Should We Prescribe Coffee After Heart Attack?

Should We Prescribe Coffee After Heart Attack?

After a heart attack, people who drink coffee have a risk of death from cardiovascular disease and coronary heart disease decreased by 20 to 30%.

Coffee would act as a natural anti-inflammatory which allows it to help fight against many chronic diseases, for example diabetes or cardiovascular diseases, having as a common point inflammation.

What studies say

Large-scale studies have already shown that coffee consumption reduces the risk of cardiovascular disease and all-cause mortality. In a study published in the American Journal of Clinical Nutrition, researchers looked at the impact of coffee consumption in patients with myocardial infarction. They show that drinking coffee – normal or decaffeinated – could significantly reduce mortality from cardiovascular disease or coronary heart disease.

In this study, researchers collected data from 4365 participants aged 60 to 80 years who had a myocardial infarction about 4 years before the start of the study.Their coffee consumption was assessed through a questionnaire and the causes of death were recorded in the years that followed.

It turns out that participants drank almost all coffee, averaging 3 cups (375 mL) a day. Those who consumed between 2 and 4 cups a day had a risk of mortality from cardiovascular disease decreased by 31% compared to those who drank less than 2. Drinking more than 4 cups a day did not significantly change this result. Similar results for coronary heart disease mortality with a decreased risk of 23% and 32% respectively for those who consumed 2 to 4 coffees a day and those who drank more than 4 coffees (compared to those who consumed less than 2 coffees) .

Finally, those who ingested more than 4 cups of coffee a day had a risk of all-cause mortality decreased by 18% compared to those who drank less than 2 cups.

This is an observational study that does not support a causal link.

The results do not reveal differences between normal coffee and decaffeinated coffee: if the link is established between coffee and cardiovascular mortality, caffeine would not be involved. ” Apart from caffeine, coffee is rich in chlorogenic acid and other polyphenols that could improve vascular function and insulin sensitivity, ” write the authors. According to the results of this study, the optimal amount of coffee to consume per day is 500 mL.

An effect attributed to chlorogenic acids

A study published in the European Journal of Nutrition suggests that the effect of coffee on the risk of cardiovascular disease would depend on the amount of two types of compounds: chlorogenic acids (CGA) and hydroxyhydroquinone (HHQ).

Chlorogenic acids are the antioxidants present in greater quantities in coffee. The roasting of coffee leads to a decrease in these chlorogenic acids and to a production of hydroxyhydroquinone.

Studies to date have sometimes led to conflicting results regarding the effect of coffee on endothelial function and cardiovascular risk. Endothelial dysfunction is often a precursor to cardiovascular disease. For the authors of this study, the different results obtained in the studies could be explained by varying levels of these two compounds.

The study included 37 participants either at the borderline of hypertension or at an early stage of hypertension. Participants received different drinks containing all the same amount of caffeine but different levels of chlorogenic acids and hydroxyhydroquinone: drink A (high level of CGA and low level of HHQ), drink B (high level of both compounds) and drink C (none of the compounds). Their results show that only beverage A that contains high levels of chlorogenic acids and low levels of hydroxyhydroquinone has a beneficial effect on endothelial function.

Previous studies have shown that chlorogenic acids lower blood pressure and can improve endothelial function. Whereas on the contrary, hydroxyhydroquinone inhibits the beneficial effects of chlorogenic acids on endothelial function and increases the production of reactive oxygen species at the origin of oxidative stress.

In practice

To benefit from the potentially beneficial effects of coffee on the cardiovascular system, one should consume about 50 cl (2 mugs) of coffee or decaffeinated coffee. However, there are contraindications and side effects, so it is best to take the advice of the doctor if you have a history of heart disease.

 

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