Gordon Fox • July 31, 2022
Can HCM Patients Use Alcohol, Chocolate, & Coffee?
Bitter, dark chocolate has a protective effect!

We hear many different claims about what HCM patients (or heart patients in general) should or shouldn’t eat and drink. This is a big topic, and for much of it, the science doesn’t have simple answers – at least not yet. But it turns out that there are some answers for three things that many people like (and many people won’t touch): wine, chocolate, and coffee.

Dr. Thomas Lüscher is a highly respected cardiologist in London and Zurich. He was editor of the European Heart Journal for over 10 years. He and his coworkers reviewed this topic ( Lüscher 2021 ) by reading over 3200 published research papers on the effects of wine, chocolate, and coffee on the heart. Their conclusions are for hearts in general and not specific to HCM, but their conclusions are sound and apply to HCM hearts as well.

Alcohol

It’s well known that alcohol isn’t good for hearts. It tends to increase blood pressure. It makes palpitations more likely. It promotes weight gain. And so on. A few years ago, an influential study  ( Leong et al. 2014 ) seemed to show that up to 4 or 5 drinks per week had a small protective effect in terms of stroke and heart attack. More careful studies ( Millwood et al. 2019 ) that controlled for genetic factors concluded that there is no protective effect.  Lüscher’s conclusion: “wine is truly a joy, but at best neutral when consumed in moderation.”

Chocolate

Research shows that dark, bitter chocolate does have a protective effect on the cardiovascular system. Importantly, other chocolates – especially milk chocolate – don’t have that effect. And milk chocolate comes with plenty of fat and sugar.  Lüscher’s conclusion: “Chocolate is a joy for our CV system, if consumed in dark, bitter form.”

Coffee

Coffee contains stimulants, so we sometimes hear people insist that it must be avoided by heart patients. The research doesn’t support this in general. People who drink coffee regularly have a much smaller response to the stimulant. Those who drink 4 cups per day or fewer have a reduced risk of heart failure. Coffee also has a protective effect against Type II diabetes and against mortality from many causes (other than cancer).  Lüscher’s conclusion: “It wakes us up, less so if you drink it regularly, and at that dose of up to 4 cups a day, might even be protective.”

Parting advice

Of course, if your doctor recommends avoiding coffee or dark, bitter chocolate, you should. If you don’t like them (or don’t like the way you react to them), by all means, avoid them! But there is no evidence that heart patients generally should avoid them, and they may even be good for you. That glass of wine?  There isn’t any evidence that it’s protective, and we know that alcohol can cause us problems. It’s your choice, but if you do have some, don’t have much!

Literature cited

Leong, D. P., A. Smyth, K. K. Teo, M. McKee, S. Rangarajan, P. Pais, L. Liu, S. S. Anand, and S. Yusuf. 2014. Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study. Circulation 130: 390–398.

Lüscher, T. F. 2001. Wine, chocolate, and coffee: forbidden joys? European Heart Journal 42: 4520-4522.

Millwood, I. Y., R. G. Walters, X. W. Mei, Y. Guo, L. Yang, Z. Bian, D. A. Bennett, Y. Chen, C. . Dong, R. Hu, G. Zhou, B. Yu, W. Jia, S. Parish, R. Clarke, G. Davey Smith, R. Collins, M. V. Holmes, L. Li, R. Peto, and Z. Chen. 2019. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500000 men and women in China. Lancet 393: 1831–1842.

HCMA Blog

By Lisa Salberg July 3, 2025
Summer, greetings to all our big-hearted friends As July approaches, our focus is already on the fall and preparing for some major events, including our annual meeting coming up in October. July will also find us on the west coast in Seattle conducting a regional patient education meeting as part of our big-hearted warrior tour. We have been following the generic drug quality issue in the United States very closely and encourage you to watch the series starting with our Hill briefing in April and following with the additional webinars with our partners at Medshadow and the People's Pharmacy, and of course the ProPublica series of articles. See them all here . We are happy to have a new team member on board - we welcome Pam as our coordinator of both our All Hearts Collaborative and Hearts and Minds project. Over the next few months, you're going to be learning more about these two amazing initiatives and how we are working to provide better services for big hearts regardless of where you live, so we are meeting all of our big-hearted friends where they are. Please stay tuned for updates from these projects coming soon. We are also creating new volunteer opportunities and engagements that we hope will make it easier for you to participate in spreading the message of the importance of diagnosis, the importance of community readiness related to CPR and AED use and, of course, helping patients get to their ultimate diagnosis and getting them on the proper treatment pathways. This July I would like to recognize all of the special birthdays in my family, including HCMA Center of Excellence coordinator, Stacey Titus-brown and my daughter Rebecca Salberg. It's a milestone birthday for Becca - it’s hard to believe I have a 30-year-old child. Wishing you all a happy and healthy summer. Go build some memories!
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