Cardiovascular effects of caffeine and caffeinated beverages
- Elsa-Grace Giardina, MD, MS, FACC, FACP, FAHA
Elsa-Grace Giardina, MD, MS, FACC, FACP, FAHA
- Professor of Medicine
- Director, Center for Women’s Health
- Columbia University Medical Center
- Section Editor
- Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
- Editor-in-Chief — Cardiovascular Medicine
- Section Editor — Coronary Heart Disease; Myopericardial Disease
- Professor of Medicine
- Mayo Clinic College of Medicine
- Deputy Editors
- Howard Libman, MD, FACP
Howard Libman, MD, FACP
- Deputy Editor — Primary Care (Adult)
- Professor of Medicine, Emeritus
- Harvard Medical School
- Gordon M Saperia, MD, FACC
Gordon M Saperia, MD, FACC
- Senior Deputy Editor — UpToDate
- Deputy Editor — Cardiovascular Medicine
- Assistant Professor of Medicine
- Tufts University School of Medicine
Consumed in coffee, tea, and soft drinks, caffeine is the most widely used pharmacologically active substance in the world. Exposure to caffeine is generally of long duration, virtually throughout the life of most consumers, and the prevalence of exposure is very high (more than 80 percent) in most countries. The main sources of caffeine and the amount found in typical sources in the United States are listed in a table (table 1).
The effects of caffeine on the cardiovascular system are the subject of this review. Non-cardiovascular effects of caffeine are discussed in detail elsewhere. (See "Benefits and risks of caffeine and caffeinated beverages".)
ACTIVE INGREDIENTS IN COFFEE
This topic focuses on the cardiovascular effects of caffeine. Most of the relevant studies of chronic caffeine ingestion have been performed in coffee drinkers. While coffee contains other compounds such as chlorogenic acid, potassium, magnesium, niacin and lignans, we are not aware of evidence to suggest that these compounds influence cardiovascular outcomes in the amounts consumed by coffee drinkers. (See "Benefits and risks of caffeine and caffeinated beverages", section on 'Active components and metabolism'.)
Caffeine is absorbed after oral, rectal, or parenteral administration, and maximal concentration is achieved in one hour . Oral bioavailability is almost 100 percent; food slows the rate of absorption but does not limit the extent. Any effects on the cardiovascular system should return to baseline after about 10 and 60 hours, as the half-life is 2 to 12 hours . (See 'Effects on the cardiovascular system' below.)
The apparent volume of distribution is between 0.4 and 0.6 L/kg, and less than 40 percent is bound to plasma proteins. Caffeine is distributed into all body compartments; it crosses the placenta and passes into breast milk.
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