Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta‐analysis of observational studies
Abstract
BACKGROUND: Atrial fibrillation (AF) is the most prevalent sustained arrhythmia, and risk factors are well established. Caffeine exposure has been associated with increased risk of AF, but heterogeneous data exist in the literature. OBJECTIVE: To evaluate the association between chronic exposure to caffeine and AF. DESIGN: Systematic review and meta-analysis of observational studies. DATA SOURCES: PubMed, CENTRAL, ISI Web of Knowledge and LILACS to December 2012. Reviews and references of retrieved articles were comprehensively searched. STUDY SELECTION: Two reviewers independently searched for studies and retrieved their characteristics and data estimates. DATA SYNTHESIS: Random-effects meta-analysis was performed, and pooled estimates were expressed as OR and 95% CI. Heterogeneity was assessed with the I(2) test. Subgroup analyses were conducted according to caffeine dose and source (coffee). RESULTS: Seven observational studies evaluating 115 993 individuals were included: six cohorts and one case-control study. Caffeine exposure was not associated with an increased risk of AF (OR 0.92, 95% CI 0.82 to 1.04, I(2)=72%). Pooled results from high-quality studies showed a 13% odds reduction in AF risk with lower heterogeneity (OR 0.87; 95% CI 0.80 to 0.94; I(2)=39%). Low-dose caffeine exposure showed OR 0.85 (95% CI 0.78 to 92, I(2)=0%) without significant differences in other dosage strata. Caffeine exposure based solely on coffee consumption also did not influence AF risk. CONCLUSIONS: Caffeine exposure is not associated with increased AF risk. Low-dose caffeine may have a protective effect.
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In the AF meta-analyses, there was no significant association between caffeine exposure and AF risk in primary or subgroup analyses considering age, sex, race, study quality, caffeine from coffee versus all sources, caffeine dose or duration of follow-up.
“There was no significant association between caffeine exposure and AF risk in primary or subgroup analyses, considering age, sex, race, study quality, caffeine from coffee versus caffeine from all sources, caffeine dose or duration of follow-up.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Caldeira et al., 2013
The Panel notes that habitual caffeine consumption from all sources up to about 1,000 mg/day was not significantly associated with an increased risk of AF in the two meta-analyses.
“The Panel notes that habitual caffeine consumption from all sources up to about 1 000 mg per day was not significantly associated with an increased risk of AF in these two meta-analyses.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Caldeira et al., 2013
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- Authors
- Caldeira, D., Martins, C., Alves, L. B., Pereira, H., Ferreira, J. J., & Costa, J.
- Affiliations
- University of Lisbon (PT)
- Hospital Garcia de Orta (PT)
- Corresponding author
- Caldeira, Daniel
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2013-09-05
- Volume
- 99
- Issue
- 19
- Pages
- 1383-1389
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2148523405
- Cited by
- 109
- References
- 54
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 11 · 2023: 7 · 2022: 9 · 2021: 6 · 2020: 8 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 10 · 2015: 14 · 2014: 9 · 2013: 2
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- caffeine, atrial fibrillation, coffee consumption, caffeine dose, arrhythmia risk factors
- MeSH terms
- Atrial Fibrillation, Caffeine, Coffee, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Risk Factors, Odds Ratio, Risk Assessment
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