Effects of Coffee on Ambulatory Blood Pressure in Older Men and Women

Abstract

Abstract-This study assessed the effects of regular coffee drinking on 24-hour ambulatory blood pressure (ABP) in normotensive and hypertensive older men and women. Twenty-two normotensive and 26 hypertensive, nonsmoking men and women, with a mean age of 72.1 years (range, 54 to 89 years), took part in the study. After 2 weeks of a caffeine-free diet, subjects were randomized to continue with the caffeine-free diet and abstain from caffeine-containing drinks or drink instant coffee (5 cups per day, equivalent to 300 mg caffeine per day) in addition to the caffeine-free diet for a further 2 weeks. Change in systolic and diastolic blood pressures (SBP, DBP) determined by 24-hour ambulatory BP monitoring showed significant interactions between coffee drinking and hypertension status. In the hypertensive group, rise in mean 24-hour SBP was greater by 4.8 (SEM, 1.3) mm Hg (Pϭ0.031) and increase in mean 24-hour DBP was higher by 3.0 (1.0) mm Hg (Pϭ0.010) in coffee drinkers than in abstainers. There were no significant differences between abstainers and coffee drinkers in the normotensive group for 24-hour, daytime, or nighttime SBP or DBP. In older men and women with treated or untreated hypertension, ABP increased in coffee drinkers and decreased in abstainers. Restriction of coffee intake may be beneficial in older hypertensive individuals. (Hypertension. 1999;33:869-873.)Key Words: coffee Ⅲ blood pressure, ambulatory Ⅲ aged Ⅲ controlled trial E levated blood pressure (BP) is a risk factor for the development of cardiovascular disease and may be exacerbated by regular consumption of coffee. Some crosssectional 1 and randomized, controlled studies 2,3 suggest an association between coffee drinking and increased BP, possibly due to caffeine. 4,5 After abstinence from coffee 6 or caffeine 7 for at least 12 hours, acute ingestion of caffeine increases BP and decreases heart rate (HR). With continued coffee or caffeine intake, tolerance develops, usually within 2 to 3 days, even in former caffeine nonusers. 8 Although no significant association between long-term caffeine or coffee intake and BP was found in some controlled trials in young and middle-aged 9,10 normotensive 11 and untreated hypertensive individuals, 12 other studies have reported short-and long-term pressor effects. [13][14][15] In a study that used ambulatory BP monitoring (ABPM), young mildly hypertensive men who were regular coffee drinkers had 2 to 3 mm Hg higher daytime systolic ambulatory BP (ABP) than nondrinkers. 16 However, there have been few studies in older men and women, 17 whose cardiovascular system is more likely to have an impaired ability to buffer pressor stimuli. One controlled study showed that chronic caffeine ingestion by elderly subjects had no significant effect on clinic or 24-hour BP levels, irrespective of BP status. 17 The present study aimed to assess, in a controlled 2-week intervention, the effects of regular coffee drinking on ABP in normotensive or hypertensive, nonsmoking older men and women, with careful control of dieta...

Coffee, caffeine and blood pressure: a critical review

“…Coffee, caffeine and blood pressure M-L Nurminen et al Rakic et al (1999) 26 54 ± 89 Instant coffee 5 cups 2 weeks Mean 24 h SBP and DBP was 4.8 and 3.0 Caffeine-free diet 2 weeks mmHg higher in coffee drinkers than in abstainers SBP, systolic blood pressure; DBP, diastolic blood pressure.…”

“…The effects of repeated caffeine intake have also been studied in controlled studies using continuous ambulatory monitoring to measure blood pressure (Table 4). Some of the long-term studies have shown that caffeine induced persistent pressor effects (by 3 ± 6 mmHg) in habitual consumers (Ammon et al, 1983;Burr et al, 1989;James, 1994;Rakic et al, 1999). Changing from caffeinated to decaffeinated coffee (van Dusseldorp et al, 1989;Superko et al, 1994) or abstinence from coffee (Bak & Grobbee, 1990;Superko et al, 1994) resulted in a slight fall (by 2 ± 5 mmHg) in blood pressure.…”

“…Daytime ambulatory blood pressure has generally been higher on caffeine days than on caffeine-free days (Jeong & Dimsdale 1990;James 1994;Superko et al, 1994;Green & Suls, 1996;Lane et al, 1998;Rakic et al, 1999), whereas some studies which reported ambulatory blood pressure recordings as 24 h means have failed to detect this pressor effect (MacDonald et al, 1991;Eggertsen et al, 1993) (Table 4).…”

“…Most of the long-term studies were of normotensive subjects, and there is relatively little information on the long-term effects of caffeine in hypertensive patients (Robertson et al, 1984;MacDonald et al, 1991;Eggertsen et al, 1993;Rakic et al, 1999).…”

Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients

“…Caffeine and risk of hypertension is another unresolved issue; whereas coffee or caffeine acutely increases blood pressure (Robertson et al, 1978;Pincomb et al, 1996;Hartley et al, 2000;Corti et al, 2002), the chronic effect of coffee consumption on blood pressure is less well known. Despite the fact that tolerance may ensue in some subjects (Robertson et al, 1981;Lovallo et al, 2004), there are data that coffee consumption is associated with chronic increases in blood pressure (Jee et al, 1999;Rakic et al, 1999;Klag et al, 2002;Noordzij et al, 2005;Savoca et al, 2005).…”