Coffee, caffeine and your heart: Q&A With Dr. Arrash Fard

Dr. Arrash Fard is here to answer all our questions about coffee and caffeine consumption, particularly for people with heart conditions like hypertension or heart disease.

Q:In general, there's a lot of conflicting information out there about how coffee affects the heart (some studies say there are protective benefits, others say heavy coffee consumption can even increase your risk of heart health issues). What's your advice for those who either have a condition like heart disease or hypertension, or are at risk for developing one later in life, when it comes to interpreting all the contradictory research out there about coffee and heart health?

A:There is no strong evidence that coffee consumption has deleterious effects on heart health when consumed in modest amounts. To go further, medical literature does not support concerns of modest coffee intake on cardiac outcomes such as death or stroke. It is generally accepted as safe for most healthy adults to consume less than 400 mg of caffeine daily. It is generally not recommended for people to discontinue coffee or caffeine intake to try improving cardiovascular outcomes.

Q:A new study published in The American Journal of Clinical Nutrition explored how the genetics of our heart health affect our coffee habits, and the results suggest that many of us tend to naturally regulate our coffee consumption based on blood pressure levels and heart rate, even if we're not consciously or intentionally doing so. What are your thoughts about this idea of our heart health guiding our dietary choices on a subconscious level? Is there something to be said here about the importance of a personalized approach and listening to your body's unique cues?

A:I believe this concept can apply to many aspects of medicine. Some people are more sensitive to caffeine and consumption in these people can result in headache, tremors, anxiety, palpitations. Often when people feel these they tend to gravitate away from caffeine or cut back their intake. This is a frequent finding I see in my practice and one I encourage especially if people are complaining of these symptoms. We often have them try to abstain from caffeine temporarily or cut back to see if the symptoms improve.

Q:Coffee aside, what should people with chronic heart-related conditions/people who are at risk of these conditions know about general caffeine use? Are there more risks/benefits associated with different forms of caffeine (energy drinks, caffeinated tea, even caffeine pills)?

A:Coffee and caffeine intake have been shown to have some health benefits including possibly lowering the risk for conditions such as Parkinson disease, Alzheimer dementia, gout, alcoholic cirrhosis of the liver as well as a decreased risk of type II diabetes. There have been some studies linking caffeine use to increased and decreased risk of certain cancers however definitive evidence of this is lacking. However, I generally advise my cardiac patients, especially those with history of arrhythmias or coronary artery disease, to avoid heavily caffeinated beverages (such as energy drinks) as there is some evidence that this heavy consumption can trigger cardiac events.

Q:Generally speaking, what's your advice regarding caffeine consumption (coffee or otherwise) for those who are mindful of their heart health because of a chronic condition/risk of developing a chronic condition? What are some ways that we can make our caffeine habits a little more heart-friendly?

A:I generally tell my patients to consume caffeine in moderation as this could be a “sweet spot” in getting the overall health and cognitive benefits of the drug without the increased risk of cardiac events. Generally avoiding energy drinks and very strong caffeinated beverages is a good idea especially if you have an underlying heart condition.

About Dr. Fard:

Inspired by his mother’s long career as a cardiology nurse, Dr. Arrash Fard knew he wanted to be a cardiologist from the time he was a young man. Before becoming a physician, he had several other hospital jobs.

After graduation from Sydney Medical School at the University of Sydney in Australia, Dr. Fard completed his residency in internal medicine and fellowship in cardiovascular disease at the Albert Einstein College of Medicine/Montefiore Medical Center in the Bronx, New York. He is certified by the American Board of Internal Medicine, the Certification Board of Nuclear Cardiology, and the National Board of Echocardiography.

Living and working all over the U.S. and in Australia has given Dr. Fard a unique perspective that helps him to relate to his patients, no matter their background. His goal is to help them fully understand their disease and diagnosis so they can achieve the best possible outcome from their treatment.