ARTICLE REVIEW

THE EFFECT OF COFFEE CONTAINING THE ACTIVE SUBSTANCE

CAFFEINE ON CARDIOVASCULAR DISEASE.
Fatimah Azzahra1, Hilma Marisa1, Jelita Septiani1, Kayla Roihatul Jannah1, Nadia Farah
Rahmatia1
1
Pharmacy Study Program, Faculty of Science and Technology, Universitas Muhammadiyah
Bandung

Abstract

Background: There is a lot of controversy regarding the relationship between coffee consumption and
cardiovascular disease risk. The relationship between coffee consumption and the risk of coronary heart
disease was first studied in the 1960s, given that the prevalence of both drinking coffee and
cardiovascular disease is equally high in Western countries. The substantive positive effects of coffee
consumption on human health are mainly related to cardiometabolic health, and coffee consumption is
moderately associated with a decrease in cardiovascular disease. Methods: The method used is to search
the literature on review articles by collecting several journals through PubMed and ScienceDirect.
Results: Five articles have been reviewed, and the results show that drinking coffee has no effect on the
risk of cardiovascular disease. Meanwhile, 8 other journals showed that consuming coffee can reduce the
risk of cardiovascular disease. Conclusion: The conclusion of the study is that consuming coffee can
reduce the risk of cardiovascular disease, depending on the amount consumed daily.

Keywords: coffee consumption, caffeine, coffee, cardiovascular, cardiovascular disease (CVD)

Abstrak

Latar Belakang: Ada banyak kontroversi mengenai hubungan antara konsumsi kopi dan risiko
penyakit kardiovaskular. Hubungan antara konsumsi kopi dan risiko penyakit jantung koroner
pertama kali dipelajari pada tahun 1960-an, mengingat prevalensi minum kopi dan penyakit
kardiovaskular sama tingginya di negara-negara Barat. Efek positif substantif dari konsumsi kopi
pada kesehatan manusia terutama terkait dengan kesehatan kardiometabolik, dan konsumsi kopi
cukup terkait dengan penurunan penyakit kardiovaskular. Metode: Metode yang digunakan
adalah dengan mencari literatur artikel review dengan mengumpulkan beberapa jurnal melalui
PubMed dan ScienceDirect. Hasil: Lima artikel telah diulas, dan hasilnya menunjukkan bahwa
minum kopi tidak berpengaruh terhadap risiko penyakit kardiovaskular. Sementara itu, 8 jurnal
lainnya menunjukkan bahwa mengonsumsi kopi dapat menurunkan risiko penyakit

1
kardiovaskular. Simpulan: Kesimpulan dari penelitian ini adalah mengkonsumsi kopi dapat
menurunkan resiko penyakit kardiovaskular, tergantung dari jumlah yang dikonsumsi setiap hari.
Kata kunci: konsumsi kopi, kafein, kopi, kardiovaskular, penyakit kardiovaskular (CVD)
Introduction
Coffee is one of the most popular and widely
consumed beverages worldwide [1-10] [14-
15]. Due to its stimulating effects on the central
nervous system as well as its taste and aroma [1].
Coffee's bioactive compounds include
chlorogenic acid (CGA), caffeine, diterpene
pentasiklik cafestol and kahweol, trigonelline,
and melanoidins [36]. Of these compounds, one
of the active compounds is caffeine [3,6].
Caffeine is a natural trimethylxanthine alkaloid
whose three methyl groups are located at
positions 1, 3, and 7 (1,3,7-trimethylxanthine)
[5]. Caffeine, one of the main psychoactive
ingredients in coffee, is a short-acting
neurostimulator with a known neuromodulatory
effect in the brain by inhibiting
phosphodiesterase, mobilizing intracellular
calcium, causing adenosine receptor antagonism,
and modulating GABA receptor function [49].
After consuming caffeine, the substance is
absorbed into the bloodstream through the
gastrointestinal tract. From there, caffeine is
distributed throughout the body. Caffeine
biologically acts as an antagonist of adenosine
A1 and A2A receptors, and these receptors are
widely distributed throughout the central and
peripheral nervous systems [7,13]. And it has
addictive properties and positive effects on
attention, arousal, mood, and alertness [8,36].
By blocking adenosine receptors, caffeine is able
to exert effects on metabolism, the
cardiovascular system, the respiratory system,
neuroinflammatory processes, nerve modulation,
and neuroprotection [7,9,19].
Many individuals who consume caffeine
continuously exhibit behaviors such as
dependence and have difficulty stopping or
reducing their caffeine intake [10,11]. There is
significant interest in the health outcomes of
these beverage consumption habits and their
potential role as modifiable risk factors for
cardiovascular disease (CVD) [12,20]. In the
past, coffee consumption was considered
unhealthy due to its caffeine content [50]. This
led to a common misconception that the
consumption of coffee in moderation was unsafe
in patients with CVD [12]. Discoveries already
collected by researchers in recent years have
generated new information regarding the effects
of coffee consumption on health, dispelling the
common belief that coffee is largely harmful [1].
A number of experimental and epidemiological
studies show that coffee consumption has
significant positive effects on human health,
particularly in terms of cardiometabolic and
moderately associated coffee consumption with
decreased cardiovascular disease [15-16].
Cardiovascular comes from the words cardio
and vascular. Cardio means "heart" and vascular
means "blood vessels." The cardiovascular
system is a system of organs that function to
transfer substances to and from cells. The
cardiovascular system consists of the heart,
blood, and blood vessels. If there is a
disturbance in the cardiovascular system, which
is a vital part of our body, it will be very harmful
to our health. Cardiovascular disorders are very
important. Almost every society on the planet
has discovered it and suffered greatly as a result.
Coronary heart disease, congenital heart disease,
2
stroke, hypertension, aneurysms, and other
cardiovascular diseases vary as well [17].
Cardiovascular disease (CVD) is considered the
leading cause of global death, accounting for
17.3 million deaths per year, which is expected
to rise to more than 23.6 million by 2030. The
main causes of CVD involve risk factors that
cannot be modified, in addition to metabolic risk
factors that are targeted along with behavioral
risk factors such as an unhealthy diet (rich in salt,
saturated fats, and calories). However, there are
still foodstuffs whose role is controversial, such
as coffee [18].
This article aims to review the results of
research on the effect of coffee consumption on
cardiovascular disease. The literature review
techniques from various international journals
were used in this study. Then the reading
sources that have been collected are analyzed
using one of the methods from international
journals, namely the cohort study method.
Method
The method in this article is in the form of a
literature review or review article used to collect
data or sources related to the influence of coffee
on cardiovascular disease. The initial search for
this article was done by collecting several
journals through PubMed and ScienceDirect. By
using the keywords "coffee, caffeine, coffee
consumption against cardiovascular diseases,"
With the number of searches for journals or
articles reviewed totaling 12.
One of the methods used in one of the journals
we found was in the European Journal of
Preventive Cardiology [47] in 2022, where the
journal used a cohort study method by collecting
participant data from the British Biobank
consisting of 502,521 participants. Then the
participants will fill out a touch-screen
questionnaire at the assessment center with
feedback on their daily coffee consumption,
such as the number of coffee cups and what kind
of coffee they drink each day. The coffee
subtypes studied in this study are decaffeinated
coffee and caffeinated coffee. Coffee
consumption in the amount of 0 cups per day is
used as a reference for comparison with other
intake levels.
Result
The European Journal of Preventive Cardiology
showed that habitual coffee intake of up to 5
cups per day was associated with a significant
reduction in the risk of CVD events when
compared to non-drinkers. A significant
reduction in the risk of congenital heart disease
(CHD) events was associated with a habitual
coffee intake of up to 5 cups/day, with the
lowest risk of CHD observed in those who
consumed 2-3 cups/day. Coffee consumption at
all levels was associated with a significant
reduction in the risk of carotid cavernosus fistula
(CCF). The lowest risk was observed in those
who consumed 2-3 cups per day.
A significant decrease in all-cause mortality was
associated with coffee consumption of up to 5
cups per day, with the greatest effect seen with
2-3 cups per day. A significant decrease in CV
mortality was observed in coffee drinkers
consuming 1–5 cups per day, with the lowest
risk at 1 cup per day. Ingestion of coffee is not
associated with the risk of sudden cardiac death.
Caffeinated coffee consumption of up to 5 cups
per day was associated with a significant
reduction in the risk of CVD, CHD, and CCF.
Caffeinated coffee consumption at all levels
significantly reduces the risk of all-cause CV
death. All causes of death were lowest at 2-3
cups/day, while CV mortality was lowest at 4-5
cups/day. On decaffeinated coffee intake and all-
cause mortality, the lowest risk is seen with 2-3
cups per day. Coffee consumption of 1 to 3 cups
per day reduces cardiovascular mortality.
3
5 other journals [9][43-46] that we reviewed
found that drinking coffee has no effect on the
risk of cardiovascular disease.Meanwhile, 7
other studies [4, 18] [38-42] found that drinking
coffee reduces the risk of cardiovascular disease.
Discussion
Coffee is a complex compound consisting of
>100 biologically active components, with
caffeine being the best known [21]. Coffee is the
most common cognitive enhancer that improves
alertness and mental concentration. However,
higher intake levels can result in feelings of
anxiety, restlessness, insomnia, and
psychomotor agitation, with toxic effects
estimated to occur with intake≥1.2g [22].
Historically, up to 80% of health practitioners
have advised CVD patients to avoid coffee [33].
This misconception has been addressed by
recent observational studies, which have not
only reported safety but also beneficial effects of
coffee intake on CVD prevention [23][34-35]. In
fact, the consumption of 3-4 cups per day is
described as quite beneficial in the prevention of
CVD in the European Society of Cardiology's
2021 guidelines [36], although such
recommendations are not made in the 2019
AH/ACC guidelines [37].
In the European Journal of Preventive
Cardiology, the two coffee subtypes were
associated with significant reductions in CVD,
CCF, CHD, and CV deaths. Caffeine increases
the release of endothelial nitric oxide, regulates
lipogenesis, reduces insulin sensitivity, and has
antioxidant properties that can all reduce CVD
[23-25]. However, coffee also contains
polyphenols such as chlorogenic acid, the
antioxidant ferulic acid, and microelements such
as magnesium.
Importantly, a beneficial effect on the reduction
of mortality is observed in caffeinated and
decaffeinated coffee drinkers [27-28] reported
an inverse association between caffeinated and
decaffeinated coffee consumption with all-cause
and CV mortality. Non-caffeinated coffee plays
a role in reducing mortality, as supported by
genomics. The genetic variant that determines
the metabolic rate of caffeine does not affect the
relationship between coffee consumption and
all-cause death [9,24]. In line with the findings
from this study, non-caffeine compounds are
likely responsible for the beneficial effects of
coffee consumption on CVD and survival.
Several other studies have found that regular
coffee drinkers have lower all-cause and
mortality CV [26-27] [29-30], with the greatest
benefit seen between 3 and 5 cups per day [31-
32].
In addition, according to other studies, coffee
consumption has been associated with a reduced
risk of CV disease. And the CGA (Chlorogenic
Acid) present in the drink is thought to be
responsible for its protective effect [38]. CGA is
often referred to as a powerful antioxidant,
which may be true in vitro by acting as an
antithrombotic agent by inhibiting platelet
activity [38].
Conclusion
Based on the results obtained from the review of
various journal articles regarding the effect of
coffee consumption on cardiovascular diseases,
it is stated that coffee consumption can reduce
the risk of cardiovascular disease depending on
the amount of daily coffee consumed.
Suggestion
More research needs to be done on the limits of
the amount of daily coffee consumption that can
increase the risk of cardiovascular disease.
4
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