Abbot Kinney is lined with three-waves espresso bars and cold brews are in every office Westwood building, so it is clear that coffee is an integral part of the everyday working life in Los Angeles, even alongside the 405 freeway. It’s coffee’s importance to the daily life of the Angeleno that makes me understand why so many customers are concerned with the impacts of their coffee consumption, particularly when it comes to their heart health.

Fortunately, the answer to the question of whether coffee is bad for someone’s heart isn’t as bad as most people expect. It’s important to note patients with a heart condition have a more complicated answer. As a cardiac surgeon, here’s what I’d like you to know.

Why Is There Confusion About Caffeine and the Heart?

For many years, coffee’s reputation in cardiovascular medicine has been hugely negative. Initial studies suggested high coffee consumption was related to increased risks to heart health. With that in mind, doctors would recommend coffee avoidance to patients with high blood pressure and arrhythmia. As it turns out, these suggestions rely on a consolidating body of evidence — and recent quality studies show the opposite.

A large 2026 review study from the European Journal of Medical Research evaluated quality studies on caffeine consumption and the cardiovascular system from a variety of research methods, clinical trials, and the epidemiological study through the lens of Mendelian randomization, With this, the author concluded that, in general, moderate caffeine consumption does not negatively impact cardiovascular health.

That said, it is safe for those with cardiovascular related conditions, but, again, the word is *moderate*. As with so many things in medicine, the dose is of utmost importance.

What Does Coffee Do to Your Heart?

Coffee and caffeine impact the body and heart in unique ways and is almost entirely through the blockade of the adenosine receptor. As a naturally occurring compound, adenosine effects heart rates and relaxation. Caffeine, on the other hand, prevents adenosine from having any effect – and is why your heart may temporarily speed up after having a cup.

Regular caffeine consumption has some cardiovascular risks; however, these risks diminish with moderate caffeine consumption. In layman’s terms, moderate caffeine consumption is good, no caffeine is neutral, and excess caffeine intake is bad.

In addition to caffeine, numerous other bioactive substances are found in coffee, some of which have cardiovascular benefits of their own and can be anti-inflammatory and anti-oxidative. That is one reason raw caffeine and coffee may have different research outcomes.

Good News! Coffee Could Be Good For Your Heart

Most people are surprised to hear this.

Cardiovascular mortality may be lower for coffee drinkers. In a study in the European Heart Journal, people who have coffee in the morning are less likely to die of cardiovascular disease than people who drink coffee all day. People who drink coffee in the morning are 16% less likely to die from any cause and 31% less likely to die from cardiovascular disease compared to people who do not drink coffee at all.

And these findings can be used in practice. As it turns out, it is not simply your consumption of coffee, your quantity of consumption, or your frequency of consumption. Rather, it is your timing of consumption that is of importance.

AFib and Coffee: The Doctors Were Wrong

Perhaps the most groundbreaking new information regarding cardiovascular medicine pertains to the area of atrial fibrillation, which is a condition that affects more than 10 million people in the United States and involves an irregular rhythm of the heart, increasing the likelihood of suffering a stroke. For a number of years, cardiologists have recommended that patients with AFib should limit or avoid the consumption of caffeinated beverages. However, this was contradicted in a 2025 trial published in JAMA and provided the most information on this phenomenon.

In the DECAF clinical trial, it was shocking to see that participants that consumed 1 cup of coffee were able to reduce their risk of developing AFib by 39%. This is in opposition to the medical community that has warned patients with heart arrhythmia disorders and encouraged them to limit or avoid the consumption of caffeine. The research team provided a number of contradictory explanations: caffeine consumption is correlated with increased exercise and therefore, decreased risk of developing AFib, it is a diuretic which can also lower blood pressure and decrease the likelihood of developing AFib, and coffee is an anti-inflammatory.

It is also important to note that while some changes to dietary habits can be beneficial, it is not recommended that AFib patients start drinking coffee on a regular basis. As with anything, dietary changes should be discussed first with a cardiologist, however, in recent studies, the recommendation to completely avoid caffeine has little to no evidence.

The Brewing Method Is More Important Than You May Think

Out of the numerous things that go unmentioned by physicians, the way a patient brews coffee has implications that impact the heart. This is especially true when it comes to the cholesterol levels of a patient.

Different brewing techniques can result in different levels of diterpenes, a natural compound found in coffee that can raise levels of cholesterol, specifically the LDL cholesterol, which is referred to as the “bad cholesterol”. Unfiltered coffee such as that obtained from a french press, Turkish coffee, or boiled coffee will retain these compounds while drip coffee, espresso, and most pod-style machines are designed to filter out the majority of diterpenes.

If you are a coffee drinker and you are also cholesterol or heart disease patient, then the act of switching from a french press to drip coffee would be a positive evidence-based act that would lead to a decrease in your cardiovascular risk.

When Caffeine Can Hurt Your Heart

The protective claim above pertains to moderate, habitual coffee drinkers – in this case, 1 to 3 coffee cups per day. With higher intake or certain pre-existing conditions, the equation shifts dramatically.

High doses and heart palpitations

High levels of caffeine (via coffee, energy drinks, or pre-workout supplements) can cause palpitations, a racing heart, and potentially serious arrhythmias in susceptible people. Energy drinks are especially worrying as they include high levels of caffeine and other stimulants (such as taurine and guarana) that may create unpredictable cardiovascular concerns which are worse than those from coffee.

If you experience your heart racing, pounding, or skipping beats and it happens after taking caffeine, that is a case you should discuss with a cardiologist.

Blood pressure sensitivity

A study showed that coffee consumption posed a risk of developing hypertension for slow caffeine metabolizers (about 59% of the population). In fast metabolizers, the opposite was true: coffee consumption decreased the risk of developing hypertension.

In other words, your genetics determine how caffeine influences your blood pressure. If your blood pressure rises every time you drink coffee, you could be a slow metabolizer, so cutting back is a justified measure.

Caffeine and heart medications

Caffeine has the potential of altering the effect of some heart medications. If you are prescribed beta-blockers, certain antiarrhythmics, or blood-thinners, consult your doctor about whether or how caffeine may be an issue. This is particularly important for individuals recovering from cardiac surgery or a heart attack.

Caffeine and heart health during pregnancy

Caffeine is able to cross the placenta during pregnancy, so the coffee intake of pregnant women or those that are trying to get pregnant is recommended to be restricted to 300 mg of caffeine a day. For comparison, an 8-ounce drip coffee has about 80 to 100 mg of caffeine.

Practical Guidelines for Caffeine Consumption in Los Angeles

With respect to existing evidence, here’s a guide to how the literature classifies your caffeine habit, specifically pertaining to the heart.

If you have no diagnosed heart condition: coffee consumption in moderation, i.e., about 1-3 paper filtered coffees, served and consumed in the morning, constitutes a safe and provides, health benefits. So, have one.

If you suffer from high blood pressure: Observe changes of coffee consumption on your blood pressure. If your pressure rises due to a caffeine boost, consider a caffeine decrease or switch to a half-caff coffee. Never substitute your prescribed antihypertensive medications with coffee.

If you have AFib: newer guidelines enable more to be said, but a lot has to do with how individual responses vary. Talk with your Cardiologist about coffee consumption before making changes.

If you have had heart surgery: In the early stages of recovery, blood pressure and heart rate changes from caffeine matter a lot, so follow your surgeon’s recovery procedure closely.

If you consume energy drinks: The high stimulant and sugar content creates stress on the cardiovascular system, and aren’t the same as plain coffee.