Elsevier

The Lancet

Volume 349, Issue 9047, 25 January 1997, Pages 279-281
The Lancet

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Is habitual caffeine use a preventable cardiovascular risk factor?

https://doi.org/10.1016/S0140-6736(96)04253-5Get rights and content

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Pressor effects of habitual caffeine consumption

Most studies have involved a single caffeine challenge. The few studies with schedules of exposure intended to resemble typical consumption patterns indicate that modest sustained decreases in blood pressure occur when caffeine beverages are either removed from the diet6 or are replaced by decaffeinated alternatives.7 Six studies in which ambulatory monitoring was used to measure blood pressure have shown similar results. Three showed persistent caffeine-induced pressor effects;8, 9, 10 three

Epidemiology of caffeine and blood pressure

Publications on the epidemiology of caffeine and cardiovascular disease include reports of a strong, positive, independent association,15, 16 and reports of no association.17, 18 The results summarised in figure may help to explain some of these inconsistencies. Of 12 epidemiological caffeine studies in which blood pressure was measured, four reported no association,2 four reported a significant positive association,2 and four reported an inverse association19, 20, 21, 22 (although 3 of the

Probable population effects of habitual caffeine consumption

The harm or benefit of changes in population blood pressure depends on the size of the change, duration of exposure to the factor responsible for the change, prevalence of exposure, and incidence of the pathological conditions to which raised blood pressure contributes (eg, coronary heart disease).24 These factors and the evidence summarised above suggest that the widespread use of caffeine probably contributes to population cardiovascular disease. Although the size of the reduction in

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      Although this result could appear to be inconsistent with the known acute effects of caffeine on BP, the absence of an association in the present context is consistent with what is known about the general diurnal pattern of caffeine consumption by adolescents. Whereas adults typically consume caffeine in separate portions throughout the day, with fewer portions consumed later than earlier in the day, followed by evening and overnight abstinence [45,46], adolescents, who have not yet transitioned to typical adult patterns, tend to consume caffeine later in the day, often in conjunction with computer gaming and other evening recreational activities [51,53]. Given an average caffeine elimination half-life of approximately 5 h and the likelihood that our participants consumed more caffeine during the latter part of the day before the laboratory session than during the morning of that day, systemic caffeine was likely to have been low or negligible at time of testing.

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      Caffeine elevated systolic and diastolic blood pressures but did not alter heart rate. Some investigators have hypothesized that caffeine is a vasoconstrictive substance.3–9 In the present study, systolic and diastolic blood pressures were elevated after caffeine ingestion, suggesting vasoconstrictive effects of caffeine.5

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