Coffee’s Cardiovascular Impact Is Written in Your Genes, Not Headlines

Conflicting headlines about coffee and heart health have confused patients and clinicians for years. The resolution lies not in the beverage itself, but in individual genetic variation. A single polymorphism in the CYP1A2 gene—the enzyme responsible for metabolizing 95% of ingested caffeine—determines whether coffee poses a cardiac risk. Approximately 45% of people are fast caffeine metabolisers, clearing the compound within 3 hours with no increased myocardial infarction risk, even at high intake. Conversely, 55% carry slow-metabolizer alleles, accumulating caffeine for 6–10 hours. For this majority population, consuming 4 or more cups daily correlates with a 64% increased odds of nonfatal MI. This precision medicine insight transforms coffee from a blanket health concern into a personalized clinical consideration.