack.
  • Around one million lives are lost per year from cardiovascular disease.
  • Cardiovascular disease claims more lives than all cancers combined.
  • Around 92 million Americans have some form of cardiovascular disease.
  • Every year, more than 795,000 people in the United States have a stroke.
  • Stroke kills more than 130,000 Americans each year. Every four minutes, someone dies of stroke.

Cardiovascular Disease, Inflammation, and Atherosclerosis
Heart disease is the leading cause of death in the US for both men and women and is also the leading cause of death worldwide. We now know that inflammation is a major factor in the development of heart disease. Numerous studies have shown that inflammation plays a key role in the development of atherosclerosis.[4] Risk factors that trigger an inflammation response in the body, such as cigarette smoking, high blood pressure, LDL cholesterol, hyperglycemia, obesity, or insulin resistance, can initiate atherosclerosis. The buildup of fatty deposits and calcium in the inner walls of the arteries narrows the arteries, making the heart work harder, and increasing the risk of a blockage leading to a heart attack or stroke.

The Role of Inflammation in Heart Attack and Stroke
“Exactly how inflammation plays a role in heart attack and stroke remains a topic of ongoing research,” according to Deepak Bhatt, M.D. “It appears that the inciting event in many heart attacks and some forms of stroke is the buildup of fatty, cholesterol-rich plaque in blood vessels.”

Bhatt is chief of cardiology for the VA Boston Healthcare System, director of the Integrated Interventional Cardiovascular Program at Brigham and Women’s Hospital & VA Boston Healthcare System, and associate professor of medicine at Harvard Medical School. “The body perceives this plaque as abnormal and foreign — it does not belong in a healthy blood vessel,” he said. “In response, the body tries to wall off the plaque from the flowing blood. However, under the wrong set of circumstances, that plaque may rupture, and its walled-off contents can come into contact with blood and trigger a blood clot formation. This combination of plaque and blood clots is what causes the majority of heart attacks and certain types of stroke, if the blood clot obstructs blood flow to the heart or brain.”[5]

Coffee Protects the Heart and Cardiovascular System
An analysis of 36 studies on coffee, included more than one million study subjects, found that those who regularly drank coffee were less likely to develop heart disease.[1] It was concluded that coffee protects the heart and cardiovascular system. Many diseases relating to the heart are caused by inflammatory conditions, including atherosclerotic blockages and heart disease. Antioxidants have been shown to reduce the incidence of death in these cases.

Coffee Reduces Risk of Heart Attack and Strokes
A team of researchers gathered data from the Framingham Heart Study, which includes information about the participants’ diet and their cardiovascular health, to look for a possible link between coffee and the risk of heart failure and stroke.[6] Machine learning was used to analyze the data, which works by finding associations, similar to the way that online sites can use a person’s history to predict which other sites or products you may be interested in.

The preliminary research showed, that compared with non-coffee drinkers, drinking coffee was associated with a lower risk of developing heart disease and a lower risk of having a stroke. The risk lowered with every additional cup of coffee consumed per week.

The team checked the validity of the machine learning analysis by using traditional analysis in two studies with similar sets of data, the Cardiovascular Heart Study and the Atherosclerosis Risk in Communities Study. The results confirmed what the machine learning analysis had found, that drinking coffee had a decreased risk of heart failure and stroke, which was consistently noted in all three studies.

Coffee Reduces the Risk of Atrial Fibrillation
Drinking coffee moderately every day may reduce the risk of developing coronary atherosclerosis, which could reduce the risk of atrial fibrillation or stroke, according to a study by a professor from the department of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health in Baltimore.[7] Eliseo Guallar, MD, and colleagues collected information on 25,138 men and women in South Korea. Their average age was 41, and none had evident cardiovascular disease. The participants had a yearly health exam when they were asked what they ate and drank. They all were given computed tomography scans to determine the amount of coronary artery calcium. The researchers then compared the participants’ calcium build-up with how much coffee they drank.

The investigators found a direct correlation between coffee and calcium. As coffee consumption rose, the amount of calcium build-up declined. Those who drank three to five cups a day had the least amount of calcium build-up. The association between higher coffee consumption and lower calcium build-up stayed the same when the study looked at age, sex, smoking, alcohol consumption, diabetes, obesity, hypertension, and hypercholesterolemia. They also took into account factors such as education, physical activity, family history of cardiovascular disease, and diet.

The Nurses’ Health Study
The Nurses’ Health Study, a long-running study of more than 80,000 women, found a reduction in stroke risk among women who drank two to three cups of coffee a week (a 19 percent reduction) and those who drank four or more cups per week (a 20 percent reduction).[8]

In the past, coffee was thought to be an unhealthy substance. But recent studies have brought to light that coffee contains numerous rich sources of antioxidants that contain anti-inflammatory properties that fight cardiovascular disease by protecting against calcium build-up and atherosclerotic plaque in blood vessels. Look for our next article on how coffee’s anti-inflammatory properties also protect against many different types of cancer.


1. Ding M, et al. Long term coffee consumption and risk of cardiovascular disease: A systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 2014;129: 643-59.
2. Wolfram S. Effects of green tea and EGCG on cardiovascular and metabolic health. J Am Coll Nutr. 2007 Aug;26(4):373S-388S.
3. Benjamin EJ, et al. Heart disease and stroke statistics 2018 at-a-glance. American Heart Association. Available at https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@ smd/documents/downloadable/ucm_498848.pdf?utm_ campaign=sciencenews17-18&utm_source=science-news&. Accessed March 1, 2018.
4. Libby P. Inflammation and cardiovascular disease mechanisms. Amer J Clin Nutr. 2006 Feb 1;83(2):456S-60S.
5. Inflammation and Heart Disease. American Heart Association. Available at http://www.heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp#. WpmcimrwbIV. Accessed March 3, 2018.
6. Stevens L, Görg C, Kao D. Coffee intake affects heart failure and stroke survival and is significant in predicting heart failure and stroke risk [abstract]. Circulation 2017;136:A21081.
7. Coffee consumption could help reduce risk of stroke, heart attack. Neurology Advisor. March 3, 2015.
8. van Dam R. Other healthy beverage options. Harvard School of Public Health. Available at: https://www.hsph.harvard. edu/nutritionsource/healthy-drinks/other-healthy-beverage-options/. Accessed March 1, 2018.

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