COFFEE CONSUMPTION IN THE PRESENCE OF
CV RISK FACTORS
Hypertension
In nonhabitual coffee drinkers, diastolic and systolic BP
rise after coffee consumption.3 This effect on BP does
not seem to be dose-dependent and exhibits large interindividual
differences. In subjects with regular, daily coffee
consumption or habitual coffee drinkers, the effect of
coffee on the BP is smaller or not detectable compared
with nonhabitual coffee drinkers.32 It is not clear whether
resting BP differs between habitual and nonhabitual
coffee drinkers. Age may also contribute to the effects
of coffee consumption. Elderly individuals show pronounced
BP increases after coffee ingestion.32
The pattern of coffee consumption is important. We
have recently shown that in healthy subjects the CV
effects of coffee differ according to drinking habits.33
A rise in BP is not seen in habitual coffee drinkers after
coffee consumption despite significant activation of
sympathetic nerve activity. In nonhabitual coffee drinkers,
intake of coffee is associated with a similar activation
of the sympathetic nervous system and rise in BP.
We also found that decaffeinated coffee increased BP
and sympathetic nervous activity in nonhabitual drinkers—suggesting
that ingredients other than caffeine may
be responsible for the CV effects induced by coffee.33
The short-term risk of hypertensive emergencies was
evaluated in healthy subjects with high coffee consumption.
In a double-blind study, regular coffee intake (eight
cups per day for 4 weeks, corresponding to a daily dose
of 500 mg caffeine) was associated with increased risk
for hypertensive emergencies.34 The analysis of dietary
risk factors for hypertension in a group of 12,000 men
taking part in the Multiple Risk Factor Intervention Trial
(MRFIT)35 showed an inverse relationship between regular
coffee consumption and BP. Due to the pronounced
tendency for tolerance development, the Seventh Report
of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure (JNC
7) recommendations for the treatment of hypertension
do not include intake of coffee or beverages containing
caffeine as a risk factor for hypertension.36