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Cardiovascular effects of caffeine and caffeinated beverages

Author
Elsa-Grace Giardina, MD, MS, FACC, FACP, FAHA
Section Editor
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Deputy Editors
Howard Libman, MD, FACP
Gordon M Saperia, MD, FACC

INTRODUCTION

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, and the prevalence of exposure is very high (>80 percent) in most countries. The main sources of caffeine and the amount found in each are summarized in the table (table 1). Coffee and tea average 100 mg of caffeine per serving, colas about 50 mg per serving, and “energy drinks” as much as 250 mg per serving.

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'.)

PHARMACOKINETICS

Caffeine is absorbed after oral, rectal, or parenteral administration, and maximal concentration is achieved in one hour [1]. 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 [2]. (See 'Cardiovascular effects' 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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Literature review current through: Nov 2017. | This topic last updated: Oct 19, 2017.
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