Medical doctors have historically instructed sufferers with atrial fibrillation and different coronary heart arrhythmias to both keep away from or considerably prohibit their caffeine consumption. A rising variety of research, nevertheless, point out that average caffeine consumption is protected — and doubtlessly useful — for sufferers with these coronary heart circumstances.
A paper revealed earlier this month within the Journal of the American Medical Affiliation (JAMA) discovered that one cup of espresso a day was related to much less recurrence of coronary heart arrhythmias in A-fib sufferers in comparison with those that abstained from caffeine.
“It was just a little shocking to some that not solely was it not scary A-fib, however it appeared to have just a little little bit of a protecting impact,” mentioned Dr. David Pederson, a heart specialist with Methodist Healthcare, who primarily works at Methodist’s cardiology clinic within the South Texas Medical Heart.
Atrial fibrillation, characterised by irregular, speedy heartbeats, is the commonest kind of coronary heart arrhythmia situation, affecting 12 million Individuals, in keeping with the U.S. Facilities for Illness Management and Prevention.
A-fib danger will increase with age and alongside different circumstances like hypertension, diabetes and weight problems — all of which afflict San Antonio and South Texas at increased charges than the nationwide common. A-fib is a serious contributor to ischemic strokes, when a blood clot prevents oxygen from reaching the mind.
“I see A-fib very generally, each week,” mentioned Dr. James Keeton, a College Well being heart specialist, who practices on the county hospital system’s major campus and its downtown Robert B. Inexperienced clinic. “It’s turning into increasingly more prevalent, particularly with growing old. There’s plenty of overlap with different cardiovascular ailments.”
Right here’s what the analysis and native cardiologists must say concerning the connection between caffeine and cardiovascular well being, how a lot caffeine is an excessive amount of, and limitations to the analysis on caffeine and coronary heart circumstances.
Does caffeine spur cardiac arrhythmias?
The frequent reply from well being care suppliers to that query has historically been “sure.” The standard knowledge has been that caffeine is pro-arrhythmic, that means it could actually spur new arrhythmias or worsen current ones in sufferers with A-fib or related circumstances, in keeping with the native cardiologists and analysis papers.
“That’s the prevailing thought amongst not simply common practitioners, but additionally possibly some cardiologists as nicely,” Keeton mentioned. “Prior to now 10 years, I believe that it wasn’t unusual for suppliers to suggest sufferers to lower their caffeine consumption due to arrhythmias.”
Caffeine — whether or not within the type of espresso, vitality drinks or caffeine drugs — could cause transient spikes in blood stress, largely in individuals who don’t devour caffeine frequently. This impact, in addition to elevated coronary heart price from caffeine, was thought to pose a hazard to individuals with A-fib.
“It was frequent recommendation for a very long time, as a result of it sort of appeared to make sense,” Pederson mentioned. “Some individuals drink espresso and really feel sort of jittery, and may really feel some palpitations. And we thought caffeine was a gentle stimulant, so it made sense that it’d trigger some arrhythmias.”
A number of research, nevertheless, now contradict caffeine’s pro-arrhythmic fame.
For instance, meta-analyses in 2013 and 2024 discovered no affiliation between cardiac arrhythmias and caffeine consumption, with the 2013 paper suggesting that low doses of caffeine may actually have a protecting impact. And in 2016, a randomized medical trial discovered that even excessive doses of caffeine — 500 milligrams, which is roughly 5 cups of espresso, administered over 5 hours, didn’t spur arrhythmias in individuals with coronary heart circumstances.
“An rising physique of analysis seems to help the concept that consuming espresso has no adverse results and should even be useful,” researchers mentioned within the 2024 paper.
The latest JAMA paper revealed earlier this month, nicknamed the DECAF research, tracked 200 adults with A-fib over six months, all of whom had a historical past of consuming caffeinated espresso.
Half of the members consumed one cup of caffeinated espresso per day, the remaining abstaining from caffeine. The group of caffeine customers’ danger of atrial fibrillation recurrence was 39% decrease than the abstaining group.
Limitations and ‘average’ caffeine consumption
There have been limitations to the DECAF research, Pederson and Keeton identified. It was comparatively small, carried out over a brief time period, and relied on members precisely reporting how a lot caffeine they consumed each day.
And extra broadly, a problem with all the research that examine the connections between coronary heart circumstances and caffeine is that they’re arduous to match since they depend on various quantities of caffeine and in numerous kinds — espresso, caffeine drugs, caffeinated gum.
Whether or not average consumption of espresso and caffeine actually has a protecting impact for individuals with coronary heart circumstances, the rising physique of analysis indicators to Keeton and Pederson that caffeine abstinence is pointless.
“That is telling me that it’s protected,” Keeton mentioned, “that in all probability we shouldn’t be instructing sufferers to keep away from caffeine. Whether or not or not caffeine use decreases the chance of arrhythmias like A-fib, I believe it’s too early to inform.”
Each docs emphasised that caffeine ought to be consumed moderately.
For them meaning someplace between one and three cups of espresso a day, or not more than about 300 milligrams. However, Keeton famous, everybody responds to caffeine in a different way. The U.S. Meals and Drug Administration advises consuming not more than 400 milligrams of caffeine every day.
It’s additionally value remembering that vitality drinks and pre-workout dietary supplements usually include a lot increased degree quantities of caffeine than the common cup of espresso. Soda, tea, darkish chocolate, and even decaffeinated espresso additionally include various quantities of caffeine.
In case you’re somebody who has a historical past of cardiovascular circumstances, listening to your consumption, and lowering it for those who do expertise palpitations or discomfort is advisable.
Pederson tells his sufferers to not fear about espresso so long as it’s not extreme and never inflicting bodily discomfort. “I guarantee them it’s not going to harm them and it could be useful,” he mentioned. “In case you actually don’t like espresso or caffeine, it makes you typically really feel dangerous, then don’t begin taking it. It’s not a therapy.”
So, what are the remedies for A-fib and related coronary heart circumstances?
Blood thinners and heart-rate-regulation drugs, procedures like a cardioversion, which makes use of an electrical shock to carry the center again into a traditional rhythm; and way of life components comparable to sustaining a wholesome weight, controlling blood stress, treating sleep apnea, common train and limiting alcohol consumption, Pederson mentioned.
That morning cup of espresso, although, can in all probability keep.
“I wouldn’t need anybody to inform me I couldn’t drink espresso,” Keeton mentioned. “I couldn’t do this.”
