Coffee consumption and blood pressure

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Although the precise nature of the relationship between coffee and blood pressure is still unclear, overall the evidence suggests that regular intake of caffeinated coffee does not increase the risk of hypertension.

A 2008 detailed review concluded that data from cross-sectional studies suggest an inverse linear or U-shaped association of habitual coffee use with blood pressure in different populations30. The authors suggested that prospective studies provide evidence of a protective effect of coffee intake (4 or more cups per day) against hypertension, mainly in women. Furthermore, the risk of hypertension may be lower in coffee abstainers. Randomized controlled trials, which are mostly of short duration (1-12 weeks), have shown that coffee intake around 5 cups per day causes a small elevation in blood pressure (1-2mmHg) when compared to abstinence or use of decaffeinated coffee.

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  • A 2011 review of 5 trials concluded that the administration of 200–300mg caffeine produced a mean increase of 8.1mmHg in systolic blood pressure (BP) and of 5.7mmHg in diastolic BP. The increase in BP was observed in the first hour after caffeine intake and lasted for 3 hours. However, in studies over a 2 week period no increase in BP was observed after coffee consumption. The authors concluded that in hypertensive individuals, caffeine intake can produce a short-term acute increase in BP. Current evidence does not support an association between longer-term coffee consumption and increased BP, or between habitual coffee consumption and an increased risk of CVD in hypertensive subjects31.
  • A dose-response meta-analysis of 172,567 participants and 37,135 incident hypertension cases showed an inverse “J-shaped” curve with hypertension risk increasing up to 3 cups per day and decreasing with higher intakes. The results suggest that habitual coffee consumption of >3 cups per day was not associated with an increased risk of hypertension compared with <1 cup per day; however, a slightly elevated risk appeared to be associated with light-to-moderate consumption of 1 to 3 cups per day32.
  • A large prospective study concluded that neither caffeinated coffee nor caffeine intake was associated with mean systolic or diastolic blood pressure, but decaffeinated coffee intake was associated with a small but clinically irrelevant decrease in mean diastolic blood pressure. Intakes of caffeinated coffee, decaffeinated coffee, and caffeine were not associated with the risk of incident hypertension. In summary, these findings suggest that caffeinated coffee, decaffeinated coffee, and caffeine are not risk factors for hypertension in postmenopausal women33.
  • A 2012 study considered the variability in the effect on blood pressure of caffeine intake, suggesting that compared with decaffeinated coffee, caffeinated coffee was associated with a significant increase in blood pressure. The authors suggested that the variability in the acute BP response to coffee may be partly explained by genetic polymorphisms of the adenosine A2A receptors and α2-adrenergic receptors34.

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