Coffee and cardiovascular health: Does timing matter?

With over three-quarters of Australians drinking coffee regularly, it’s a staple in most patients’ diets. Emerging evidence is shifting how we view coffee’s impact on cardiovascular health, from lipid metabolism to blood pressure and even mortality risk.

Coffee contains not just caffeine, but a mix of antioxidants, diterpenes (like cafestol and kahweol), and other compounds that interact with lipid metabolism, blood pressure regulation, and inflammation. For GPs, understanding these factors can help support personalised, evidence-informed guidance, particularly for patients with dyslipidaemia, hypertension, or cardiovascular disease.

Coffee and blood lipids

While moderate coffee intake has generally been associated with reduced risk of heart disease and all-cause mortality¹, some studies have highlighted important considerations related to lipids and blood pressure:

• A 2020 systematic review and meta-analysis of randomised controlled trials found that coffee consumption modestly increased total cholesterol (by 0.21 mmol/L), LDL-C (by 0.14 mmol/L), and triglyceride levels (by 0.12 mmol/L). These effects were more pronounced with boiled coffee, compared to filtered, instant, or decaf options. HDL cholesterol was unaffected.²
• The dose-response analysis suggested greater increases in lipid levels at 3–5 cups/day and >6 cups/day, particularly with unfiltered coffee.²
• Coffee affects blood lipids. For patients with dyslipidemia, it's advisable to limit intake to <3 cups/day of filtered coffee.²

Coffee and blood pressure

Recent research suggests coffee may not increase hypertension risk as previously thought. A 2023 systematic review and meta-analysis of 25 observational studies found that higher coffee consumption was associated with a 7% reduction in hypertension risk.³

While caffeine can slightly raise blood pressure in the short term (2 mmHg systolic, 1 mmHg diastolic), tolerance typically develops with regular consumption, and long-term intake (up to 6 cups/day) doesn’t significantly affect blood pressure, even in those with hypertension.³

New insights: Does coffee timing matter?

Building on this, emerging data suggest timing may also play a role in coffee’s health impact.

A recent large cohort study followed 40,725 adults and identified two patterns of coffee drinking: morning-only and all-day consumption. After adjusting for confounders, only the morning-only pattern was associated with lower all-cause and cardiovascular mortality compared to non-coffee drinkers.⁴

While the findings are preliminary and observational, they suggest that consuming coffee earlier in the day may better align with circadian rhythms, potentially supporting cardiovascular health by avoiding sleep disruption and subsequent metabolic stress. However, more research is needed to confirm these associations.

Key takeaway for clinical practice

Coffee remains a staple in many diets, and for most patients, moderate intake can fit within a heart-healthy lifestyle. The latest evidence suggests that the type and amount of coffee matter as boiled coffee may impact lipids more than filtered types. Additionally, timing of intake may influence long-term outcomes. Morning coffee might be more beneficial than all-day sipping, but more research is needed to recommend patients change their timing. GPs can encourage patients to tailor their coffee habits to their individual health goals.

– Sarah Marko, Accredited Practising Dietitian

Next steps in your learning journey

🎓 Certificate Courses in Clinical Nutrition

Our university-assured, structured pathway to elevate your knowledge in clinical nutrition management. ➡️ Explore full program >

🎓 Micro-Courses in Clinical Nutrition

Explore short, bite-sized CPD modules in focused topics in clinical nutrition. Complete in less than 10 hours! ➡️ Browse Micro-Courses >

🎓 HealthCert 365 subscription

Prefer flexible learning across many topics? Access 4,000+ CPD hours on-demand with HealthCert 365 — an annual subscription for one flat fee. ➡️ Discover HealthCert 365 >

Explore more educational content in Clinical Nutrition.

CPD self-submission

You can self-record this blog for CPD. Quick Log CPD hours with the RACGP/ACRRM via the usual self-submission process. You will be asked to reflect on what you have learned, and you will require supporting evidence such as a screenshot. For more information, view the: RACGP CPD guide | ACRRM CPD guide

References

1. Ungvari Z, Kunutsor SK. Coffee consumption and cardiometabolic health: a comprehensive review of the evidence. Geroscience. 2024 Dec;46(6):6473-6510. doi: 10.1007/s11357-024-01262-5. Epub 2024 Jul 4. PMID: 38963648; PMCID: PMC11493900.
2. Du Y, Lv Y, Zha W, Hong X, Luo Q. Effect of coffee consumption on dyslipidemia: A meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2020 Nov 27;30(12):2159-2170. doi: 10.1016/j.numecd.2020.08.017. Epub 2020 Aug 21. PMID: 33239163.
3. Haghighatdoost F, Hajihashemi P, de Sousa Romeiro AM, Mohammadifard N, Sarrafzadegan N, de Oliveira C, Silveira EA. Coffee Consumption and Risk of Hypertension in Adults: Systematic Review and Meta-Analysis. Nutrients. 2023 Jul 7;15(13):3060. doi: 10.3390/nu15133060. PMID: 37447390; PMCID: PMC10347253.
4. Wang X, Ma H, Sun Q, Li J, Heianza Y, Van Dam RM, Hu FB, Rimm E, Manson JE, Qi L. Coffee drinking timing and mortality in US adults. Eur Heart J. 2025 Feb 21;46(8):749-759. doi: 10.1093/eurheartj/ehae871. PMID: 39776171; PMCID: PMC11843000.