Higher coffee consumption was associated with increased odds of myocardial infarction (MI) but lower risks of stroke and cardiac arrhythmias, according to an updated meta-analysis of observational studies published in the BMC Cardiovascular Disorders. The pooled analysis included 38 studies involving 2,856,002 participants and evaluated associations between coffee or caffeine intake and multiple cardiovascular outcomes. 

The analysis included cohort and case-control studies identified through systematic searches of PubMed, Web of Science, Cochrane Library, Embase, and Scopus for studies published between 2000 and 2025. Studies reporting hazard ratios (HRs), relative risks (RRs), or odds ratios (ORs) for cardiovascular outcomes associated with coffee intake were included. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute tool.

Comparisons between the highest and lowest coffee intake categories showed no significant associations with coronary heart disease (HR 0.98; p=0.80) or heart failure (HR 1.03; p=0.62). In contrast, higher coffee consumption was associated with greater odds of MI (OR 1.48; p<0.0001).

Coffee consumption also showed inverse associations with stroke (HR 0.89; p=0.01) and cardiac arrhythmias (HR 0.94; p=0.04). In addition, a non-linear relationship was observed between caffeine intake and cardiovascular disease mortality among patients with hypertension, with higher caffeine intake associated with lower mortality risk (HR 0.68; p=0.001).

The findings showed differing associations across cardiovascular outcomes, with higher coffee intake associated with increased MI risk but lower risks of stroke, arrhythmias, and cardiovascular disease mortality among patients with hypertension.