Ding · Circulation 2014 · Systematic review and dose-response meta-analysis · n=36 studies (1,279,804 participants)

Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies.

Cited 574 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of prospective cohort studies

PubMed 24201300 · doi:10.1161/CIRCULATIONAHA.113.005925 · record verified 2026-08-30

What was done

A systematic review and dose-response meta-analysis of prospective cohort studies was conducted via PubMed and EMBASE searches. Eligible studies assessed long-term coffee consumption and cardiovascular disease (CVD) outcomes, including coronary heart disease (CHD), stroke, heart failure, and CVD mortality. Risk estimates were pooled using dose-response models.

What was found

Across 36 prospective cohort studies encompassing 1,279,804 participants and 36,352 CVD cases, a non-linear relationship was identified (P for trend < 0.001; P for nonlinearity < 0.001). Compared with the lowest coffee consumption (median 0 cups/day), relative risks for CVD were: - Median 1.5 cups/day: RR 0.89 (95% CI, 0.84–0.94) - Median 3.5 cups/day: RR 0.85 (95% CI, 0.80–0.90) - Median 5.0 cups/day: RR 0.95 (95% CI, 0.87–1.03) Nonlinear inverse associations were also observed separately for CHD risk (P for nonlinearity < 0.001) and stroke risk (P for nonlinearity < 0.001).

Why it matters

This large meta-analysis demonstrates that moderate coffee consumption (3 to 5 cups daily) is associated with the lowest CVD risk, and heavy consumption does not increase risk compared to non-consumption.

Limits

The analysis is restricted to observational prospective cohorts, leaving residual confounding (such as smoking, diet, or socioeconomic status) possible. The abstract does not report details on coffee preparation methods, bean types, decaffeinated versus caffeinated differences, or geographic distribution.

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