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Cardiovascular disease – still the biggest killer

Cardiovascular disease is a collective term used to describe conditions affecting the heart and circulation, including coronary heart disease, heart attack and stroke.

In Europe, cardiovascular disease – CVD – (principally coronary heart disease and stroke) is a main cause of death, accounting for 45% of all deaths (52% of all deaths in women and 42% of all deaths in men)1,2. A 2016 review of the burden of CVD in Europe attributes CHD and cerebrovascular disease with 1.8 million and 1.1 million deaths, respectively1.

CVD costs the healthcare systems of the EU €196 billion every year2. It is projected to remain the single leading cause of death and, by 2030, it is estimated that almost 23.6 million people will die from CVD3.

Coffee consumption and cardiovascular health

A majority of prospective cohort studies looking at coffee consumption and cardiovascular disease suggest that a moderate intake of coffee (3-5 cups per day) may have a protective effect against CVD mortality risk4,5,6.

Most studies that have reviewed the association between coffee consumption and stroke have suggested that drinking coffee is associated with a reduced risk (particularly in women), although some have shown contradictory results7,8,9.

Any effect of moderate coffee consumption on blood pressure is relatively small and it appears any effects may be due to compounds other than caffeine in coffee10,11.

Coffee’s effect on cholesterol levels is largely dependent on the method of brewing. Unfiltered coffees (such as Scandinavian boiled coffee, Cafetière (plunger pot), Greek and Turkish coffee) raise total and LDL cholesterol; this is not the case with filtered coffee because the cholesterol-raising compounds in coffee, e.g. cafestol and kahweol, are retained in the paper filter. Soluble coffee contains hardly any of these compounds, whilst espresso contains approximately half the amount of unfiltered coffee. As espresso is served in small quantities, a moderate consumption of espresso coffee can be expected to have a negligible effect on serum cholesterol levels. The effects on cholesterol levels are transient and are reduced after the cessation of consumption.

The mechanisms underlying the associations seen between coffee consumption and reduced risk of stroke, and potential associations with risk factors for coronary heart disease need further investigation. It is unlikely that caffeine is solely responsible for these effects. Other coffee constituents, such as soluble fibre, potassium and polyphenols, may be involved.


  1. Townsend N. et al. (2016) Cardiovascular disease in Europe: epidemiological update. Eur Heart J, published online ahead of print.
  2. European Heart Network, ‘European Cardiovascular Disease Statistics 2012’. Available at: http://www.ehnheart.org/cvd-statistics.html.
  3. World Health Organization ‘Cardiovascular diseases (CVDs) Factsheet’. Available at: http://www.who.int/mediacentre/factsheets/fs317/en/
  4. Wu J. et al. (2009) Coffee consumption and the risk of coronary heart disease: a meta-analysis of 21 prospective cohort studies. Int J Cardiology, 137:216-225.
  5. Ding M. et al (2014) Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circ, 129(6):643-59.
  6. Crippa A. et al. (2014) Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis. Am J Epidemiol, 180(8):763-75.
  7. Lopez-Garcia E. et al. (2009) Coffee consumption and risk of stroke in women. Circ, 119:1116-1123
  8. Larrson S.C. and Orsini N. (2011) Coffee consumption and risk of stroke: A dose-response meta-analysis of prospective studies, Am J Epidemiol, 174(9):993-100.
  9. Kim B. et al. (2012) Coffee consumption and stroke risk: A meta-analysis of epidemiologic studies. Korean J Fam Med, 33(6):356-65.
  10. Geleijnse J.M. (2008) Habitual coffee consumption and blood pressure: An epidemiological perspective. Vasc Health Risk Man, 4(5):963-970.
  11. Rhee J.J. et al. (2016) Coffee and Caffeine Consumption and the Risk of Hypertension in Postmenopausal Women. AJCN, 103(1):210-7.

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