Drinking Coffee With Heart Disease: What You Need to Know
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Should I Drink Coffee if I Have Heart Disease?

Should I Drink Coffee if I Have Heart Disease?
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Published on June 6, 2025
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If you have heart disease, you’ve likely been told by your healthcare provider to be cautious about what you eat and drink, including that morning cup (or two) of joe. One of the most widely consumed beverages in the world, coffee is known for its stimulating effects and potential health benefits. But for individuals with certain heart conditions, coffee’s protective effects don’t always outweigh its risks.

Coffee Drinkers May Live Longer

A new study suggests that coffee may help people live longer. Researchers found that more coffee drinking led to less deaths by heart disease, diabetes, stroke, and other diseases.
Coffee Drinkers May Live Longer

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How Coffee and Caffeine Affect the Heart

“Coffee contains caffeine, a natural stimulant that affects the heart and blood vessels,” says Robert Ostfeld, MD, the director of preventive cardiology at Montefiore Health System in New York.

When you drink coffee, its caffeine content temporarily blocks adenosine receptors, reducing the calming effects of the neurotransmitter adenosine and increasing the body’s production of the hormones norepinephrine and adrenaline. This response stimulates your sympathetic nervous system, leading to a rise in heart rate and the constriction of blood vessels.

“In the short term, caffeine may cause a temporary rise in blood pressure and heart rate, especially in people who aren’t habitual coffee drinkers. For regular drinkers, the body tends to adapt, and these effects are often milder.”

Caffeine consumption also has the potential to affect heart rhythms, because of the stimulant’s relationship with the sympathetic nervous system. In some populations, caffeine may influence heart rhythm for the better, but evidence of its potential benefit is complex and mixed.

Coffee’s impact on conditions like coronary artery disease is also unclear. In some cases, moderate coffee consumption can help decrease one’s risk for heart failure, atrial fibrillation, and high blood pressure.

Potential Benefits of Coffee for Heart Health

“Some trials demonstrate that drinking one to three cups [of coffee] a day can have long-lasting effects on reducing cardiovascular risks and even all-cause mortality, meaning people actually live longer,” says Aditya Mangla, DO, the chief of cardiology at Jamaica Hospital Medical Center in New York. This moderate coffee consumption may help reduce blood pressure and cholesterol, as well as decrease a person’s risk for atrial fibrillation and heart failure.

A coffee habit may lower your stroke risk as well, namely ischemic stroke, which is caused by a blood clot blocking necessary blood flow to the brain.

 Women who drink three to four cups of coffee a day appear to experience the most significant reduction in overall stroke risk.

Finally, drinking coffee may help decrease a person’s risk of type 2 diabetes, and the more one drinks, the lower the risk.

 Type 2 diabetes is one health factor that increases a person’s risk of heart disease.

Potential Risks of Coffee for People With Heart Disease

On the other hand, coffee consumption may pose certain risks for heart health as well.

“Caffeine in general can increase heart rate and, in some people, raise blood pressure,” says Dr. Mangla, adding that these effects tend to be short-lived and are unlikely to be clinically significant.

 With that said, some people with more severe high blood pressure may have an increased risk of cardiovascular disease-related death if they drink two or more cups of coffee a day.

It’s possible that coffee consumption may impact heart rhythms, too. For example, coffee consumption may increase a person’s chances of experiencing premature ventricular contractions, a type of abnormal heartbeat that can be considered a predictor of heart failure.

 “With regards to arrhythmia, [caffeine] can precipitate a sense of heart racing and can even precipitate certain fast heart rhythms,” says Mangla.
Finally, consuming caffeine too close to bedtime can lower your sleep quality.

 Sleep problems are commonly associated with heart health issues, as poor sleep is linked to major cardiovascular disease risk factors like obesity, high blood pressure, and diabetes.

Factors That Can Influence Coffee’s Impact on the Heart

Not all coffee is created equal, and not everyone is affected by coffee in the same way. In fact, several factors may affect a person’s response to coffee, as well as its implications for their heart health.

“Each individual may respond differently to [the] caffeine [in coffee], especially in terms of blood pressure or heart rhythm, so monitoring your response with your physician may be helpful,” says Dr. Ostfeld.

The amount of coffee a person consumes can change its overall impact on heart health as well, with higher amounts possibly being more detrimental than moderate consumption.

 “Most cardiology and public health groups agree that up to three to four cups of coffee per day is generally safe for healthy adults, and often for those with well-managed heart disease,” says Ostfeld. The amount of caffeine in a cup of coffee can vary significantly depending on the style, roast, and brewing method.

The type of coffee may matter, too. For example, drinking unfiltered coffee may increase a person’s risk for elevated cholesterol, a risk factor for heart disease.

 Alternatively, decaffeinated, instant, and ground coffee consumption are all associated with reduced risk of cardiovascular disease, and decaf coffee drinking in particular is associated with a decreased risk for arrhythmia.

How coffee is prepared is also worth considering. For example, adding cream or sugar to coffee can add extra calories and fat to the beverage, altering its overall health profile. “Added sugar, syrups, or creamers may turn coffee from heart-helpful to heart-harming,” says Ostfeld.

Ostfeld adds that genetics can also play a role in how coffee drinking affects heart health, as some people metabolize caffeine slowly, increasing their overall sensitivity to the stimulant.

Coffee and Heart Disease: What Experts Recommend

Expert advice regarding coffee and caffeine consumption for people with heart disease varies.

“Patients who are sensitive to caffeine and those with certain heart rhythm issues should avoid caffeine,” says Mangla.

“People with certain arrhythmias like atrial fibrillation or supraventricular tachycardia may need to be cautious with caffeine, as caffeine can occasionally trigger palpitations or rapid heartbeats,” says Ostfeld.

People with more severe high blood pressure may also want to exercise caution. “Those with uncontrolled high blood pressure should limit caffeine until their blood pressure is more optimized,” says Ostfeld.

If you have heart failure, Ostfeld advises speaking with your cardiologist, noting most guidelines don’t suggest restricting coffee consumption unless your symptoms worsen.

The potential health benefits of coffee may still apply to someone who has heart disease, especially when the beverage is consumed without added sugars or high-fat cream. Ostfeld notes that its anti-inflammatory properties, blood vessel protection, and associated lower risk for certain heart conditions are worth considering.

That doesn’t mean that coffee is a treatment for heart disease. “Coffee [is] overall neutral,” says Sean Heffron, MD, a preventive cardiologist at the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart in New York, notes that. “I certainly don't counsel patients to consume coffee for the heart benefits, nor do I discourage them necessarily from consuming it for the heart benefits.”

Overall, moderation is key for people with heart disease who want to drink coffee. “There are very limited guidelines,” says Mangla. ”However, the general recommendation is to limit caffeine [consumption] to less than 400 milligrams (mg) per day, which would equate to less than four cups of usual brewed coffee.”

When to Talk to Your Doctor

Talk to your doctor about your coffee consumption if you have heart disease and you start to experience troubling symptoms.

“If you have a symptom that's concerning to you or that's unusual, speak to your doctor about that symptom,” says Dr. Heffron. “I would suspect, in the vast majority of cases, any symptoms are unrelated to coffee intake.”

If you have questions about how drinking coffee could impact your heart health, ask and get the guidance you need. Your doctor can help you come up with a plan that fits your particular situation, taking into account specific heart conditions you have, medications you take, and your overall lifestyle.

“Caffeine may interact with or amplify the effects of certain medications such as blood pressure medications, stimulants, antibiotics, and thyroid medications,” says Ostfeld. “Speak with your physician if there are any such concerns.”

The Takeaway

  • One of the most popular beverages in the world, coffee is known for its stimulating effects and potential health benefits.
  • There are some cardiovascular risks associated with drinking coffee, such as changes to blood pressure, heart rate, and heart rhythm, so those with existing heart health concerns should be mindful of their overall consumption.
  • Several factors can contribute to how a person’s body (and heart) responds to coffee, including caffeine sensitivity, the type of coffee consumed, the amount of coffee consumed, and whether it’s prepared with added sugar and high-fat cream.
  • Moderation is typically recommended for people with heart health concerns who want to drink coffee, but talk with your doctor to determine the safest coffee consumption for you based on your health, current medication regimen, and lifestyle.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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  11. Marcus GM. Coffee’s Effects on Cardiac Arrhythmias, Physical Activity, Sleep and Serum Glucose: Insights From the Coffee and Real-time Atrial and Ventricular Ectopy Trial. Clinical and Translational Medicine. July 27, 2023.
  12. Premature Ventricular Contractions. Cleveland Clinic. July 29, 2022.
  13. Gardiner C et al. The Effect of Caffeine on Subsequent Sleep: A Systematic Review and Meta-Analysis. Sleep Medicine Reviews. March 2, 2023.
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Reyna Franco, RDN

Medical Reviewer
Member of American College of Lifestyle Medicine

Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.

In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.

Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size. She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.

She is the chair of the American College of Lifestyle Medicine's Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.

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Jessica Freeborn has worked as a health and wellness freelance writer since 2021. She is passionate about encouraging people to take control of their health and stay informed about the latest medical advancements. She has two nursing degrees and has used her healthcare experience to enhance her writing and research.

As someone with type 1 diabetes, she understands the complexities surrounding diabetes management and wants to provide people with accurate information and dispel misconceptions about diabetes treatment.

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