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Sivalokanathan S, Małek ŁA, Malhotra A. The Cardiac Effects of Performance-Enhancing Medications: Caffeine vs. Anabolic Androgenic Steroids. Diagnostics (Basel) 2021; 11:diagnostics11020324. [PMID: 33671206 PMCID: PMC7922604 DOI: 10.3390/diagnostics11020324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 12/19/2022] Open
Abstract
Several performance-enhancing or ergogenic drugs have been linked to both significant adverse cardiovascular effects and increased cardiovascular risk. Even with increased scrutiny on the governance of performance-enhancing drugs (PEDs) in professional sport and heightened awareness of the associated cardiovascular risk, there are some who are prepared to risk their use to gain competitive advantage. Caffeine is the most commonly consumed drug in the world and its ergogenic properties have been reported for decades. Thus, the removal of caffeine from the World Anti-Doping Agency (WADA) list of banned substances, in 2004, has naturally led to an exponential rise in its use amongst athletes. The response to caffeine is complex and influenced by both genetic and environmental factors. Whilst the evidence may be equivocal, the ability of an athlete to train longer or at a greater power output cannot be overlooked. Furthermore, its impact on the myocardium remains unanswered. In contrast, anabolic androgenic steroids are recognised PEDs that improve athletic performance, increase muscle growth and suppress fatigue. Their use, however, comes at a cost, afflicting the individual with several side effects, including those that are detrimental to the cardiovascular system. This review addresses the effects of the two commonest PEDs, one legal, the other prohibited, and their respective effects on the heart, as well as the challenge in defining its long-term implications.
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Affiliation(s)
- Sanjay Sivalokanathan
- Cardiovascular Clinical Academic Group, St. George’s University of London and St. George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK;
| | - Łukasz A. Małek
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Aneil Malhotra
- Cardiovascular Clinical Academic Group, St. George’s University of London and St. George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK;
- Division of Cardiovascular Sciences, University of Manchester and Manchester University NHS Foundation Trust, Manchester Institute of Health and Performance, Manchester M11 3BS, UK
- Correspondence:
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Wingerter R, Steiger N, Burrows A, Estes NAM. Impact of Lifestyle Modification on Atrial Fibrillation. Am J Cardiol 2020; 125:289-297. [PMID: 31761147 DOI: 10.1016/j.amjcard.2019.10.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/15/2022]
Abstract
Atrial Fibrillation (AF) is the most common arrhythmia in adults, and the rapid increase in AF prevalence has been classified by experts as an epidemic. The mechanisms of AF are complex and incompletely understood. While many aspects of management are now based on high quality evidence, other clinical decisions are based on experience and judgment. This article provides an up to date review relating to lifestyle modification and its effect on AF to inform clinical treatment. This comprehensive review used PubMed and Google Scholar to perform keyword searches of articles published between 1998 and the present, with the exception of the 1978 "Holiday Heart" article. Robust data has emerged identifying multiple risk factors for development of AF, including age, sex, hypertension, diabetes mellitus, obesity, alcohol consumption, exercise, and obstructive sleep apnea. Recent evidence indicates that lifestyle modification has a significant role in mitigating the risk and burden of AF. In conclusion, based on the available evidence, an interdisciplinary approach to lifestyle modification will likely reduce risk and/or symptom burden of AF.
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Affiliation(s)
- Rebecca Wingerter
- College of Medicine at University of Central Florida, Orlando, Florida
| | | | | | - N A Mark Estes
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Hejazi MM, Bacha AO, Kaleemuddin M, Al-Abassi FA, Al-Alsieni AI, Kazmi I, Anwar F. Alteration of serum immunoglobins, C-reactive protein, vitamin D, and electrolyte by atenolol and amlodipine in stress-induced hypertensive rats. Mol Cell Biochem 2017; 445:99-103. [PMID: 29248973 DOI: 10.1007/s11010-017-3255-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/10/2017] [Indexed: 02/07/2023]
Abstract
The present study is designed for the assessment of various pathological changes like immunoglobins, C-reactive protein, vitamin D, sodium, potassium, calcium in stress-induced hypertensive rats. Albino Wistar rats of sex male were grouped into six. Each group consists of six animals. Groups were Group I (normal control), Group II (disease control), Group III (amlodipine control), Group IV (atenolol control), Group V (amlodipine treatment), and Group VI (atenolol treatment). Group II, V, and VI animals exposed to regular stress by placing them in cages individually and giving foot electric shocks (1 mA, 50 ms duration with 0.5-1 min of intervals regulated randomly by a computer) along with forced swimming (30 min) in order to induce hypertension in rats. This stress was given two times daily (morning and evening) for regular 15 days. Induction of hypertension was confirmed by measuring the tail arterial pressure of blood and angiotensin II. For next 1 month, Group III and V animals are treated with amlodipine with 1 mg/kg, s.c. dose while Group IV and VI animals were given 10 mg/kg, s.c. the dose of atenolol once daily. At the end of the experimental work, blood collected, rats sacrificed, and serum separated. Serum sodium, potassium, immunoglobins, C-reactive protein, vitamin D, and calcium were measured by semi-auto-analyzer. Stress-induced hypertension in rats produced altered serum sodium, potassium, immunoglobins, C-reactive protein, vitamin D, and calcium level which is restored by atenolol. Administration of amlodipine in animals without hypertension shows alteration in the level of immunoglobins, calcium, vitamin D, and electrolytes.
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Affiliation(s)
- Moayad Mustafa Hejazi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ala Osman Bacha
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Kaleemuddin
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad A Al-Abassi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulbasit I Al-Alsieni
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia. .,Glocal School of Pharmacy, Glocal University, Sahranpur, Uttar Pradesh, 247121, India.
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
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Hung CL, Lai YJ, Chi PC, Chen LC, Tseng YM, Kuo JY, Lin CI, Chen YC, Lin SJ, Yeh HI. Dose-related ethanol intake, Cx43 and Nav1.5 remodeling: Exploring insights of altered ventricular conduction and QRS fragmentation in excessive alcohol users. J Mol Cell Cardiol 2017; 114:150-160. [PMID: 29097069 DOI: 10.1016/j.yjmcc.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/05/2017] [Accepted: 10/27/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Chronic, excessive ethanol intake has been linked with various electrical instabilities, conduction disturbances, and even sudden cardiac death, but the underlying cause for the latter is insufficiently delineated. METHODS We studied surface electrocardiography (ECG) in a community-dwelling cohort with moderate-to-heavy daily alcohol intake (grouped as >90g/day, ≤90g/day, and nonintake). RESULTS Compared with nonintake, heavier alcohol users showed markedly widened QRS duration and higher prevalence of QRS fragmentation (64.3%, 50.9%, and 33.7%, respectively, χ2 12.0, both p<0.05) on surface ECG across the 3 groups. These findings were successfully recapitulated in 14-week-old C57BL/6 mice that were chronically given a 4% or 6% alcohol diet and showed dose-related slower action potential upstroke, reduced resting membrane potential, and disorganized or decreased intraventricular conduction (all p<0.05). Immunodetection further revealed increased ventricular collagen I depots with Cx43 downregulation and remodeling, together with clustered and diminished membrane Nav1.5 distribution. Administration of Cx43 blocker (heptanol) and Nav1.5 inhibitor (tetrodotoxin) in the mice each attenuated the suppression ventricular conduction compared with nonintake mice (p<0.05). CONCLUSIONS Chronic excessive alcohol ingestion is associated with dose-related phenotypic intraventricular conduction disturbances and QRS fragmentation that can be recapitulated in mice. The mechanisms may involve suppressed gap junction and sodium channel functions, together with enhanced cardiac fibrosis that may contribute to arrhythmogenesis.
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Affiliation(s)
- Chung-Lieh Hung
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Jun Lai
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Ching Chi
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Chia Chen
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - Ya-Ming Tseng
- Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Yuan Kuo
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-I Lin
- Institute of Physiology, National Defense Medical Center, Taipei, Taiwan; Department of Biophysics, National Defense Medical Center, Taipei, Taiwan
| | - Yao-Chang Chen
- Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan
| | - Shing-Jong Lin
- Institute of Clinical Medicine, and, Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hung-I Yeh
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan.
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Mattioli AV, Pennella S, Farinetti A, Manenti A. Energy Drinks and atrial fibrillation in young adults. Clin Nutr 2017; 37:1073-1074. [PMID: 28527645 DOI: 10.1016/j.clnu.2017.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/24/2017] [Accepted: 05/01/2017] [Indexed: 11/25/2022]
Abstract
The present paper evaluates the association between Energy Drinks (EDs) and occurrence of atrial fibrillation (AF) in young people. Data from three clinical cases of AF after EDs consumption are reported. All patients presented with palpitations, nausea and anxiety. ECG showed AF with high ventricular response (135-170 bpm range frequency). Anamnestic record reported a high consumption of EDs during the previous 8 h from the onset of AF. In one case ED was associated with a moderate quantity of alcohol. Patients were successfully cardioverted both spontaneously and after pharmacological treatment. After cardioversion: the ECG and echocardiogram appeared normal in all patients; the toxicological tests and the laboratory analyses resulted negative. Our experience suggests that larger consumption of EDs, especially when combined with alcoholic beverages, could act as a trigger in the development of AF in young patients. This action may be caused by the synergic effect of caffeine and other substances present in EDs. Following the increasing consumption of EDs in young people, we suggest a careful attention to cardiac complications.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
| | - Sonia Pennella
- Istituto Nazionale per le ricerche cardiovascolari, U.O. University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Farinetti
- Section of Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Manenti
- Section of Surgery, University of Modena and Reggio Emilia, Modena, Italy
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Abstract
We present a case of atrial fibrillation with rapid ventricular response in a 28-year-old previously healthy man in the context of daily consumption of 2 Monster energy drinks and 2 to 3 beers. We have obtained consent from this patient to present his case. Our observation adds to the developing literature describing an association between highly caffeinated drinks and adverse cardiovascular events. The previous cases in the literature and the proposed underlying mechanisms of this association are briefly discussed in this article. With the rising popularity of energy drinks, clinicians should be aware of their arrhythmogenic potential and consider screening for these products in patients who present with otherwise unexplained arrhythmias.
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7
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Chrysant SG. The impact of coffee consumption on blood pressure, cardiovascular disease and diabetes mellitus. Expert Rev Cardiovasc Ther 2017; 15:151-156. [PMID: 28128673 DOI: 10.1080/14779072.2017.1287563] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Coffee is the most widely consumed beverage, next to water. However, there has been a long-standing controversy regarding its safety on blood pressure (BP) and cardiovascular disease (CVD) and intuitively, physicians dissuaded their patients from coffee drinking. Areas covered: This controversy was, primarily, based on older prospective studies or case reports, which showed a positive association of coffee drinking with the incidence of hypertension and CVD. In contrast to these reports, recent, well controlled, studies have demonstrated either a neutral or beneficial effect of moderate coffee consumption (3-4 cups/day), on BP, CVD, heart failure (HF), cardiac arrhythmias, or diabetes mellitus (DM). For the preparation of this special report, an English language focused search of the Medline database was conducted between 2010 and 2016 on studies with data on effect on the coffee consumption in patients with high BP, CVD, HF, cardiac arrhythmias or DM. Of the 94 abstracts reviewed, 34 pertinent papers were selected, and the findings from these papers together with collateral literature will be discussed in this special report. Expert commentary: Based on the evidence from these studies, coffee consumption in moderation, is safe and is beneficial in both healthy persons as well as patients with high BP, CVD, HF, cardiac arrhythmias or DM. Therefore, coffee restriction is not warranted for these patients, although some caution should be exercised.
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Affiliation(s)
- Steven G Chrysant
- a Department of Cardiology , University of Oklahoma College of Medicine , Oklahoma City , OK , USA
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Zulli A, Smith RM, Kubatka P, Novak J, Uehara Y, Loftus H, Qaradakhi T, Pohanka M, Kobyliak N, Zagatina A, Klimas J, Hayes A, La Rocca G, Soucek M, Kruzliak P. Caffeine and cardiovascular diseases: critical review of current research. Eur J Nutr 2016; 55:1331-43. [PMID: 26932503 DOI: 10.1007/s00394-016-1179-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 02/06/2016] [Indexed: 12/21/2022]
Abstract
Caffeine is a most widely consumed physiological stimulant worldwide, which is consumed via natural sources, such as coffee and tea, and now marketed sources such as energy drinks and other dietary supplements. This wide use has led to concerns regarding the safety of caffeine and its proposed beneficial role in alertness, performance and energy expenditure and side effects in the cardiovascular system. The question remains "Which dose is safe?", as the population does not appear to adhere to the strict guidelines listed on caffeine consumption. Studies in humans and animal models yield controversial results, which can be explained by population, type and dose of caffeine and low statistical power. This review will focus on comprehensive and critical review of the current literature and provide an avenue for further study.
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Affiliation(s)
- Anthony Zulli
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Renee M Smith
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Jan Novak
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic.,Department of Physiology, Masaryk University, Brno, Czech Republic
| | - Yoshio Uehara
- Division of Clinical Nutrition, Faculty of Home Economics, Kyoritsu Women's University, Tokyo, Japan
| | - Hayley Loftus
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Tawar Qaradakhi
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | | | | | - Jan Klimas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Odborarov 10, 832 32, Bratislava, Slovak Republic
| | - Alan Hayes
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Giampiero La Rocca
- Human Anatomy Section, Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy
| | - Miroslav Soucek
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Peter Kruzliak
- Laboratory of Structural Biology and Proteomics, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho tr 1/1946, Brno, 612 42, Czech Republic.
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Larsson SC, Drca N, Jensen-Urstad M, Wolk A. Coffee consumption is not associated with increased risk of atrial fibrillation: results from two prospective cohorts and a meta-analysis. BMC Med 2015; 13:207. [PMID: 26394673 PMCID: PMC4579587 DOI: 10.1186/s12916-015-0447-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether coffee consumption affects the risk of developing atrial fibrillation (AF) remains unclear. We sought to investigate the association between coffee consumption and incidence of AF in two prospective cohorts, and to summarize available evidence using a meta-analysis. METHODS Our study population comprised 41,881 men in the Cohort of Swedish Men and 34,594 women in the Swedish Mammography Cohort who had provided information on coffee consumption in 1997 and were followed up for 12 years. Incident cases of AF were ascertained by linkage with the Swedish Hospital Discharge Register. For the meta-analysis, prospective studies were identified by searching PubMed and Embase through 22 July 2015, and by reviewing the reference lists of retrieved articles. Study-specific relative risks were combined using a random effects model. RESULTS We ascertained 4,311 and 2,730 incident AF cases in men and women, respectively, in the two cohorts. Coffee consumption was not associated with AF incidence in these cohort studies. The lack of association was confirmed in a meta-analysis, including six cohort studies with a total of 10,406 cases of AF diagnosed among 248,910 individuals. The overall relative risk (95% confidence interval) of AF was 0.96 (0.84-1.08) for the highest versus lowest category of coffee consumption, and 0.99 (0.94-1.03) per 2 cups/day increment of coffee consumption. CONCLUSIONS We found no evidence that coffee consumption is associated with increased risk of AF.
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Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Nikola Drca
- Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mats Jensen-Urstad
- Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Molnar J, Somberg JC. A Rapid Method to Evaluate Cardiac Repolarization Changes: The Effect of Two Coffee Strengths on the QT Interval. Cardiology 2015; 131:203-8. [DOI: 10.1159/000381177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 02/19/2015] [Indexed: 11/19/2022]
Abstract
Objectives: To assess the effect of coffee on ventricular repolarization as measured by an electrocardiogram. Methods: Fifty-four healthy volunteers (34 males and 20 females, age 23 ± 5 years) received 1 cup of coffee (caffeine content 120 mg) and 11 participants received 2 cups. Blood pressure and heart rate were measured prior to coffee and every hour thereafter for 5 h. A 12-lead digital Holter recorded continuously, and RR, QT, and QTc intervals were obtained every 30 min. Results: Following coffee, RR increased from 802 ± 102 to 873 ± 126 ms (p = 0.001), QT increased from 359 ± 26 to 367 ± 27 ms at 1.5 h (p = 0.047), and QTc decreased from 387 ± 21 to 381 ± 23 ms at 30 min (p = 0.001), with no changes noted at other time points. Caffeine users and caffeine-naive subjects did not differ in QTc effects (p = 0.971). Females had longer QTc at each time point than males (p = 0.037), but neither had QTc prolongation following coffee. The heart rate decreased from 73 ± 9 to 69 ± 11 bpm at 1 h (p = 0.018), and no significant changes in blood pressure were noted. The effects of 1 or 2 cups of coffee did not differ in terms of QTc (p = 0.663), heart rate (p = 0.161), diastolic (p = 0.250), or systolic blood pressure (p = 0.168). Conclusion: Neither 1 nor 2 cups of coffee increased ventricular repolarization.
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Energy Drink Overconsumption in Adolescents: Implications for Arrhythmias and Other Cardiovascular Events. Can J Cardiol 2015; 31:572-5. [DOI: 10.1016/j.cjca.2014.12.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 01/22/2023] Open
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Abstract
BACKGROUND The present analysis was conducted in response to inconsistent epidemiologic studies on the relation between consumption of tea and cardiovascular diseases. OBJECTIVE We undertook a literature review of the consistency and strength of the associations between tea and cardiovascular diseases on the basis of published observational studies and meta-analyses addressing tea or tea flavonoids and cardiovascular disease risk. DESIGN We performed a search in 3 databases for meta-analyses and compared them with studies they subsumed. We performed an additional search for subsequent studies to determine whether the conclusions were consistent. RESULTS Many epidemiologic studies have been conducted and summarized in 5 meta-analyses on either tea consumption or flavonoid consumption and cardiovascular disease or the subset of stroke. Heterogeneity of effect was seen when the outcome included all cardiovascular diseases. In the case of stroke, a consistent, dose-response association with tea consumption on both incidence and mortality was noted with RRs of 0.80 (95% CI: 0.65, 0.98) for flavonoids and 0.79 (95% CI: 0.73, 0.85) for tea when high and low intakes were compared or the addition of 3 cups/d was estimated. CONCLUSION Thus, the strength of this evidence supports the hypothesis that tea consumption might lower the risk of stroke.
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Affiliation(s)
- Lenore Arab
- David Geffen School of Medicine, University of California, Los Angeles, CA
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14
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Caldeira D, Martins C, Alves LB, Pereira H, Ferreira JJ, Costa J. Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies. Heart 2013; 99:1383-9. [DOI: 10.1136/heartjnl-2013-303950] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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15
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Higgins JP, Babu KM. Caffeine reduces myocardial blood flow during exercise. Am J Med 2013; 126:730.e1-8. [PMID: 23764265 DOI: 10.1016/j.amjmed.2012.12.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 12/25/2022]
Abstract
Caffeine consumption has been receiving increased interest from both the medical and lay press, especially given the increased amounts now available in energy products. Acute ingestion of caffeine usually increases cardiac work; however, caffeine impairs the expected proportional increase in myocardial blood flow to match this increased work of the heart, most notably during exercise. This appears to be mainly due to caffeine's effect on blocking adenosine-induced vasodilatation in the coronary arteries in normal healthy subjects. This review summarizes the available medical literature specifically relating to pure caffeine tablet ingestion and reduced exercise coronary blood flow, and suggests possible mechanisms. Further studies are needed to evaluate this effect for other common caffeine-delivery systems, including coffee, energy beverages, and energy gels, which are often used for exercise performance enhancement, especially in teenagers and young athletes.
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Affiliation(s)
- John P Higgins
- Memorial Hermann Ironman Sports Medicine Institute, The University of Texas Medical School at Houston, Houston, TX 77030-1501, USA.
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Bidel S, Tuomilehto J. The Emerging Health Benefits of Coffee with an Emphasis on Type 2 Diabetes and Cardiovascular Disease. EUROPEAN ENDOCRINOLOGY 2013; 9:99-106. [PMID: 29922362 PMCID: PMC6003581 DOI: 10.17925/ee.2013.09.02.99] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/20/2013] [Indexed: 12/19/2022]
Abstract
Debate persists whether coffee is beneficial or problematic for human health. Coffee consumption has been associated with a decrease in risk of developing type 2 diabetes, and numerous epidemiological studies have demonstrated that healthy, habitual coffee drinkers are more protected from the risk of contracting diabetes than individuals who do not drink coffee. Coffee consumption has been associated with a reduced incidence of impaired glucose tolerance, hyperglycaemia and insulin sensitivity. Data suggest that several coffee components, such as chlorogenic acids, are involved in the health benefits of coffee. Various mechanisms for this protective effect have been proposed, including effects on incretin release, liver glucose metabolism and insulin sensitivity. Epidemiological data support numerous other health benefits for coffee, including reduced cardiovascular disease (CVD), a protective effect against some neurodegenerative conditions, a favourable effect on liver function and a protective effect against certain cancers These associations are based mainly on observational studies and are currently insufficient to recommend coffee consumption as an interventional strategy for risk reduction in type 2 diabetes and other metabolic diseases While excessive consumption can have adverse effects on some conditions, particularly in terms of sleep quality, these effects vary among individuals and most people do not have any symptoms from coffee drinking. Moderate coffee consumption is associated with no or little risk of severe diseases and may offer substantial health benefits. Thus, coffee is a safe, low-energy beverage and suitable for most adult people.
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Affiliation(s)
- Siamak Bidel
- National institute for Health and Welfare and Hjelt institute, University of Helsinki, Finland
| | - Jaakko Tuomilehto
- Centre for Vascular Prevention, Danube-University Krems, Austria; Red RECAVA Grupo, Hospital Universitario La Paz, Madrid, Spain; King Abdulaziz University, Jeddah, Saudi Arabia; Department of Public Health, University of Helsinki, Finland
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Pohanka M, Dobes P. Caffeine inhibits acetylcholinesterase, but not butyrylcholinesterase. Int J Mol Sci 2013; 14:9873-82. [PMID: 23698772 PMCID: PMC3676818 DOI: 10.3390/ijms14059873] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 04/29/2013] [Accepted: 04/30/2013] [Indexed: 11/30/2022] Open
Abstract
Caffeine is an alkaloid with a stimulant effect in the body. It can interfere in transmissions based on acetylcholine, epinephrine, norepinephrine, serotonin, dopamine and glutamate. Clinical studies indicate that it can be involved in the slowing of Alzheimer disease pathology and some other effects. The effects are not well understood. In the present work, we focused on the question whether caffeine can inhibit acetylcholinesterase (AChE) and/or, butyrylcholinesterase (BChE), the two enzymes participating in cholinergic neurotransmission. A standard Ellman test with human AChE and BChE was done for altering concentrations of caffeine. The test was supported by an in silico examination as well. Donepezil and tacrine were used as standards. In compliance with Dixon’s plot, caffeine was proved to be a non-competitive inhibitor of AChE and BChE. However, inhibition of BChE was quite weak, as the inhibition constant, Ki, was 13.9 ± 7.4 mol/L. Inhibition of AChE was more relevant, as Ki was found to be 175 ± 9 μmol/L. The predicted free energy of binding was −6.7 kcal/mol. The proposed binding orientation of caffeine can interact with Trp86, and it can be stabilize by Tyr337 in comparison to the smaller Ala328 in the case of human BChE; thus, it can explain the lower binding affinity of caffeine for BChE with reference to AChE. The biological relevance of the findings is discussed.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, 50001 Hradec Kralove, Czech Republic
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +420-973-253-091
| | - Petr Dobes
- Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Zluty Kopec 7, 65653 Brno, Czech Republic; E-Mail:
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