Coffee consumption and blood pressure

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

A 2008 review concluded that data from cross-sectional studies suggest an inverse linear or U-shaped association between habitual coffee intake and blood pressure in different populations33. The authors suggested that prospective studies showed a protective effect of coffee intake (4 or more cups per day) against hypertension, mainly in women. The study stated that further investigation was needed to discover whether abstainers are at a lower or higher risk of hypertension than occasional coffee drinkers (1–2 cups per day). The same study also found that randomised controlled trials, which are mostly of short duration (1-12 weeks), suggest that coffee intake of around 5 cups per day may cause a small elevation in blood pressure (1-2mmHg) when compared to abstinence or use of decaffeinated coffee.

  • A 2011 review of 5 trials concluded that the administration of 200-300mg caffeine produced a mean increase of 8.1mmHg in systolic blood pressure (BP) and of 5.7mmHg in diastolic BP. The increase in BP was observed in the first hour after caffeine intake and lasted for 3 hours. However, in studies over a 2 week period, no increase in BP was observed after coffee consumption. The authors concluded that in hypertensive individuals, caffeine intake can produce a short-term acute increase in BP. Current research does not support an association between longer-term coffee consumption and increased BP, or between habitual coffee consumption and an increased risk of CVD in hypertensive subjects34.
  • A dose-response meta-analysis of 172,567 participants and 37,135 incident hypertension cases showed an inverse J-shaped curve, with hypertension risk increasing up to 3 cups per day and decreasing with higher intakes. The results suggest that habitual coffee consumption of >3 cups per day was not associated with an increased risk of hypertension compared with <1 cup per day; however, a slightly elevated risk appeared to be associated with light-to-moderate consumption of 1-3 cups per day35.
  • A large prospective study concluded that neither caffeinated coffee nor caffeine intake was associated with mean systolic or diastolic blood pressure, but decaffeinated coffee intake was associated with a small but clinically irrelevant decrease in mean diastolic blood pressure. Intakes of caffeinated coffee, decaffeinated coffee, and caffeine were not associated with the risk of incident hypertension. These findings suggest that caffeinated coffee, decaffeinated coffee, and caffeine are not risk factors for hypertension in postmenopausal women36.
  • A 2012 study considered the variability in the effect of caffeine intake on blood pressure, suggesting that compared with decaffeinated coffee, caffeinated coffee was associated with a significant increase in blood pressure. The authors suggested that the variability in the acute BP response to coffee may be partly explained by genetic polymorphisms of the adenosine A2A receptors and α2-adrenergic receptors37.
  • A 2017 dose–response meta-analysis of prospective cohort studies concluded that increased coffee consumption is associated with a modest decrease in risk of hypertension in prospective cohort studies. Smoking status is a potential effect modifier on the association between coffee consumption and risk of hypertension38.
  • Results from a cohort of 13,374 individuals from the Spanish SUN Project suggested an inverse association between regular coffee consumption and the risk of hypertension in women, which was strongest among women with a suboptimal food pattern, particularly a low adherence to the Mediterranean diet39.
  • A further dose-response meta-analysis suggested a significant protective effect of coffee consumption on hypertension starting from the consumption of 3 cups of coffee per day40.
  • A 2018 systematic review and data analysis, including 243,869 individuals and 58,094 incident cases of hypertension suggested that consumption of coffee was inversely associated with the risk of hypertension in a dose–response manner. The hypertension risk was reduced by 3%, 5%, 8% and 10% for 2, 4, 6, and 8 cups/day, respectively, compared with individuals with no coffee intake41.
  • Research published in 2018 reviewed associations between coffee consumption and blood pressure in relation to the incidence of a nucleotide polymorphism associated with risk of high blood pressure. The authors concluded that there was a significant interaction effect between coffee consumption and genetic risk of high blood pressure in those consuming more than 3 cups of coffee per day. This is a new area of research and further investigation is required before conclusions can be drawn42.

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