Caffeine and cardiovascular disease risk factors

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The majority of prospective cohort studies looking at coffee/caffeine consumption did not find any adverse effect of coffee/caffeine consumption on cardiovascular function. There was no association between caffeine consumption and arrhythmias29, atrial fibrillation30 and cardiac variability31 showing that there is no need to abstain from caffeine in those populations. In the case of heart failure and coronary heart disease, studies have focused on coffee and hence constituents of coffee other than caffeine might be involved in the positive effects observed on these pathologies. Moderate coffee consumption is inversely associated with risk of heart failure, with the largest inverse association observed for consumption of 4 cups per day32. Likewise coffee consumption does not increase the long-term risk of coronary heart disease and seems even to lower it in women33.

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Caffeine and Blood pressure

Caffeine has a slight, transient hypertensive effect. At low doses, it would be comparable to the transient increase experienced during a conversation. A meta-analysis of 16 studies reported that the ingestion of caffeine leads to transient increases in blood pressure that reach a mean value of 4.16 mmHg (2.13–6.20) for systolic blood pressure and 2.41 mmHg (0.98–3.84) for diastolic blood pressure. On the other hand, coffee consumption leads to rather moderate, non significant increases in blood pressure [systolic: 1.22 mmHg (0.52–1.92) and diastolic: 0.49 mmHg (0.06–1.04)]. There is no effect of caffeine on heart rate34.

The difference between the effects of coffee and caffeine on blood pressure reflect the presence of other constituents in coffee that mitigate the effects of caffeine. The risk of hypertension associated with caffeine intake might vary according to the P450-1A2 genotype with slow metabolisers being more at risk of developing hypertension35. In general, coffee consumption is not associated with an increased risk of hypertension36.

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Caffeine and Cholesterol

Caffeine is not linked to increased levels of cholesterol. A recent survey of individuals taking caffeine- containing drugs found no association between caffeine concentrations and total cholesterol and low density lipoproteins (LDL) levels in any group of the study37. The situation is somewhat different for coffee. A meta-analysis reported that trials using filtered coffee demonstrate virtually no effect on serum cholesterol. Consumption of unfiltered coffee increases serum total and LDL-cholesterol levels38 due to other componentsin coffee. These effects on cholesterol levels are transient and are reduced after the cessation of consumption of unfiltered coffee.

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Caffeine and Homocysteine

There is some evidence that high intakes of coffee may increase blood homocysteine levels. Caffeine also increases homocysteine but five times less than coffee39. However, it is still unclear whether reducing homocysteine levels leads to a reduced risk of cardiovascular disease and no causal relationship between high homocysteine levels and cardiovascular disease has been established.

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