Is there a link between coffee and arrhythmia - new research
Kyiv • UNN
New research shows that consuming caffeinated coffee is safe for people with atrial fibrillation and may reduce the risk of disease recurrence. The results of the four-year DECAF clinical trial were presented at the annual conference of the American Heart Association.
Drinking caffeinated coffee is "safe for people with atrial fibrillation (A-fib) and may help prevent recurrence of the condition," according to new research, UNN reports, citing NBC News.
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Atrial fibrillation is a common heart condition that causes a rapid heartbeat and can lead to heart failure, blood clots, and stroke. Doctors have long tried to understand whether caffeine, which can increase heart rate and blood pressure, can trigger episodes similar to fluttering or pounding in the chest that cause dizziness or shortness of breath.
"There are no standard recommendations regarding the combination of atrial fibrillation and caffeine," said Dr. Gregory Marcus, a cardiologist and professor of medicine at the University of California, San Francisco, who led the DECAF study (Does Eliminating Coffee Avert Fibrillation?). "I very often encounter patients who have stopped drinking caffeinated coffee simply because their doctor recommended they do so due to atrial fibrillation."
The results of the DECAF study, a four-year clinical trial examining the effects of coffee consumption on people with a history of heart rhythm disorders who had either recovered or been treated, were presented Sunday at the American Heart Association's annual conference in New Orleans and published in JAMA. Marcus is an associate editor of JAMA.
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Researchers recruited 200 older adults from Australia, Canada, and the United States who regularly consumed coffee for the past five years. The average age of participants was 70, and one-third were women.
Over six months, participants were randomized into two groups: those who abstained from caffeine and those who drank at least one cup daily. All participants self-reported their consumption of coffee and caffeinated beverages during telemedicine or video consultations conducted one, three, and six months after the start of the study.
Using data from electrocardiograms (ECGs) taken in the doctor's office, cardiac monitors, and implanted cardiac devices, Marcus and his team determined whether and when people in each group experienced their first recurrent episode of atrial fibrillation. These cases included episodes of atrial flutter – a related condition that also causes abnormal contractions of the upper chambers of the heart.
Both groups had roughly similar alcohol habits. Not all study participants drank coffee at the start of the study, but the number of daily coffee drinkers in each group was similar.
Before the study began, 60% of participants in the coffee-drinking group and 65% in the non-coffee-drinking group stated that coffee had never caused an episode of atrial fibrillation.
Over the six months of the study, 111 people, or 56%, had a recurrent episode of atrial flutter. Participants in the coffee-drinking group were less likely to have a recurrence – 47% compared to 64% in the non-coffee-drinking group – and the first episode occurred later.
Approximately one-third of participants in the non-coffee-drinking group admitted to drinking at least one cup during the study, while others did not consume coffee at all.
"This is the latest study to show that coffee can reduce the risk of heart problems and other metabolic diseases," the publication states.
Previous observational studies have shown that coffee drinkers have a lower risk of atrial fibrillation, but the new study demonstrates a causal link, Marcus said.
"I was somewhat surprised by the magnitude of the protective effect of caffeinated coffee in preventing atrial fibrillation," Marcus said.
Dr. Joanna Contreras, a cardiologist at Mount Sinai Fuster Heart Hospital in New York, noted that the most important finding of the study was that "drinking one cup of coffee a day seems to be absolutely safe for people with atrial fibrillation, rather than that coffee has a protective effect."
"There's no hard and fast rule. Everyone reacts differently to caffeine," said Contreras, who was not involved in the study.
Moderation is key, Contreras said.
"If people are drinking six or seven cups of coffee and then Red Bull and Celsius, that's a different story," she said.
The study has significant limitations, including the influence of other caffeinated beverages besides coffee. The study did not track differences in physical activity or dietary habits. People who drink coffee may also exercise more, Marcus suggested.
It is unclear why coffee consumption was associated with a lower risk of recurrent irregular heartbeats. It is possible that an anti-inflammatory compound in coffee, rather than caffeine itself, could have reduced recurrences in the coffee-drinking group, Marcus said.
If caffeine is the cause, then caffeine's stimulation of the body's adrenaline response may help prevent atrial fibrillation. People often report episodes when relaxed, such as during sleep or after a large meal, when adrenaline levels are low, Marcus said, when the part of the nervous system responsible for rest and digestion is activated.
In addition, the study only included people who did not currently have episodes of atrial fibrillation. The results may not be applicable to people with uncontrolled disease.
"If a person had atrial fibrillation, caffeine could certainly increase the heart rate during that episode and therefore lead to worsening symptoms," he said.
"For people who already regularly drink coffee, this shows that you can have a cup of coffee in the morning and not experience problems if you have atrial fibrillation," Contreras said.