JAHA: Patients with severe hypertension should drink coffee with caution!

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JAHA: Patients with severe hypertension should drink coffee with caution!

Scientists find that coffee consumption of more than 2 cups per day in patients with grade 2-3 hypertension is associated with a 105% increased risk of death from cardiovascular disease.

In the general population, drinking coffee is associated with a reduction in the incidence and mortality of hypertension, but in the hypertensive population, the benefit of coffee on blood pressure appears to be greater than that of the hypertensive population because caffeine intake causes an acute response to increased blood pressure. Depends on the drinker’s blood pressure level [1].

Therefore, what blood pressure level is beneficial to drinking coffee, and what blood pressure level should be cautious when drinking coffee?

Dr. Hiroyasu Iso of the Department of Social Medicine, Osaka University School of Medicine, and his team compared the relationship between coffee or green tea consumption and the risk of cardiovascular disease death in the Japanese population under different blood pressure stratifications. The study was published in JAHA [2].

This prospective study analysis of nearly 20,000 people showed that compared with non-coffee drinkers, patients with grade 2-3 hypertension (systolic blood pressure ≥ 160mmHg, diastolic blood pressure ≥ 100mmHg) consumed more than 2 cups of coffee per day, which was associated with heart disease. A 105% increase in the risk of death from vascular disease was associated , but if coffee consumption was less than 2 cups/day, it might be associated with a lower risk of death from cardiovascular disease .

This is the first study to find a positive association between high coffee consumption and the risk of death from cardiovascular disease in patients with severe hypertension .

JAHA: Patients with severe hypertension should drink coffee with caution!

The research data come from the Japan Cancer Risk Assessment Cooperative Cohort Study (JACC), which is a large, nationwide, community-based prospective study.

After excluding patients who reported stroke, coronary heart disease, and cancer at baseline, a total of 28,609 participants were included in the final analysis, including 6,574 men and 12,035 women, aged 40-79 years.

Participants were divided into 4 groups according to blood pressure levels, divided into optimal and normal blood pressure (systolic blood pressure 130mmHg, diastolic blood pressure 85mmHg), normal high blood pressure (systolic blood pressure 130-139mmHg, or diastolic blood pressure 85-89mmHg), grade 1 high Blood pressure (systolic blood pressure 140-150mmHg, or diastolic blood pressure 90-99mmHg), grade 2-3 hypertension (systolic blood pressure ≥ 160mmHg, or diastolic blood pressure ≥ 100mmHg).

Participants’ coffee consumption was classified as occasional or never, <1 cup, 1 cup, or ≥2 cups per day.

The results of the analysis showed that people who drink coffee regularly may be younger, but have poorer lifestyle habits, smoke and drink alcohol, do not like vegetables, have higher total cholesterol levels, and have lower systolic blood pressure regardless of blood pressure levels.

A total of 824 cardiovascular disease deaths were recorded during a median follow-up of 18.9 years.

Among patients with grade 2-3 hypertension, coffee consumption of ≥2 cups per day was associated with a 105% increased risk of death from cardiovascular disease (95% CI, 1.17-3.59) compared with no coffee drinkers.

If the patient’s coffee intake is low, such as <1 cup/day, it is associated with a 2% reduction in the risk of death from cardiovascular disease (95% CI, 0.67-1.43); 1 cup/day is associated with a 26% reduction in the risk of death from cardiovascular disease Related ((95% CI, 0.37-1.46).

Among participants with other blood pressure levels, there was no significant association between coffee consumption and the risk of death from cardiovascular disease .

Previous studies have proved that coffee contains many cardiovascular beneficial components, which can reduce serum cholesterol levels and improve endothelial function [3].

According to the researchers’ analysis, these beneficial ingredients are likely to offset each other to a certain extent with the negative effects of caffeine (that is, a transient increase in blood pressure) .

Patients with high blood pressure are more susceptible to the effects of caffeine, and the beneficial ingredients cannot offset it.

But then again, doesn’t green tea also contain caffeine? Why haven’t I heard someone say that after drinking green tea, “heart palpitations”?

The researchers also analyzed the relationship between green tea consumption and the risk of death from cardiovascular disease.

It was found that although green tea lovers may be older, unemployed, smokers, and less fond of fruit, regardless of blood pressure levels and green tea intake, green tea intake was not associated with an increased risk of cardiovascular disease death , even drinking 5 -6 cups of green tea, also irrelevant.

This may be understood to mean that the beneficial compounds in green tea counteract the negative effects of caffeine better than those in coffee, the researchers said . This may be mediated by epigallocatechin-3-gallate, the most abundant polyphenol in green tea.

As a prospective study, this study minimized recall bias; cardiovascular disease deaths were more frequent in hypertensive populations, which facilitated assessment of the effect of coffee and green tea intake.

Of course, there are also problems in the study, such as relatively simple consumption assessment, and it is difficult to exclude residual confounding factors and unmeasured factors.

In general, patients with severe hypertension should avoid drinking a lot of coffee. The effect of coffee and green tea on patients with high blood pressure needs more research to confirm.

Singularity,,,

references:
[1]Mostofsky E, Schlaug G, Mukamal KJ, et al. Coffee and acute ischemic stroke onset: the Stroke Onset Study[J]. Neurology, 2010, 75(18): 1583-1588.
[2]Teramoto M, Yamagishi K, Muraki I, et al. Coffee and Green Tea Consumption and Cardiovascular Disease Mortality Among People With and Without Hypertension[J]. Journal of the American Heart Association, 2022: e026477.
[3]Lopez-Garcia E, van Dam RM, Qi L, Hu FB. Coffee consumption and markers of inflammation and endothelial dysfunction in healthy and diabetic women. Am J Clin Nutr. 2006;84:888–893. doi: 10.1093/ ajcn/84.4.888

JAHA: Patients with severe hypertension should drink coffee with caution!

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