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Antonio J, Newmire DE, Stout JR, Antonio B, Gibbons M, Lowery LM, Harper J, Willoughby D, Evans C, Anderson D, Goldstein E, Rojas J, Monsalves-Álvarez M, Forbes SC, Gomez Lopez J, Ziegenfuss T, Moulding BD, Candow D, Sagner M, Arent SM. Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2323919. [PMID: 38466174 DOI: 10.1080/15502783.2024.2323919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 03/12/2024] Open
Abstract
Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Daniel E Newmire
- Texas Woman's University, Exercise Physiology and Biochemistry Laboratory, School of Health Promotion and Kinesiology, Denton, TX, USA
| | - Jeffrey R Stout
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | | | - Lonnie M Lowery
- Nutrition, Exercise and Wellness Associates, Cuyahoga Falls, OH, USA
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Joseph Harper
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Darryn Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Dawn Anderson
- Indiana Tech, Exercise and Sport Performance Laboratory, Fort Wayne, IN, USA
| | - Erica Goldstein
- Stetson University, Department of Health Sciences, Deland, FL, USA
| | - Jose Rojas
- Keiser University, Fort Lauderdale, FL, USA
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Matías Monsalves-Álvarez
- Universidad de O´Higgins, Exercise Metabolism and Nutrition Laboratory. Instituto de Ciencias de la Salud, Rancagua, Chile
- Motion Human Performance Laboratory, Lo Barnechea, Chile
| | - Scott C Forbes
- Brandon University, Department of Physical Education Studies, CBrandon, MB, Canada
| | | | - Tim Ziegenfuss
- The Center for Applied Health Sciences, Canfield, OH, USA
| | - Blake D Moulding
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | - Darren Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | | | - Shawn M Arent
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
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Tsirimiagkou C, Basdeki ED, Kyriazopoulou Korovesi AA, Chairistanidou C, Ouamer DS, Argyris A, Sfikakis PP, Karatzi K, Protogerou AD. Habitual consumption of instant coffee is favorably associated with arterial stiffness but not with atheromatosis. Clin Nutr ESPEN 2021; 45:363-368. [PMID: 34620341 DOI: 10.1016/j.clnesp.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Epidemiological data suggest that moderate habitual coffee consumption associates with lower cardiovascular disease (CVD) risk; however scarce data exist regarding the association of coffee with subclinical vascular disease (SVD). We aimed at investigating the above association with habitual instant coffee consumption - a widely consumed coffee in Greece-in high CVD risk but free of established CVD adults. RESEARCH METHODS & PROCEDURES In a cross-sectional design study we measured: (i) two 24 h dietary recalls to assess coffee consumption, (ii) arterial stiffness, by carotid to femoral pulse wave velocity - (PWV) and carotid compliance, arterial remodeling by carotid intima-media thickness (IMT), pressure wave reflection by augmentation index (AIx) and atheromatosis by carotid plaques. RESULTS In 1041 participants (55.6% females, 53.6 ± 14.0 years), 30% habitually consumed instant coffee (0.53 ± 1.15 cups/day). Consumption of instant coffee was inversely associated with systolic blood pressure (β = -1.19, p = 0.007), AIx (β = -0.71, p = 0.043), PWV (β = -0.22, p = 0.000) and IMT (β = -0.01, p = 0.025), but these associations lost their significance after multiple adjustments for confounders. Instant coffee consumption was positively associated with carotid compliance independent from all possible confounders (β = 0.005, p = 0.003). CONCLUSION Habitual moderate instant coffee consumption is inversely associated with arterial stiffening and potential with arterial remodeling. These favorable vascular associations offer a potential pathophysiological link between habitual coffee consumption and lower incidence of CVD. Future studies are needed to examine the long-term effects of habitual instant coffee consumption on vascular structure and function.
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Affiliation(s)
- Christiana Tsirimiagkou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | - Eirini D Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | | | - Christina Chairistanidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | | | - Antonios Argyris
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece
| | - Petros P Sfikakis
- 1st Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Greece
| | - Kalliopi Karatzi
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece; Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece.
| | - Athanase D Protogerou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece; Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece.
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3
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Azad BJ, Heshmati J, Daneshzad E, Palmowski A. Effects of coffee consumption on arterial stiffness and endothelial function: a systematic review and meta-analysis of randomized clinical trials. Crit Rev Food Sci Nutr 2021; 61:1013-1026. [PMID: 32292049 DOI: 10.1080/10408398.2020.1750343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Endothelial function (EF) and arterial stiffness (AS) are predictors of cardiovascular disease. As previous research concerning the effect of coffee intake on EF and AS was controversial, we conducted a systematic review and meta-analysis to synthesize research. METHODS We performed a systematic search in PubMed, Scopus and Web of Science to find clinical trials investigating the effect of coffee intake on EF or AS up to March 2020.Random-effects models were used to estimate the pooled weighted mean difference (WMD) between intervention and control groups for randomized controlled trials (RCTs). Between study heterogeneity was estimated using Cochran's Q and the I 2-inconsistency index. Internal validity of included randomized trials was determined with the Cochrane Collaboration's tool for assessing the risk of bias. RESULTS Twenty-three articles were included for qualitative and 11 articles for quantitative synthesis. Meta-analysis of 14 RCTs (nine articles) indicated a positive short-term (postprandial) effect of coffee intake on flow-mediated dilation (FMD) as a measure of EF (WMD: 1.93%[95% CI: 1.10-2.75]; I 2= 97.9%). Meta-analysis of three long-term RCTs(two articles) found no such effect on FMD (WMD: -0.08% [-3.82 to 3.66]; I 2= 61.4%).Most short-term information was from studies at low or unclear risk of bias, while the proportion of long-term information from studies at high risk of bias was considerable. CONCLUSION The results from this meta-analysis suggest a beneficial short-term effect of coffee
intake on EF as measured by FMD. However, there might be unfavorable effects on AS. Our findings must be interpreted cautiously as the number of studies were low and included studies had a considerable risk of bias.
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Affiliation(s)
- Banafsheh Jafari Azad
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elnaz Daneshzad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Harber MP, McCurry A, Carlini N, Kistler B, Fleenor BS. Caffeine ingestion alters central hemodynamics following aerobic exercise in middle-aged men. Eur J Appl Physiol 2020; 121:435-443. [PMID: 33098463 DOI: 10.1007/s00421-020-04521-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/01/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To examine the acute influence of caffeine on post-exercise central blood pressures, arterial stiffness, and wave reflection properties. METHODS In a double-blind randomized placebo-controlled crossover study design, ten middle-aged males (55 ± 5 year) completed two exercise trials after ingestion of caffeine (400 mg) or placebo. Measurements were taken before and 30 min post-ingestion via cuff-based pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (PWV). Participants performed a 40-min cycling bout at 70% HRmax with matched workloads between trials. PWA and PWV were reassessed 30 min post-exercise. RESULTS Prior to exercise, compared to placebo, caffeine increased brachial systolic blood pressure (bSBP) (+ 12.3 ± 2.4 mmHg; p = 0.004), brachial diastolic blood pressure (bDBP) (+ 7.7 ± 0.9 mmHg; p = 0.011), central systolic blood pressure (cSBP) (+ 11.1 ± 2.1 mmHg; p = 0.005) and central diastolic blood pressure (cDBP) (+ 7.6 ± 1.0 mmHg; p = 0.012). PWV was higher 30 min after pill ingestion (p = 0.021 for time) with a trend for a greater increase in caffeine (p = 0.074 for interaction). bSBP (p = 0.036) and cSBP (p = 0.007) were lower after exercise but remained higher (both p < 0.001) in caffeine compared to placebo. PWV remained higher (p = 0.023) after exercise in caffeine compared to placebo but was not influenced by exercise. At rest, augmentation pressure (AP) and index (AIx) were not influenced by caffeine ingestion. Conversely, AIx was lower (p = 0.009) after exercise in placebo only. CONCLUSION In healthy and active middle-aged men, pre-exercise caffeine ingestion led to higher central and peripheral systolic blood pressures, PWV and AIx at 30 min post-exercise, indicating an increased left ventricular workload which may have implications for cardiovascular event risk.
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Affiliation(s)
- Matthew P Harber
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA.
| | - Allison McCurry
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
| | - Nicholas Carlini
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
| | - Brandon Kistler
- Nutrition and Dietetics, Ball State University, Muncie, IN, USA
| | - Bradley S Fleenor
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
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5
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Nabofa EE, Alada AR. Cardiovascular Effects of Caffeine in Rabbits Involve Beta-1 Adrenergic Receptor Activation. J Caffeine Adenosine Res 2020. [DOI: 10.1089/caff.2019.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mocciaro G, Bresciani L, Tsiountsioura M, Martini D, Mena P, Charron M, Brighenti F, Bentley S, Harvey M, Collins D, Del Rio D, Ray S. Dietary absorption profile, bioavailability of (poly)phenolic compounds, and acute modulation of vascular/endothelial function by hazelnut skin drink. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ponte B, Pruijm M, Ackermann D, Ehret G, Ansermot N, Staessen JA, Vogt B, Pechère-Bertschi A, Burnier M, Martin PY, Eap CB, Bochud M, Guessous I. Associations of Urinary Caffeine and Caffeine Metabolites With Arterial Stiffness in a Large Population-Based Study. Mayo Clin Proc 2018; 93:586-596. [PMID: 29551227 DOI: 10.1016/j.mayocp.2017.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/24/2017] [Accepted: 12/07/2017] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the influence of caffeine on arterial stiffness by exploring the association of urinary excretion of caffeine and its related metabolites with pulse pressure (PP) and pulse wave velocity (PWV). PARTICIPANTS AND METHODS Families were randomly selected from the general population of 3 Swiss cities from November 25, 2009, through April 4, 2013. Pulse pressure was defined as the difference between the systolic and diastolic blood pressures obtained by 24-hour ambulatory monitoring. Carotid-femoral PWV was determined by applanation tonometry. Urinary caffeine, paraxanthine, theophylline, and theobromine excretions were measured in 24-hour urine collections. Multivariate linear and logistic mixed models were used to explore the associations of quartiles of urinary caffeine and metabolite excretions with PP, high PP, and PWV. RESULTS We included 863 participants with a mean ± SD age of 47.1±17.6 years, 24-hour PP of 41.9±9.2 mm Hg, and PWV of 8.0±2.3 m/s. Mean (SE) brachial PP decreased from 43.5 (0.5) to 40.5 (0.6) mm Hg from the lowest to the highest quartiles of 24-hour urinary caffeine excretion (P<.001). The odds ratio (95% CI) of high PP decreased linearly from 1.0 to 0.52 (0.31-0.89), 0.38 (0.22-0.65), and 0.31 (0.18-0.55) from the lowest to the highest quartile of 24-hour urinary caffeine excretion (P<.001). Mean (SE) PWV in the highest caffeine excretion quartile was significantly lower than in the lowest quartile (7.8 [0.1] vs 8.1 [0.1] m/s; P=.03). Similar associations were found for paraxanthine and theophylline, whereas no associations were found with theobromine. CONCLUSION Urinary caffeine, paraxanthine, and theophylline excretions were associated with decreased parameters of arterial stiffness, suggesting a protective effect of caffeine intake beyond its blood pressure-lowering effect.
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Affiliation(s)
- Belen Ponte
- Service of Nephrology, Department of Specialties, University Hospital of Geneva, Switzerland; Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Switzerland
| | - Menno Pruijm
- Service of Nephrology, University Hospital of Lausanne, Switzerland
| | - Daniel Ackermann
- Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - Georg Ehret
- Department of Cardiology, University Hospital of Geneva, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neurosciences, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Hospital of Cery, Prilly, Switzerland
| | - Jan A Staessen
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Belgium; Department of Epidemiology, Maastricht University, the Netherlands
| | - Bruno Vogt
- Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - Antoinette Pechère-Bertschi
- Unit of Hypertension, Department of Community Medicine and Primary Care and Emergency Medicine, University Hospital of Geneva, Switzerland
| | - Michel Burnier
- Service of Nephrology, University Hospital of Lausanne, Switzerland
| | - Pierre-Yves Martin
- Service of Nephrology, Department of Specialties, University Hospital of Geneva, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neurosciences, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Hospital of Cery, Prilly, Switzerland; School of Pharmacy Geneva-Lausanne, Universities of Geneva and Lausanne, Switzerland
| | - Murielle Bochud
- Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Switzerland
| | - Idris Guessous
- Unit of Population Epidemiology, Department of Community Medicine and Primary Care and Emergency Medicine, University Hospital of Geneva, Switzerland; Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Switzerland.
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Ioakeimidis N, Tzifos V, Vlachopoulos C, Terentes-Printzios D, Georgakopoulos C, Tousoulis D. Acute effect of coffee on aortic stiffness and wave reflections in healthy individuals: differential effect according to habitual consumption. Int J Food Sci Nutr 2018; 69:870-881. [DOI: 10.1080/09637486.2017.1422700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nikolaos Ioakeimidis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Vaios Tzifos
- Department of Interventional Cardiology, Henry Dunant Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Terentes-Printzios
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christos Georgakopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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9
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Caffeine and cardiovascular health. Regul Toxicol Pharmacol 2017; 89:165-185. [DOI: 10.1016/j.yrtph.2017.07.025] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/21/2017] [Accepted: 07/23/2017] [Indexed: 02/07/2023]
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Sansone R, Ottaviani JI, Rodriguez-Mateos A, Heinen Y, Noske D, Spencer JP, Crozier A, Merx MW, Kelm M, Schroeter H, Heiss C. Methylxanthines enhance the effects of cocoa flavanols on cardiovascular function: randomized, double-masked controlled studies. Am J Clin Nutr 2017; 105:352-360. [PMID: 28003203 DOI: 10.3945/ajcn.116.140046] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/22/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cocoa flavanol intake, especially that of (-)-epicatechin, has been linked to beneficial effects on human cardiovascular function. However, cocoa also contains the methylxanthines theobromine and caffeine, which may also affect vascular function. OBJECTIVE We sought to determine whether an interaction between cocoa flavanols and methylxanthines exists that influences cocoa flavanol-dependent vascular effects. DESIGN Test drinks that contained various amounts of cocoa flavanols (0-820 mg) and methylxanthines (0-220 mg), either together or individually, were consumed by healthy volunteers (n = 47) in 4 different clinical studies-3 with a randomized, double-masked crossover design and 1 with 4 parallel crossover studies. Vascular status was assessed by measuring flow-mediated vasodilation (FMD), brachial pulse wave velocity (bPWV), circulating angiogenic cells (CACs), and blood pressure before and 2 h after the ingestion of test drinks. RESULTS Although cocoa flavanol intake increased FMD 2 h after intake, the consumption of cocoa flavanols with methylxanthines resulted in a greater enhancement of FMD. Methylxanthine intake alone did not result in statistically significant changes in FMD. Cocoa flavanol ingestion alone decreased bPWV and diastolic blood pressure and increased CACs. Each of these changes was more pronounced when cocoa flavanols and methylxanthines were ingested together. It is important to note that the area under the curve of the plasma concentration of (-)-epicatechin metabolites over time was higher after the co-ingestion of cocoa flavanols and methylxanthines than after the intake of cocoa flavanols alone. Similar results were obtained when pure (-)-epicatechin and the methylxanthines theobromine and caffeine were consumed together. CONCLUSION A substantial interaction between cocoa flavanols and methylxanthines exists at the level of absorption, in which the methylxanthines mediate an increased plasma concentration of (-)-epicatechin metabolites that coincides with enhanced vascular effects commonly ascribed to cocoa flavanol intake. This trial was registered at clinicaltrials.gov as NCT02149238.
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Affiliation(s)
- Roberto Sansone
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | | | - Ana Rodriguez-Mateos
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.,Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Yvonne Heinen
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Dorina Noske
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Jeremy P Spencer
- Molecular Nutrition Group, School of Chemistry, Food and Pharmacy, University of Reading, Reading, United Kingdom; and
| | - Alan Crozier
- Department of Nutrition, University of California Davis, Davis, CA
| | - Marc W Merx
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | | | - Christian Heiss
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany;
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Acute effect of coffee consumption on arterial stiffness, evaluated using an oscillometric method. Artery Res 2017. [DOI: 10.1016/j.artres.2017.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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12
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Bailey DG, Dresser GK, Urquhart BL, Freeman DJ, Arnold JM. Coffee-Antihypertensive Drug Interaction: A Hemodynamic and Pharmacokinetic Study With Felodipine. Am J Hypertens 2016; 29:1386-1393. [PMID: 27481881 DOI: 10.1093/ajh/hpw081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/12/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES A period of abstinence from coffee to permit caffeine elimination appears to enable increased blood pressure on subsequent exposure. We hypothesized that this would offset the antihypertensive effect of the dihydropyridine calcium channel blocker felodipine. METHODS A randomized, single-dose, crossover study assessed hemodynamic and pharmacokinetic effects following 2 days without coffee and caffeine-containing foods. Consistently brewed black coffee (2×300ml), felodipine maximum recommended dose (10mg), and coffee plus felodipine were tested in middle-aged normotensive subjects. RESULTS Pretreatment plasma caffeine concentrations were unquantifiable. After coffee, blood pressure changes (mm Hg) averaged over study hours 1-4 were increased for brachial systolic (7.6, P < 0.001) and diastolic (4.9, P < 0.001) and aortic systolic (7.4, P < 0.001), pulse (3.0, P < 0.05) and augmentation (1.4, P < 0.05) relative to baseline. After coffee plus felodipine, they were higher for brachial systolic (4.0, P < 0.05) and diastolic (3.9, P < 0.001) and aortic systolic (4.6, P < 0.05) compared to felodipine alone. The pressor effects of coffee and its modulation by felodipine were variable among individuals. Coffee containing caffeine (127mg) caused maximum pressor effect. Caffeine and felodipine pharmacokinetics were similar for coffee and felodipine given alone or in combination indicating an interaction having a pharmacodynamic basis. Plasma felodipine concentration-diastolic blood pressure reduction relationship shifted with coffee such that doubling the felodipine concentration would eliminate the pressor effect. However, this may increase the risk of adverse drug events particularly during the timeframe without coffee. CONCLUSION Intermittent coffee ingestion might complicate hypertension diagnosis and management for many individuals.
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Affiliation(s)
- David G Bailey
- Lawson Health Research Institute, London Health Sciences Centre, Western University, London, Ontario, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - George K Dresser
- Lawson Health Research Institute, London Health Sciences Centre, Western University, London, Ontario, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | | | - David J Freeman
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - John Malcolm Arnold
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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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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Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cífková R, Cosentino F, De Carlo M, Gallino A, Landmesser U, Laurent S, Lekakis J, Mikhailidis DP, Naka KK, Protogerou AD, Rizzoni D, Schmidt-Trucksäss A, Van Bortel L, Weber T, Yamashina A, Zimlichman R, Boutouyrie P, Cockcroft J, O'Rourke M, Park JB, Schillaci G, Sillesen H, Townsend RR. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis 2015; 241:507-32. [DOI: 10.1016/j.atherosclerosis.2015.05.007] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/29/2015] [Accepted: 05/14/2015] [Indexed: 02/07/2023]
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Fatima N, Pingali U, Pilli R. Evaluation of Phyllanthus emblica extract on cold pressor induced cardiovascular changes in healthy human subjects. Pharmacognosy Res 2014; 6:29-35. [PMID: 24497739 PMCID: PMC3897005 DOI: 10.4103/0974-8490.122914] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 06/18/2013] [Indexed: 11/05/2022] Open
Abstract
Background: Acute and chronic stress is a risk factor for the development and progression of coronary artery disease. Increased arterial stiffness is an independent marker for cardiovascular disease. Cold pressor test (CPT) is known to be associated with substantial activation of the autonomic nervous system. Objective: The aim of this study was to evaluate the effect of Phyllanthus emblica extract on cold pressor stress test induced changes on cardiovascular parameters and aortic wave reflections in healthy human subjects. Materials and Methods: This was a double-blind, placebo-controlled, crossover study. Participants were randomized to receive either two capsules of P. emblica extract 250 mg (containing aqueous extract of P. emblica, highly standardized by high-performance liquid chromatography to contain low molecular weight hydrolysable tannins emblicanin-A, emblicanin-B, pedunculagin and punigluconin) or two capsules of placebo twice daily for 14 days. Pharmacodynamic parameters such as heart rate, augmentation pressure, augmentation index (AIx), subendocardial viability ratio (SEVR), radial and aortic blood pressure (BP) were recorded before and after CPT at baseline and end of treatment. After washout period of 14 days, subjects crossed over to the other treatment and the same test procedure was repeated again. Safety assessments were done at baseline and at the end of treatment. Results: A total of 12volunteers completed the study. Compared with baseline and placebo, P. emblica extract produced a significant decrease of mean percent change in the indices of arterial stiffness (AIx, radial and aortic BP) and increase in SEVR, an index of myocardial perfusion with CPT. Both treatments were well-tolerated and no serious adverse events were reported. Conclusion: Proprietary P. emblica extract, showed a significant decrease in cold pressor stress test induced changes on aortic wave reflections.
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Affiliation(s)
- Nishat Fatima
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India
| | - Usharani Pingali
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India
| | - Raveendranadh Pilli
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India
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Phillips AA, Bredin SSD, Cote AT, Drury CT, Warburton DER. Aortic distensibility is reduced during intense lower body negative pressure and is related to low frequency power of systolic blood pressure. Eur J Appl Physiol 2012; 113:785-92. [DOI: 10.1007/s00421-012-2489-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 08/29/2012] [Indexed: 12/18/2022]
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McMullen MK, Whitehouse JM, Shine G, Whitton PA, Towell A. Caffeine in hot drinks elicits cephalic phase responses involving cardiac activity. Food Funct 2012; 3:931-40. [PMID: 22614720 DOI: 10.1039/c2fo00002d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Caffeine stimulates both oropharyngeal and gut bitter taste receptors (hTAS2Rs) and so has the potential to elicit reflex autonomic responses. Coffee containing 130 mg caffeine has been reported to increase heart rate for 30 min post-ingestion. Whereas added-caffeine, in doses of 25 to 200 mg, ingested with decaffeinated coffee/tea decreases heart rate 10 to 30 min post-ingestion. This study aimed to clarify caffeine's chemosensory impact. Double-espresso coffees were compared to a placebo-control capsule in a double-blind between-measures design. Coffees tested were regular coffee (130 mg caffeine) and decaffeinated coffee with added-caffeine (0, 67 and 134 mg). Cardiovascular measures from three post-ingestion phases: 1) 0 to 5; 2) 10 to 15; and 3) 25 to 30 min; were compared to pre-ingestion measures. Participants comprised 11 women in the control group and 10 women in the test group. Decaffeinated coffee elicited no changes. Decaffeinated coffee with 67 mg caffeine: decreased dp/dt in Phase 1. Decaffeinated coffee with 134 mg caffeine: increased heart rate in Phases 1 and 2; decreased spontaneous baroreflex sensitivity in Phase 1; and increased diastolic pressure in Phases 2 and 3. Regular coffee: increased heart rate in Phases 1 and 2; decreased dp/dt in all phases; and decreased systolic pressure in Phase 1. Caffeine is the substance in regular coffee which elicits chemosensory autonomic reflex responses, which involves heart activity and the baroreflex. Compared to the caffeine in regular coffee, added-caffeine elicits somewhat different chemosensory responses including a more pronounced pressor effect and resetting of the baroreflex. Caffeine in commonly consumed amounts, as well as modulating body processes by blocking adenosine receptors, can elicit reflex autonomic responses during the ingestion of caffeinated drinks. It is plausible that caffeine stimulates hTAS2Rs, during the ingestion of coffee, eliciting cephalic phase responses. These cephalic phase responses likely result from vagal withdrawal and it is uncertain whether they enhance digestion or not.
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Shechter M, Shalmon G, Scheinowitz M, Koren-Morag N, Feinberg MS, Harats D, Sela BA, Sharabi Y, Chouraqui P. Impact of acute caffeine ingestion on endothelial function in subjects with and without coronary artery disease. Am J Cardiol 2011; 107:1255-61. [PMID: 21349479 DOI: 10.1016/j.amjcard.2010.12.035] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Revised: 12/21/2010] [Accepted: 12/21/2010] [Indexed: 11/17/2022]
Abstract
Although coffee is a widely used, pharmacologically active beverage, its impact on the cardiovascular system is controversial. To explore the effect of acute caffeine ingestion on brachial artery flow-mediated dilation (FMD) in subjects without coronary artery disease (CAD; controls) and patients with CAD, we prospectively assessed brachial artery FMD in 40 controls and 40 age- and gender-matched patients with documented stable CAD on 2 separate mornings 1 week to 2 weeks apart. After overnight fasting, discontinuation of all medications for ≥12 hours, and absence of caffeine for >48 hours, participants received capsules with caffeine 200 mg or placebo. One hour after drug ingestion, participants underwent brachial artery FMD and nitroglycerin-mediated dilation (NTG) using high-resolution ultrasound. As expected, patients with CAD were more often diabetic, hypertensive, obese, dyslipidemic, and smoked more than controls (p <0.01 for all comparisons). Aspirin, Clopidogrel, angiotensin-converting enzyme inhibitors, β blockers, and statins were significantly more common in patients with CAD than in controls (p <0.01 for all comparisons). At baseline, FMD, but not NTG, was significantly lower in patients with CAD compared to controls. Acute caffeine ingestion significantly increased FMD (patients with CAD 5.6 ± 5.0% vs 14.6 ± 5.0%, controls 8.4 ± 2.9% vs 18.6 ± 6.8%, p <0.001 for all comparisons) but not NTG (patients with CAD 13.0 ± 5.2% vs 13.8 ± 6.1%, controls 12.9 ± 3.9% vs 13.9 ± 5.8%, p = NS for all comparisons) and significantly decreased high-sensitivity C-reactive protein (patients with CAD 2.6 ± 1.4 vs 1.4 ± 1.2 mg/L, controls 3.4 ± 3.0 vs 1.2 ± 1.0 mg/L, p <0.001 for all comparisons) in the 2 groups compared to placebo. In conclusion, acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation.
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Affiliation(s)
- Michael Shechter
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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Pase MP, Grima NA, Sarris J. The effects of dietary and nutrient interventions on arterial stiffness: a systematic review. Am J Clin Nutr 2011; 93:446-54. [PMID: 21147858 DOI: 10.3945/ajcn.110.002725] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although dietary and nutrient interventions have been extensively studied as a means of improving arterial stiffness, to our knowledge no systematic analysis of the data has been conducted. OBJECTIVE The aim of the current study was to systematically review the human clinical trial data and qualitatively examine the efficacy of dietary and nutrient interventions in the treatment of arterial stiffness. DESIGN We systematically searched multiple databases until July 2010 for relevant randomized controlled human clinical trials of common dietary and nutrient interventions in the treatment of arterial stiffness. Located studies were subject to strict inclusion criteria and objectively assessed for scientific quality. RESULTS Of the 75 relevant studies located, we considered 38 studies to be appropriate for review. Results revealed support for intakes of omega-3 (n-3) fish oils (Cohen's d = 0.21-0.81) and soy isoflavones (Cohen's d = 0.35-0.39) in the treatment of arterial stiffness. There was limited but consistent evidence to suggest that salt restriction (Cohen's d = 0.28-0.37) as well as consumption of fermented-milk products (Cohen's d = 0.15-0.33) that contain bioactive peptides improved arterial stiffness. The evidentiary support for intakes of vitamins, micronutrients, and herbal medicines was insufficient. Limited but consistent evidence suggested that caffeine intake acutely increased arterial stiffness (Cohen's d = 0.34-0.51). CONCLUSIONS Current evidence from several small studies suggests that omega-3 and soy isoflavone supplementation provides an effective means of reducing arterial stiffness. There was little research that explored intakes of herbal medicines or micronutrients in the treatment of arterial stiffness, and this remains an area of potential research.
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Affiliation(s)
- Matthew P Pase
- National Institute of Complementary Medicine Centre for Study of Natural Medicines and Neurocognition, Melbourne, Australia.
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21
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Abstract
In the concentration range that is normally achieved in humans, e.g., after the drinking of coffee or in patients treated with theophylline, the cardiovascular effects of methylxanthines are primarily due to antagonism of adenosine A(1) and A(2) receptors. Inhibition of phosphodiesterases or mobilization of intracellular calcium requires much higher concentrations. In conscious humans, acute exposure to caffeine results in an increase in blood pressure by an increased total peripheral resistance, and a slight decrease in heart rate. This overall hemodynamic response is composed of direct effects of caffeine on vascular tone, on myocardial contractility and conduction, and on the sympathetic nervous system. Caffeine is the most widely consumed methylxanthine, mainly derived from coffee intake. Regular coffee consumption can affect various traditional cardiovascular risk factors, including a slight increase in blood pressure, an increase in plasma cholesterol and homocysteine levels, and a reduced incidence of type 2 diabetes mellitus. Although most prospective studies have not reported an association between coffee consumption and coronary heart disease, these findings do not exclude that the acute hemodynamic and neurohumoral effects of coffee consumption could have an adverse effect in selected patient groups who are more vulnerable for these effects, based on their genetic profile or medication use.
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Affiliation(s)
- Niels P Riksen
- Department of Pharmacology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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McMullen MK, Whitehouse JM, Shine G, Towell A. Habitual coffee and tea drinkers experienced increases in blood pressure after consuming low to moderate doses of caffeine; these increases were larger upright than in the supine posture. Food Funct 2011; 2:197-203. [DOI: 10.1039/c0fo00166j] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Increased arterial stiffness and impaired endothelial function in nonalcoholic Fatty liver disease: a pilot study. Am J Hypertens 2010; 23:1183-9. [PMID: 20634799 DOI: 10.1038/ajh.2010.144] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease both in the general and pediatric population and has been associated with increased cardiovascular risk. Arterial function and early atherosclerotic changes are markers of cardiovascular disease and independent predictors of the corresponding risk. Through a global approach, we investigated the relationships between NAFLD and functional arterial changes and early atherosclerosis. METHODS A total of 23 consecutive patients (mean age 55 ± 14 years, 11 males) with biopsy evidence of NAFLD and 28 control subjects matched for age, gender, body mass index, and other cardiovascular risk factors participated in the study. RESULTS Compared to controls, NAFLD subjects had significantly higher carotid-femoral pulse wave velocity (PWV; 8.2 ± 1.3 m/s vs. 6.9 ± 1.3 m/s, P = 0.001), higher carotid intima-media thickness (IMT; 0.79 ± 0.18 mm vs. 0.67 ± 0.13 mm, P = 0.01), and reduced flow-mediated dilatation (FMD; 1.92 ± 2.11% vs. 4.8 ± 2.43%, P < 0.001). In multivariable analysis, presence of NAFLD was an independent determinant of both PWV and FMD, whereas leptin was an independent determinant of PWV (B = 0.036, P < 0.05), and adiponectin was independently associated with FMD (B = 0.104, P < 0.05). In addition, histological activity of liver disease expressed by the global Brunt Grade was associated independently with FMD (B = -1.054, P < 0.05). CONCLUSIONS NAFLD is associated with arterial stiffness and endothelial dysfunction. Given the important independent prognostic role of these arterial indexes, these findings have important implications for increased cardiovascular risk in patients with NAFLD.
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Vyssoulis G, Karpanou E, Kyvelou SM, Vlachopoulos C, Tzamou V, Stefanadis C. Prostate-specific antigen levels are associated with arterial stiffness in essential hypertensive patients. J Sex Med 2010; 9:3205-10. [PMID: 20722777 DOI: 10.1111/j.1743-6109.2010.01979.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Prostate-specific antigen (PSA) has been recently related to cardiovascular system in a multifactorial way. Arterial stiffness is a independent predictor of cardiovascular events and is involved in the pathogenesis of hypertension. The aim of the present study was to investigate whether PSA values, are associated with arterial stiffness indices in patients with essential arterial hypertension. METHODS The study comprised 150 consecutive male patients (mean age 60 years) with uncomplicated never-treated essential hypertension. All patients underwent a complete clinical and laboratory evaluation, including measurement of PSA levels. Aortic stiffness and arterial wave reflection assessment was made by using carotid-femoral (PWVc-f) pulse wave velocity and aortic augmentation index corrected for heart rate (AIx75). Patients with prostate cancer or benign prostate hyperplasia (PSA > 4 ng/mL) were excluded from the study. RESULTS PSA was positively associated with waist-to-hip ratio (r = 0.235, P = 0.04), PWVc-f (r = 0.426, P < 0.001), AIx75 (r = 0.264, P = 0.001), and high sensitivity C-reactive protein (hsCRP; r = 0.376, P < 0.001). In categorization to PSA quartiles, patients in the higher quartile presented with higher waist-to hip ratio (P = 0.009), PWVc-f (P < 0.00001), AIx75 (P < 0.001) and hsCRP (P < 0.001) values. In multivariate analysis after adjustment for various confounders PSA remained a significant determinant of PWVc-f values (beta [SE] = 0.477 [0.13], R(2) = 0.405, P < 0.001). CONCLUSION The present study points towards an association between PSA levels and aortic stiffness in untreated essential hypertensive males. Potential causal relationships between PSA and arterial stiffness remain to be further explored.
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Affiliation(s)
- Gregory Vyssoulis
- Hypertension Unit, 1st Cardiology Clinic Athens University, Hippokration Hospital, Athens, Greece
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Kastorini CM, Chrysohoou C, Panagiotakos D, Aggelopoulos P, Liontou C, Pitsavos C, Stefanadis C. Moderate coffee consumption lowers the likelihood of developing left ventricular systolic dysfunction in post-acute coronary syndrome normotensive patients. J Med Food 2009; 12:29-36. [PMID: 19298193 DOI: 10.1089/jmf.2008.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the present work was to evaluate the association between coffee consumption and the development of left ventricular systolic dysfunction (LVSD) in patients who had had an acute coronary syndrome. During 2006-2007, 144 male (65 +/- 14 years) and 50 female (71 +/- 12 years) post-acute coronary syndrome patients who developed LVSD (ejection fraction <40%) after the cardiac event and 129 male (64 +/- 12 years) and 51 female (67 +/- 10 years) post-acute coronary syndrome patients without LVSD (ejection fraction >50%) were included in the study. Participants were consequently selected. Detailed information regarding their medical records, sociodemographic and anthropometric data, and various psychological and lifestyle characteristics (physical activity, smoking habits, etc.) were recorded. In particular, nutritional habits, including coffee consumption, were evaluated using a semiquantitative food-frequency questionnaire. Multi-adjusted analysis revealed that in normotensive patients coffee consumption of 1-2 cups/day was associated with 88% (95% confidence interval, 0.02-0.84) lower likelihood of developing LVSD and consumption of >3 cups/day with 90% (95% confidence interval, 0.01-0.88) lower likelihood for LVSD, compared with no history of consumption of coffee and after adjusting for various confounders. In contrast, in hypertensive patients coffee consumption of >3 cups/day was associated with 4.5-fold higher likelihood for developing LVSD (95% confidence interval, 0.89-22.58) as compared with no history of coffee consumption. Coffee consumption has opposite effects on the likelihood of developing LVSD in post-acute coronary syndrome patients depending on their blood pressure levels.
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Riksen NP, Rongen GA, Smits P. Acute and long-term cardiovascular effects of coffee: Implications for coronary heart disease. Pharmacol Ther 2009; 121:185-91. [DOI: 10.1016/j.pharmthera.2008.10.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Accepted: 10/21/2008] [Indexed: 10/21/2022]
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Association of arterial stiffness with the angiotensin-converting enzyme gene polymorphism in healthy individuals. Am J Hypertens 2008; 21:1354-8. [PMID: 18833197 DOI: 10.1038/ajh.2008.295] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Arterial stiffness is an important determinant of cardiovascular morbidity and mortality. The I/D polymorphism of angiotensin-converting enzyme (ACE) gene is associated with cardiovascular disease. However, the relationship between ACE polymorphism, arterial stiffness, and wave reflections in healthy, low-risk population has not been defined yet. METHODS The study included 282 apparently healthy, low-risk individuals (mean age 39.7 +/- 8.9 years, 178 males). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness, while wave reflections were assessed by augmentation index (AIx) of the central pressure waveform. I/D polymorphism of the ACE gene was determined in all subjects for the prevalence of the DD, ID, and II genotype (39, 44, and 17%, respectively). C-reactive protein (CRP) levels were determined as a marker of chronic, subclinical inflammation. RESULTS After adjustment for potential confounding factors, presence of D allele was associated with lower values of PWV compared to II genotype (P < 0.05), implying lower aortic stiffness for D allele carriers. There was no association between ACE genotype and wave reflections or peripheral and central systolic pressures. CONCLUSIONS In apparently healthy individuals, D allele is associated with lower aortic stiffness, whereas there is no association of the ACE polymorphism with wave reflections. This finding provides new insights into the possible links between ACE gene, regulation of large artery stiffness, and has implications for cardiovascular risk.
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The acute effect of green tea consumption on endothelial function in healthy individuals. ACTA ACUST UNITED AC 2008; 15:300-5. [DOI: 10.1097/hjr.0b013e3282f4832f] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Arterial transfer functions and the reconstruction of central aortic waveforms: myths, controversies and misconceptions. J Hypertens 2008; 26:4-7. [PMID: 18090531 DOI: 10.1097/hjh.0b013e3282f0c9f5] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Vlachopoulos C, Aznaouridis K, Dima I, Ioakeimidis N, Vasiliadou C, Zervoudaki A, Gialernios T, Stefanadis C. Negative association between serum levels of matrix metalloproteinases-2 and -9 and aortic stiffness in healthy adults. Int J Cardiol 2007; 122:232-8. [PMID: 17289174 DOI: 10.1016/j.ijcard.2006.11.099] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 10/15/2006] [Accepted: 11/11/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Arterial stiffness is a marker of cardiovascular disease and independent predictor of cardiovascular risk. Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases that degrade components of the extracellular matrix, which is an important determinant of the arterial elastic properties. This study sought to investigate the association between MMP-2 and MMP-9 (gelatinase A and B respectively) and arterial stiffness in healthy human subjects. METHODS A total of 213 apparently healthy subjects (mean age 41 years, range 18 to 60, 141 males and 72 females) were studied. Carotid-femoral pulse wave velocity (PWV) and aortic augmentation index (AIx) were measured as indices of aortic stiffness and wave reflections respectively. Associations with serum levels of total MMP-2, total MMP-9 and high-sensitivity C-reactive protein (hsCRP) were evaluated with multiple regression models. RESULTS In these models, PWV exhibited a significant negative association with both MMP-2 (standardized b=-0.177, P=0.003) and MMP-9 (b=-0.122, P=0.032), after controlling for potential confounding factors such as age, gender, blood pressure, heart rate, body-mass index, smoking habits (pack-years), blood glucose, total cholesterol, and level of subclinical inflammation expressed by hsCRP (adjusted R2 of models 0.352 and 0.338 respectively). On the other hand, no relationship between MMP-2 or MMP-9 and AIx was found. CONCLUSIONS Circulating MMP-2 and MMP-9 are inversely associated with large artery stiffness but not with wave reflections in healthy persons. This finding implies that these gelatinases may have a possible role in the determination of arterial function and has potential implications for their involvement in the pathophysiology of cardiovascular diseases.
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Corsetti G, Pasini E, Assanelli D, Bianchi R. Effects of acute caffeine administration on NOS and Bax/Bcl2 expression in the myocardium of rat. Pharmacol Res 2007; 57:19-25. [PMID: 18082418 DOI: 10.1016/j.phrs.2007.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 07/11/2007] [Accepted: 07/16/2007] [Indexed: 11/27/2022]
Abstract
Caffeine is the most frequently ingested neuroactive drug in the world and it is largely used to delay fatigue and improve physical activity. Caffeine can modulate NO synthesis in cells and may influence muscular function by modifying the cellular cycle life-death. There is little data concerning the relationship between caffeine in the heart, NOS expression and apoptosis and no data regarding the acute effect of high doses of caffeine in the in vivo myocardium. We therefore studied hemodynamic NOS and Bax/Bcl2 expression in the rat myocardium after a single cafffeine administration. Thirty-two male rats were divided into six groups: the first was iv-injected with caffeine (16 mg/kg), the second with caffeine + L-NAME (30 mg/kg), the third with caffeine + L-arg (0.5 g/kg), the fourth with caffeine + L-NAME + L-arg and finally the fifth with saline. Mean arterial blood pressure (MAP) was monitored for 30 min, then the animals were killed. The sixth group was injected with caffeine and killed after 2 h. The hearts were isolated and processed by immunohistochemistry. We found that caffeine increased MAP temporarily while caffeine + L-NAME increased it for a longer period. In the control myocardium, all NOS isoforms were expressed. The Bcl2 were strongly expressed inside the perinuclear cytoplasm whereas Bax was very faintly detectable in the peripheral cytoplasm. In caffeine and caffeine + L-NAME treated animals, NOS expression disappeared. Bax and Bcl2 expression did not vary. The l-arg administration reversed these caffeine and L-NAME effects on NOS expression. Two hours after caffeine, NOS expression increased and Bax and Bcl2 expression did not vary, although Bcl2 was mainly expressed in the peripheral cytoplasm. We conclude that improved caffeine-induced physical performance could also be related to caffeine's ability to interfere with endogenous myocardial NO synthesis. Furthermore, we suggest that myocardial cell plays an effective anti-apoptotic role against acute caffeine administration.
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Affiliation(s)
- Giovanni Corsetti
- Division of Human Anatomy, Department of Biomedical Sciences and Biotechnology, University of Brescia, viale Europa 11, 25124 Brescia, Italy
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Abstract
1. Arteries become stiffer with increasing age and various disease states. A complete description of arterial mechanical properties in vivo is not possible, although a number of methods have been used. 2. Detailed discussion in the present review is limited to pulse wave velocity and estimates of central waveform morphology derived by the application of a generalized arterial transfer function. 3. Many drugs affect these parameters, either increasing or decreasing apparent stiffness. However, the extent to which changes reflect changes in blood pressure rather than more fundamental vessel wall properties remains unclear. Similarly, it is as yet unknown whether determining the need for, or assessing the effectiveness of, drug treatment by the assessment of arterial mechanical properties will offer any advantage and the usefulness of these techniques as routine clinical tools remains to be established.
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Affiliation(s)
- Sarah A Hope
- Monash Cardiovascular Research Centre, Monash University and Monash Medical Centre, Melbourne, Victoria, Australia.
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Abstract
Coffee seems to have distinct acute and long-term effects on health, which can be modified by genetic background. Coffee consumption is potentially protective against the development of type 2 diabetes, but given the lack of a solid biological basis for this association, and the possible adverse cardiovascular effects of coffee, recommendations for optimal coffee intake are difficult to establish.
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Affiliation(s)
- Hannia Campos
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
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Vlachopoulos C, Alexopoulos N, Stefanadis C. Lifestyle modification and arterial stiffness and wave reflections: A more natural way to prolong arterial health. Artery Res 2007. [DOI: 10.1016/s1872-9312(07)70003-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Vlachopoulos CV, Vyssoulis GG, Alexopoulos NA, Zervoudaki AI, Pietri PG, Aznaouridis KA, Stefanadis CI. Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients. Eur J Clin Nutr 2006; 61:796-802. [PMID: 17164828 DOI: 10.1038/sj.ejcn.1602577] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Aortic stiffness and wave reflections are important markers and prognosticators of cardiovascular risk. Caffeine increases acutely aortic stiffness and wave reflections. Furthermore, chronic coffee consumption is associated with increased aortic stiffness and wave reflections in normotensive subjects. In the present study, we aimed to assess the association between chronic coffee consumption, and aortic stiffness and wave reflections in hypertensive patients. DESIGN Epidemiological survey. SETTING Hypertension Unit, University Hospital. SUBJECTS-METHODS: We examined 259 never-treated hypertensives (age 50+/-12 years, 165 males) without diabetes mellitus, who were asked to describe in detail the type and amount of coffee they consumed. Carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) were measured non-invasively as indices of aortic stiffness and wave reflections, respectively. RESULTS When controlled for gender, age, height, smoking status, heart rate, mean pressure, HDL cholesterol and hsCRP, AIx was found to be higher with increasing daily coffee consumption. Post hoc analysis revealed that all groups of coffee consumption had higher AIx compared to no-consumption. PWV did not differ among groups of daily coffee consumption. Each participant had 35% higher relative risk of having high AIx for each cup (150 ml) of coffee per day, and 40% higher relative risk for each 10 cup-years. CONCLUSIONS Coffee consumption is associated with increased wave reflections, but not aortic stiffness in never-treated hypertensive patients. This finding may have important clinical implications for cardiovascular health in hypertensive subjects.
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Affiliation(s)
- C V Vlachopoulos
- Hypertension Unit, 1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece.
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Swampillai J, Rakebrandt F, Morris K, Jones CJH, Fraser AG. Acute effects of caffeine and tobacco on arterial function and wave travel. Eur J Clin Invest 2006; 36:844-9. [PMID: 17087778 DOI: 10.1111/j.1365-2362.2006.01738.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Caffeine and tobacco consumption are risk factors for heart failure, but their effects remain controversial. It has been hypothesized that they cause alterations in arterial stiffness and arterial wave travel which may increase ventricular loading. In this study the authors examined the influence of these widely used stimulants on wave intensity and arterial stiffness parameters using carotid wave intensity analysis. MATERIALS AND METHODS A new Doppler-based ultrasound method was used to measure the acute effects of caffeine and tobacco on wave intensity in the right common carotid artery. The measurements enabled changes in arterial stiffness parameters to be recorded. RESULTS In 17 subjects compared with 10 controls, caffeine increased blood pressure, early systolic wave intensity and wave speed, but late-systolic wave intensity and mid-systolic reflections were unchanged. In 11 smokers studied before and after smoking one cigarette, blood pressure and arterial stiffness increased but wave intensity was unchanged. No changes were observed in the controls. CONCLUSIONS Increased wave intensity during ejection after caffeine suggested sympathomimetic effects on the left ventricular function. Increased wave speed in the common carotid artery implied augmented central loading after caffeine, but the absence of measurable changes in local arterial stiffness in the carotid artery suggested more complex and regional effects. Cigarette smoking acutely increased local arterial stiffness in the common carotid artery. These changes can be detected using wave intensity analysis.
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Affiliation(s)
- J Swampillai
- Wales Heart Research Institute, Wales College of Medicine, Cardiff University, Cardiff, UK.
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Kitahara Y, Hattori N, Yokoyama A, Nakajima M, Kohno N. Effect of CPAP on brachial-ankle pulse wave velocity in patients with OSAHS: An open-labelled study. Respir Med 2006; 100:2160-9. [PMID: 16650974 DOI: 10.1016/j.rmed.2006.03.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Revised: 03/09/2006] [Accepted: 03/15/2006] [Indexed: 11/24/2022]
Abstract
Pulse wave velocity (PWV) is a good indicator of arterial stiffness and an important predictor of cardiovascular events. Recent studies have revealed that PWV increases in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and it also correlates with its severity. However, the therapeutic effect of continuous positive airway pressure (CPAP) on PWV remains undetermined. To clarify this point, we started CPAP treatment on 17 OSAHS patients. Brachial-ankle PWV was measured before starting CPAP, and at 2 months and 4 months after the start of CPAP. Before the CPAP treatment, mean brachial-ankle PWV of the patients was 15.6+/-0.6 m/s, and mean Epworth sleepiness scale (ESS) score was 8.6+/-1.0. Brachial-ankle PWV was found to positively correlate with heart rate, systolic and diastolic blood pressures, mean blood pressure, and arousal index. During the study period, the CPAP treatment did not have a significant effect on heart rate, blood pressures and serum total cholesterol levels. However, it significantly improved ESS score at 4 months after the start of CPAP (P=0.001), while it effectively decreased brachial-ankle PWV at 2 months and at 4 months after the start of CPAP (P=0.010 and P=0.027, respectively). The CPAP treatment was shown to decrease brachial-ankle PWV without affecting blood pressures in OSAHS patients. Although the precise mechanism for this effect is unclear, our finding suggests a close relationship between OSAHS and arterial stiffness, while also reemphasizing the clinical importance of CPAP treatment.
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Affiliation(s)
- Yoshihiro Kitahara
- Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biochemical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Papaioannou TG, Vlachopoulos C, Ioakeimidis N, Alexopoulos N, Stefanadis C. Nonlinear dynamics of blood pressure variability after caffeine consumption. Clin Med Res 2006; 4:114-8. [PMID: 16809403 PMCID: PMC1483890 DOI: 10.3121/cmr.4.2.114] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The occurrence of continuous blood pressure (BP) fluctuations is an intrinsic feature of the cardiovascular system and is related to complex cardiovascular mechanisms and environmental stimulations or daily habits such as coffee drinking. The aim of this study was to investigate the effect of caffeine on indices expressing the complex and "chaotic" nonlinear characteristics of BP variability. DESIGN Fourteen healthy subjects consumed 240 mg of caffeine or placebo according to a randomized, double-blind, crossover design. Continuous radial pressure waveforms were recorded by applanation tonometry at baseline and at 30, 60, 90 and 120 minutes after ingestion of caffeine or placebo. METHODS Approximate entropy (ApEn) was determined to assess BP irregularity. Detrended fluctuation analysis was also used to quantify the fractal correlation properties of the BP data by estimating the scaling (self-similarity) exponent alpha. Analysis of variance for repeated measurements was used to detect significant changes in the measured variables at 30, 60, 90 and 120 minutes after ingestion of caffeine or placebo. RESULTS BP fluctuations demonstrated high regularity and predictability as indicated by the low values of ApEn (0.2 +/- 0.3), and they remained unchanged after caffeine ingestion. In contrast, the long-term scaling exponent alpha of the BP time series was significantly increased from 0.99 to 1.04 (p=0.01) after caffeine ingestion, while the placebo induced no significant change. CONCLUSIONS Caffeine induced greater "randomness" in BP fluctuations, possibly by triggering cardiovascular mechanisms that could not be directly specified but should be investigated in future studies.
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Affiliation(s)
- Theodore G Papaioannou
- First Department of Cardiology, Hippocration Hospital, National and Kapodistrian University of Athens, Greece.
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Vlachopoulos C, Alexopoulos N, Dima I, Aznaouridis K, Andreadou I, Stefanadis C. Acute Effect of Black and Green Tea on Aortic Stiffness and Wave Reflections. J Am Coll Nutr 2006; 25:216-23. [PMID: 16766780 DOI: 10.1080/07315724.2006.10719535] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE While most studies have shown an inverse relation between tea consumption and cardiovascular risk, other studies have shown opposite results. Aortic stiffness and wave reflections are markers of cardiovascular disease and prognosticators of cardiovascular risk. METHODS The acute effect of black and green tea on aortic stiffness and wave reflections was assessed in 29 healthy volunteers in a randomized, single-blind, sham-procedure controlled, cross-over design. In the black tea sub-study, 16 subjects received 6 gm of tea, caffeine (175 mg), or hot water in 3 different sessions. In the green tea sub-study, 13 subjects received 6 gm of tea, caffeine (125 mg), or hot water. Carotid-femoral pulse wave velocity and wave reflection indices were measured at baseline and for 3 hours after consumption. RESULTS Black tea increased pulse wave velocity during the first 90 min (increase by 0.49 m/sec, P < 0.05), showing a rapid return towards baseline values thereafter (P = 0.07 for the whole study period); in contrast, green tea had no effect. Both black and green tea increased augmentation index (by 5.0% and by 6.6%, P < 0.01 and P < 0.001, respectively) throughout the study. These changes were less than the respective changes produced by caffeine. Both black and green tea had a significant pressor effect. No change in oxidant status was found with both types of tea. CONCLUSIONS Both black and green tea increases acutely wave reflections and only black tea increases aortic stiffness. Tea flavonoids may play a role in the attenuation of the effects of caffeine contained in tea.
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Vlachopoulos C, Dima I, Aznaouridis K, Vasiliadou C, Ioakeimidis N, Aggeli C, Toutouza M, Stefanadis C. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 2005; 112:2193-200. [PMID: 16186422 DOI: 10.1161/circulationaha.105.535435] [Citation(s) in RCA: 339] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Aortic stiffness is a marker of cardiovascular disease and an independent predictor of cardiovascular risk. Although an association between inflammatory markers and increased arterial stiffness has been suggested, the causative relationship between inflammation and arterial stiffness has not been investigated. METHODS AND RESULTS One hundred healthy individuals were studied according to a randomized, double-blind, sham procedure-controlled design. Each substudy consisted of 2 treatment arms, 1 with Salmonella typhi vaccination and 1 with sham vaccination. Vaccination produced a significant (P<0.01) increase in pulse wave velocity (at 8 hours by 0.43 m/s), denoting an increase in aortic stiffness. Wave reflections were reduced significantly (P<0.01) by vaccination (decrease in augmentation index of 5.0% at 8 hours and 2.5% at 32 hours) as a result of peripheral vasodilatation. These effects were associated with significant increases in inflammatory markers such as high-sensitivity C-reactive protein (P<0.001), high-sensitivity interleukin-6 (P<0.001), and matrix metalloproteinase-9 (P<0.01). With aspirin pretreatment (1200 mg PO), neither pulse wave velocity nor augmentation index changed significantly after vaccination (increase of 0.11 m/s and 0.4%, respectively; P=NS for both). CONCLUSIONS This is the first study to show through a cause-and-effect relationship that acute systemic inflammation leads to deterioration of large-artery stiffness and to a decrease in wave reflections. These findings have important implications, given the importance of aortic stiffness for cardiovascular function and risk and the potential of therapeutic interventions with antiinflammatory properties.
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Papamichael CM, Aznaouridis KA, Karatzis EN, Karatzi KN, Stamatelopoulos KS, Vamvakou G, Lekakis JP, Mavrikakis ME. Effect of coffee on endothelial function in healthy subjects: the role of caffeine. Clin Sci (Lond) 2005; 109:55-60. [PMID: 15799717 DOI: 10.1042/cs20040358] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Coffee is one of the most widely used pharmacologically active beverages. The present study was designed to evaluate the acute effect of coffee ingestion on endothelial function in healthy individuals, and the potential role of caffeine. We studied 17 healthy young adults (28.9+/-3.0 years old; nine men), who were regular non-heavy coffee drinkers. The endothelial performance was estimated by endothelium-dependent FMD (flow-mediated dilatation) of the brachial artery before and 30, 60, 90 and 120 min after ingestion of a cup of caffeinated coffee (80 mg of caffeine) or the corresponding decaffeinated beverage (< 2 mg of caffeine) in two separate sessions, following a randomized single-blind cross-over design. There was no difference in baseline FMD values between the two sessions [7.78 compared with 7.07% after caffeinated and decaffeinated coffee respectively; P = NS (not significant)]. Caffeinated coffee led to a decline of FMD (7.78, 2.86, 2.12, 4.44 and 4.57% at baseline, 30, 60, 90 and 120 min respectively; P < 0.001). This adverse effect was focused at 30 (P = 0.004) and 60 min (P < 0.001). No significant effect on FMD was found with the decaffeinated coffee session (7.07, 6.24, 5.21, 7.41 and 5.20%; P = NS). The composite effect of the type of coffee consumed over time on FMD was significantly different (P = 0.021). In conclusion, coffee exerts an acute unfavourable effect on the endothelial function in healthy adults, lasting for at least 1 h after intake. This effect might be attributed to caffeine, given that decaffeinated coffee was not associated with any change in the endothelial performance.
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Affiliation(s)
- Chris M Papamichael
- Vascular Laboratory, Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens 15561, Greece.
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Hope SA, Tay DB, Meredith IT, Cameron JD. Waveform dispersion, not reflection, may be the major determinant of aortic pressure wave morphology. Am J Physiol Heart Circ Physiol 2005; 289:H2497-502. [PMID: 16024572 DOI: 10.1152/ajpheart.00411.2005] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The objective of this study was to investigate the determinants of aortic pressure waveform morphology in the thoracoabdominal aorta with specific reference to features of potential prognostic value for cardiovascular disease. In particular, we aimed to determine the location of major pressure wave reflection sites within the aorta. Aortic pressure waveforms were acquired with 2-Fr Millar Mikro-tip catheter transducers in 40 subjects (26 men, 14 women), and repeated in 10 subjects, at five predetermined points within the aorta: aortic root, transverse arch, and at the levels of the diaphragm, renal arteries, and aortic bifurcation. Waveforms were analyzed for augmentation index (AI), time to inflection point (Ti), and pressure parameters. AI decreased progressively between the aortic root and bifurcation (P < 0.001), and Ti increased (P < 0.01). There was the expected progressive peripheral amplification of systolic and pulse pressures and fall in time to peak pressure (all P < 0.001). There was no difference on repeat pullback or between sexes. These data are at variance with the concept that central AI results solely from pressure wave reflection, when Ti would be expected to decrease and AI increase with distal progression. Pressure wave propagation phenomena may contribute, and the potential role of frequency dispersion merits investigation.
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Affiliation(s)
- Sarah A Hope
- Cardiovascular Research Centre, Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria 3168, Australia
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Karatzis E, Papaioannou TG, Aznaouridis K, Karatzi K, Stamatelopoulos K, Zampelas A, Papamichael C, Lekakis J, Mavrikakis M. Acute effects of caffeine on blood pressure and wave reflections in healthy subjects: should we consider monitoring central blood pressure? Int J Cardiol 2005; 98:425-30. [PMID: 15708175 DOI: 10.1016/j.ijcard.2003.11.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2003] [Revised: 11/22/2003] [Accepted: 11/23/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Data concerning blood pressure changes, acutely induced by caffeine consumption, are conflicting. Furthermore, limited data exist regarding central hemodynamic response to caffeine ingestion by healthy young subjects. We investigated the acute effect of coffee (80 mg of caffeine) and decaffeinated coffee on peripheral and central hemodynamics, as well as on wave reflections. SUBJECTS For this purpose, 16 healthy volunteers (eight females and eight males, mean age 29+/-3.2 years) were investigated. METHODS Repeated measurements were performed at baseline and 30, 60, 90 and 120 min after oral administration of each beverage in a double-blind crossover design. Aortic blood pressures, augmentation index (AI) and pressure (AP) and timing of reflected waves were evaluated by using applanation tonometry and pulse wave analysis. RESULTS Regular coffee increased central systolic (SBP) and diastolic pressure (DBP) from 96.2+/-9.9 to 101.1+/-10.1 mmHg, p=0.011 and from 72.6+/-9.4 to 76.5+/-9.0 mmHg, p=0.027, respectively, but no change was observed following consumption of decaffeinated coffee. Peripheral systolic blood pressure did not change significantly after the administration of either coffee. Augmentation index increased significantly following regular coffee consumption. The change in AI was significantly higher following regular compared to decaffeinated coffee consumption as shown by analysis of variance (ANOVA) for repeated measures (p=0.001). CONCLUSIONS These caffeine effects reveal an unfavourable effect on wave reflections and therefore on left ventricular (LV) pulsatile afterload. It also revealed a significant acute effect of caffeine consumption on central hemodynamics which is not observed at peripheral pressures.
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Affiliation(s)
- Emmanouil Karatzis
- Vascular Laboratory, Department of Clinical Therapeutics, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece
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Vlachopoulos C, Panagiotakos D, Ioakeimidis N, Dima I, Stefanadis C. Chronic coffee consumption has a detrimental effect on aortic stiffness and wave reflections. Am J Clin Nutr 2005; 81:1307-12. [PMID: 15941880 DOI: 10.1093/ajcn/81.6.1307] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The effect of coffee consumption on the cardiovascular system is still an unresolved issue. Aortic stiffness and wave reflections are important prognosticators of cardiovascular disease risk. We have shown that caffeine acutely increases aortic stiffness and wave reflections. OBJECTIVE The objective was to investigate the effect of chronic coffee consumption on aortic stiffness and wave reflections. DESIGN This was a cross-sectional study of 228 healthy subjects: 141 men (x +/- SD: 41 +/- 8 y old) and 87 women (41 +/- 9 y old). Aortic stiffness was evaluated with carotid-femoral pulse wave velocity (PWV). Wave reflections were evaluated with augmentation index (AIx) and augmented pressure (AP) of the aortic pressure waveform with the use of high-fidelity pulse wave analysis. Coffee consumption was ascertained over 1 y with a food-frequency questionnaire. RESULTS A linear relation between coffee consumption and PWV, AIx, and AP was observed (P for trend < 0.05). Compared with the nonconsumption group, PWV was on average 13% higher, AIx was 2-fold higher, and AP was 2.4-fold higher (P < 0.01 for all) in the high-consumption group (>450 mL/d). The findings remained significant after control for confounders such as age, sex, smoking habits, body mass index, total and LDL cholesterol, triacylglycerols, blood glucose, mean blood pressure, and heart rate. The linear relation (P for trend < 0.05) observed between coffee consumption and arterial pressures was largely explained when the covariates were entered in the model. CONCLUSIONS Chronic coffee consumption exerts a detrimental effect on aortic stiffness and wave reflections, which may increase the risk of cardiovascular disease.
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Affiliation(s)
- Charalambos Vlachopoulos
- 1st Department of Cardiology, Hippokration Hospital, School of Medicine, University of Athens, Athens, Greece.
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Vlachopoulos C, Kosmopoulou F, Panagiotakos D, Ioakeimidis N, Alexopoulos N, Pitsavos C, Stefanadis C. Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections. J Am Coll Cardiol 2005; 44:1911-7. [PMID: 15519028 DOI: 10.1016/j.jacc.2004.07.049] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Revised: 07/25/2004] [Accepted: 07/28/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We investigated the acute and chronic combined effect of cigarette smoking and caffeine intake on aortic stiffness and wave reflections. BACKGROUND We have shown that smoking and caffeine separately increase arterial stiffness. Aortic stiffness and wave reflections are important determinants of the efficient performance of the cardiovascular system and prognosticators of cardiovascular risk. METHODS The acute effects of smoking (one cigarette), caffeine (200 mg, equivalent to 2 cups of coffee), and smoking plus caffeine were studied in 24 healthy subjects according to a randomized, placebo- and sham procedure-controlled crossover design. The chronic effect of smoking and caffeine was studied in a population study that enrolled 160 healthy subjects. RESULTS Acute study: there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity (p < 0.01) and augmentation index (p < 0.05). When smoking followed caffeine intake, pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4%, respectively, reaching a total of 0.85 m/s and 17.4%, 0.17 m/s and 9.2% in excess of the mere sum of caffeine effect (0.33 m/s and 4%) alone and smoking effect alone (0.35 m/s and 4.2%). Population study: there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity (p < 0.05) and augmentation index (p = 0.001). CONCLUSIONS The present study shows, for the first time, that when smoking and caffeine intake are combined, they interact and exert a synergistic, unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis.
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Hodgson JM, Burke V, Puddey IB. Acute effects of tea on fasting and postprandial vascular function and blood pressure in humans. J Hypertens 2005; 23:47-54. [PMID: 15643124 DOI: 10.1097/00004872-200501000-00012] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Effects of regular exposure to polyphenolic compounds found in tea, leading to improved endothelial function and blood pressure, may reduce cardiovascular disease risk. Controlled trials in humans have found that ingestion of tea can improve endothelial function, but also cause a rapid onset acute increase in blood pressure. OBJECTIVE To examine the acute effects of tea consumption on fasting and postprandial vascular function and blood pressure. METHODS Endothelium-dependent dilatation of the brachial artery, assessed using ultrasound and blood pressure were measured in 20 participants with a history of coronary artery disease. Measurements were performed at baseline and at 3.5 h (blood pressure) and 4 h (endothelial function) after drinking three cups of black tea or hot water (consumed at time = 0, 1.5 and 3 h) with and without a high-fat (50 g) meal: a total of four treatments administered in random order. RESULTS The high-fat meal did not impair endothelial function. In comparison to water alone, endothelium-dependent dilatation was increased by the meal with tea (1.7 (0.4, 3.0)%, P = 0.02), but was not significantly altered by the tea alone (0.7 (-0.6, 2.0)%, P = 0.32). Systolic blood pressure was significantly increased by tea alone in comparison to each of the other three groups: water alone (9.3 (4.5, 14.1) mmHg, P = 0.0003), meal with water (9.8 (5.0, 14.6) mmHg, P = 0.0001) and meal with tea (7.2 (2.4,12.0) mmHg, P = 0.004). Consumption of a meal negated the acute increase in systolic blood pressure found with tea in the fasting state. CONCLUSION Consumption of food may alter the acute effects of tea on vascular function and blood pressure.
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Affiliation(s)
- Jonathan M Hodgson
- University of Western Australia School of Medicine and Pharmacology, Western Australian Institute for Medical Research (WAIMR), Royal Perth Hospital Unit, Perth, Western Australia.
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Abstract
While sildenafil (Viagra) is widely prescribed for erectile dysfunction, its effect on arterial function is not established. The elastic properties of the aorta, as well as the magnitude and timing of wave reflection, are important factors for efficient performance of the cardiovascular system and have been identified as prognosticators of cardiovascular risk. A total of 24 subjects with coronary artery disease, of whom 14 were hypertensives, aged 69 +/- 8 years, were studied in a randomized, placebo-controlled, double-blind, cross-over design. Measurements lasted for 3 h after the sildenafil intake (50 mg, p.o.) or placebo. Aortic elastic properties were evaluated with carotid-femoral pulse wave velocity; wave reflection was evaluated with augmentation index and augmented pressure of the aortic pressure waveform. Pulse wave velocity decreased significantly (by 0.65 m/s, p = 0.005), denoting a decrease in aortic stiffness. Augmentation index and augmented pressure decreased significantly (by 4.47% absolute and by 4.01 mmHg; p < 0.001 and p = 0.001, respectively), denoting a decreased effect of wave reflection from the periphery. Aortic pulse pressure decreased significantly (by 6.74 mmHg, p < 0.05). An active effect of the drug on aortic wall appears to contribute to the decrease in pulse wave velocity, although other mechanisms such as a decrease of blood pressure and autonomic reflexes could also have contributed. The effect of sildenafil lasted throughout the study (3 h), being evident 30 min after drug intake. In conclusion, this study shows, for the first time, that sildenafil has a favorable effect on aortic stiffness and wave reflection in patients with coronary artery disease. This finding may have important implications for cardiovascular performance and exercise capacity during intercourse.
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Affiliation(s)
- Charalambos Vlachopoulos
- Medical Professorial Unit, St Vincent's Hospital and Clinic, University of New South Wales, Sydney, Australia.
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Cameron J, Grassi G. Effects of caffeine on arterial function and haemodynamics: implications for cardiovascular risk. J Hypertens 2003; 21:491-3. [PMID: 12640238 DOI: 10.1097/00004872-200303000-00010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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