Coffee may impair blood pressure control

Diet and lifestyle are foundational to blood pressure management, but clinical guidelines do not make any recommendations specific to caffeine or coffee consumption

Hypertension affects approximately 30% of adults in affluent countries, such as the United States and Spain.

Hypertension becomes increasingly difficult to control with age, resulting in less than half of treated patients over the age of 60 achieving adequate blood pressure control.

Clinical trials demonstrate transient rises in blood pressure after coffee consumption, but the relationship between habitual coffee intake and blood pressure has not been established.

To evaluate the association between habitual coffee consumption and blood pressure control in hypertensive patients, researchers in Spain assessed data from a cross-sectional study of 1164 individuals aged 63 or older (the ENRICA study).

Of the 715 participants who were hypertensive, 85% were coffee drinkers. Those who drank three or more cups of coffee per day had significantly higher 24h systolic and diastolic blood pressures than those who did not drink coffee.

When compared with non-coffee drinkers, the odds ratios for uncontrolled blood pressure among hypertensive patients were 1.95 for those consuming 1 cup/day; 1.41 for those consuming 2 cups/day; and 2.55 for those consuming 3 cups/day.

It is unclear from these data whether heavy coffee consumption poses much more risk than moderate coffee consumption. Coffee consumption of any amount appears to put the hypertensive patient at about two times the risk for uncontrolled blood pressure. Researchers conclude that in elderly patients with uncontrolled hypertension, it is reasonable to ask about coffee intake and reduce habitual consumption.