Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies

Caldeira, Daniel; Martins, Cristina; Alves, Luís Brandão; Pereira, Hélder; Ferreira, Joaquim J.; Costa, João

doi:10.1136/heartjnl-2013-303950

Cited by 81 publications

(52 citation statements)

References 50 publications

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“…We speculated another component of green tea might reduce the effect of EGCG. Green tea contains large quantities of caffeine which is not directly associated with decreased incidence of AF [13, 49- 50]. High frequency-high concentration, or long-term green tea consumption may lead to high cumulative doses of caffeine which might contribute to an incidence of AF [51].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, elevated levels of sympathetic activity have been shown to be detrimental [51, 55]. Thus, while caffeine intake might be associated with increased incidence of AF, data remains inconclusive at this point in time [49]. Persistent AF risk for patients decreased with the increasing frequency, duration and concentration of green tea consumed.…”

Section: Discussionmentioning

confidence: 99%

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Low-dose green tea intake reduces incidence of atrial fibrillation in a Chinese population

et al. 2016

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The aim of the present study was to assessthe association between green tea intake and incidence of atrial fibrillation (AF) in a Chinese population. A total of 801 (mean age: 62 years; 56% male) subjects were enrolled: 401 AF patients and 400 controls. All subjects completed a questionnaire and the associations between their green tea drinking habits and incidence of AF were assessed using the odds ratio (OR) and binary logistic regression. After multivariate adjustment, green tea intake presented as a protective factor against the incidence of AF (OR: 0.349, 95% CI: 0.253-0.483, P < 0.001). The green tea protection showed downward trend with increasing green tea intake (P for the trend= 0.001). Low frequency, low concentration, short-term tea consumption was classified as low-dose green tea intake. Green tea intake decreased the incidence of both paroxysmal AF (OR: 0.307, 95% CI: 0.216-0.436, P < 0.001) and persistent AF (OR: 0.355, 95% CI: 0.261-0.482, P < 0.001) and may be associated with a decreased incidence of AF. This study suggests that low-dose green tea intake strongly protects against AF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low-dose green tea intake reduces incidence of atrial fibrillation in a Chinese population

et al. 2016

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“…Patients are looking for clear guidance with respect to how best to reduce their risk and burden of AF. Emerging evidence related to diet, 80 caffeine, 150 yoga, 151 and acupuncture 129 represent potentially important steps forward in the incorporation of patient-driven prevention research. Social networking may have a significant role in the prevention and treatment of AF, similar to ongoing efforts in obesity and diabetes management.…”

Section: The Need For Innovative Research Structures and Methodsmentioning

confidence: 99%

Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013

et al. 2015

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“…Caffeine continues to be a dietary compound of public health interest. Recent meta-analyses have examined the association of caffeine intake with diseases and conditions such as breast cancer (3) and atrial fibrillation (4), and associations with positive health outcomes have been observed in some cases, such as with Parkinson’s disease (5). Caffeine consumption is generally considered to be safe; however, fatalities due to apparent caffeine intoxication (6), as well as associations of adverse health events with caffeinated “energy” drinks (7) have been reported.…”

Section: Introductionmentioning

confidence: 99%

Urine Excretion of Caffeine and Select Caffeine Metabolites Is Common in the US Population and Associated with Caffeine Intake

Rybak

Sternberg

Pao

et al. 2015

The Journal of Nutrition

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Background Caffeine is a widely consumed psychoactive stimulant and is of epidemiological interest. Major sources of caffeine are challenging to standardize, and the use of biomarkers has been proposed as an alternative means of assessing intake. Objective We described urine caffeine and caffeine metabolite concentrations (n = 2466) and excretion rates (n = 2261) in the U.S. population ≥6 y by age, sex, race-ethnicity and caffeine intake (from foods, beverages and dietary supplements). Methods We measured caffeine and 14 of its metabolites in spot urine samples from the cross- sectional NHANES 2009–2010 by use of liquid chromatography-tandem mass spectrometry. Results Caffeine and its metabolites were detectable in the urine of most persons, generally at concentrations ≥1 μmol/L. Median concentrations (95% CI) ranged from 0.560 (0.497–0.620) μmol/L to 58.6 (48.6–67.2) μmol/L; median excretion rates from 0.423 (0.385–0.468) nmol/min to 46.0 (40.7–50.2) nmol/min. Urine concentrations and excretion rates for 9 analytes (caffeine, theophylline, paraxanthine, 1-methylxanthine, 1-methyluric acid, 1,3-dimethyluric acid, 1,7- dimethyluric acid, 1,3,7-trimethyluric acid, and 5-acetylamino-6-amino-3-methyluracil) had moderate correlations with caffeine intake (Spearman |r| 0.55–0.68, P <0.0001); the remaining analytes had low correlations (|r| 0.15–0.33, P <0.0001). We observed larger differences in geometric mean concentrations and excretion rates between the highest vs. lowest quartiles of caffeine intake for these 9 compounds compared to the rest. Consistent with dietary caffeine intake, we observed that urine concentrations and excretion rates for most compounds were significantly (P <0.05) higher in males vs. females, non-Hispanic whites vs. Hispanics and non- Hispanic blacks, and highest in persons aged 40–59 y. Conclusion Excretion of caffeine and its metabolites in urine was common in the U.S. population. Based on the observed associations between spot urine concentrations or excretion rates with caffeine intake, several of these compounds show promise as potential biomarkers of caffeine intake.

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Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies

Abstract: Caffeine exposure is not associated with increased AF risk. Low-dose caffeine may have a protective effect.

Cited by 81 publications

References 50 publications

Low-dose green tea intake reduces incidence of atrial fibrillation in a Chinese population

Low-dose green tea intake reduces incidence of atrial fibrillation in a Chinese population

Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013

Urine Excretion of Caffeine and Select Caffeine Metabolites Is Common in the US Population and Associated with Caffeine Intake

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