Some people cannot even start their day until they have at least had one cup of coffee and, based on findings from a recent study, that's fine - even for patients with heart disease.
"There was a concern that coffee might be harmful for people with heart disease," said Dr. Donald Nardone, innovational cardiologist with Susquehanna Health. "This probably reassures people that moderate amount of coffees are safe for people with congestive heart failure. By drinking a couple cups of coffee a day, you're not placing yourself at any risk of developing heart failure."
The study, called Habitual Coffee Consumption and Risk of Heart Failure, came out earlier this summer. Researchers reviewed five studies of coffee consumption and heart failure risk published between 2001 and 2011, which combined, studied 6,522 heart failure events among 140,220 men and women. Four of the studies were conducted in Sweden and one in Finland.
"A lot of the studies up to this point have shown different things for congestive heart failure," Nardone said. "We thought it was not good for people who had heart disease or at a risk. Caffeine can raise blood pressure. Most people who drink coffee regularly develop a tolerance to caffeine. The effect on raising blood pressure is not a problem over time."
While he would not call the study a definitive one, he said that along with more recent evidence, it does seem to suggest that coffee is safe for people with heart failure.
He is not at the point of recommending the coffee for people until more controlled studies are done.
The study explains that moderate consumption is equal to four northern European services per day, which actually equates to about two typical 8-ounce American services.
Excessive coffee consumption is 10 northern European servings per day, or four or five coffees from popular American coffee restaurant chains, where serving sizes vary from 9 to 20 fluid ounces per serving.
"Moderate cups of coffee, two, three, four, are safe for people with heart problems," Nardone said. "It doesn't increase the risk for heart failure. That's all you can take from (the study). I'm not recommending coffee as a treatment for heart disease. Moderate consumption does not appear to be harmful."
Researchers also did not take into account for brew strength, which typically is weaker in the United States than in Europe.
Caffeinated and decaffeinated also is not differentiated, but most of the coffee consumed in Sweden and Finland is caffeinated.
If a person normally drinks three to four cups of coffee a day and then goes to the hospital for heart failure, the person would not be made to completely stop drinking coffee. In the past, hospitals would make patients stop drinking it completely.
"Now we know that's initially not a good thing," Nardone said. "They go through withdrawal if they usually drink three or four cups and then go cold turkey."
Instead, the hospital generally allows patients to drink a couple of regular coffees a day so they do not go through withdrawal.
"We can reassure patients that have heart conditions or risk factors and drinking moderate amounts of coffee does not appear to be harmful for them."
For decades, people have debated whether coffee is good or bad, partly because people love coffee, he said.
"It's an important part of people's daily routine," Nardone said. "People are worried about heart disease. They enjoy their coffee. They want to make sure it's not bad for them."
What is safe to eat and drink after a heart attack is not always clear.
Nardone gave the example that there is caffeine in soda, but that it does not seem to have the same protective benefit as it does from coffee.
"No one knows why that is," he said. "It doesn't mean soda is bad for you and coffee is good for you. It's an interesting observation. ... There's still a lot we don't know."