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.
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:
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.
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
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