Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections

Vlachopoulos, Charalambos; Kosmopoulou, Foteini; Panagiotakos, Demosthenes B.; Ioakeimidis, N.; Alexopoulos, Nikolaos; Pitsavos, Christos; Stefanadis, Christodoulos

doi:10.1016/j.jacc.2004.07.049

Cited by 131 publications

(110 citation statements)

References 36 publications

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“…This study extends the findings of our previous studies that showed that caffeine increases acutely aortic stiffness and wave reflections both in normotensive and hypertensive patients (Vlachopoulos et al, 2001(Vlachopoulos et al, , 2003a(Vlachopoulos et al, , b, 2004a, and that chronic coffee consumption is associated with increased aortic stiffness and wave reflections in healthy normotensive subjects without cardiovascular risk factors, except from smoking (Vlachopoulos et al, 2004a(Vlachopoulos et al, , 2005a. Interestingly, the findings of the present study are not a direct extrapolation of the findings in normotensive subjects, because, contrary to those, only wave reflections are affected, indicating a different behaviour of large and small arteries in hypertension.…”

Section: Discussionsupporting

confidence: 90%

“…The chronic effect of coffee consumption on arterial elastic properties is less well studied. As we have previously shown, coffee consumption has a chronic detrimental effect on aortic stiffness and wave reflections in normotensive subjects (Vlachopoulos et al, 2004a(Vlachopoulos et al, , 2005a. However, the association between chronic coffee consumption, and arterial stiffness and wave reflections in hypertensives, that is, a population with already impaired elastic properties, has not been examined yet.…”

Section: Introductionmentioning

confidence: 93%

“…Hypertension is associated with increased aortic stiffness and enhanced wave reflections; furthermore, increased aortic stiffness and enhanced wave reflections are implicated in the pathogenesis of systolic hypertension (Stefanadis et al, 1997;Nichols and O'Rourke, 1998;Vlachopoulos and O'Rourke, 2000). On the other hand, it has been shown that caffeine exerts an acute detrimental effect on aortic stiffness and wave reflections both in normotensive and in hypertensive subjects (Vlachopoulos et al, 2001(Vlachopoulos et al, , 2003a(Vlachopoulos et al, , 2003b(Vlachopoulos et al, , 2004aMahmud and Feely, 2001;Karatzis et al, 2005). The chronic effect of coffee consumption on arterial elastic properties is less well studied.…”

Section: Introductionmentioning

confidence: 99%

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Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients

Alexopoulos

et al. 2006

Eur J Clin Nutr

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Objective: Aortic stiffness and wave reflections are important markers and prognosticators of cardiovascular risk. Caffeine increases acutely aortic stiffness and wave reflections. Furthermore, chronic coffee consumption is associated with increased aortic stiffness and wave reflections in normotensive subjects. In the present study, we aimed to assess the association between chronic coffee consumption, and aortic stiffness and wave reflections in hypertensive patients. Design: Epidemiological survey. Setting: Hypertension Unit, University Hospital. Subjects-methods: We examined 259 never-treated hypertensives (age 50712 years, 165 males) without diabetes mellitus, who were asked to describe in detail the type and amount of coffee they consumed. Carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) were measured non-invasively as indices of aortic stiffness and wave reflections, respectively. Results: When controlled for gender, age, height, smoking status, heart rate, mean pressure, HDL cholesterol and hsCRP, AIx was found to be higher with increasing daily coffee consumption. Post hoc analysis revealed that all groups of coffee consumption had higher AIx compared to no-consumption. PWV did not differ among groups of daily coffee consumption. Each participant had 35% higher relative risk of having high AIx for each cup (150 ml) of coffee per day, and 40% higher relative risk for each 10 cup-years. Conclusions: Coffee consumption is associated with increased wave reflections, but not aortic stiffness in never-treated hypertensive patients. This finding may have important clinical implications for cardiovascular health in hypertensive subjects. Sponsorship: None.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients

Alexopoulos

et al. 2006

Eur J Clin Nutr

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“…Caffeine levels peak 30-120 min after oral intake and caffeine's half-life is 3-6 h. Caffeine tolerance diminishes the acute effect of caffeine on BP, and hypertensive individuals are more susceptible to BP changes with caffeine administration and/or intake. 10 Various components, including cigarette smoking and caffeine, are being increasingly investigated for the possible impact on arterial stiffness (AS) and wave reflection and on cardiovascular risk. 11,12 Caffeine consumption is a risk factor for heart failure, but its effects remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Coffee, nutritional status, and renal artery resistive index

et al. 2010

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Background: The relationship between nutrition and atherosclerosis is known, even dissociated from protein malnutrition. Cardiovascular impact of several nutrients is known; among them the action of coffee is still debated and cardiovascular effect of caffeine has been investigated without definite results. Objective: The aim of this study is to investigate whether coffee habits, and/or quantity of coffee consumption, have any relationship with renal resistive index (RRI), a hallmark of arterial stiffness (AS). The relationship of AS with nutritional status assessed by body composition and serum albumin, insulin resistance (assessed by HOMA), and renal function assessed by glomerular filtration rate (GFR) is concurrently investigated. Methods: This study was done with 221 consecutive patients, without diabetes, cancer, liver, renal, and heart disease, referred for clinical noninvasive assessment and nutritional counseling: 124 essential hypertensive and 97 nonhypertensive patients were eligible. Personalized Mediterranean diet, physical activity increase, and smoking withdrawal counseling were provided. Results: By multiple linear regression, fat-free mass (FFM), HOMA (positive relationship), and number of cups of coffee/day (negative relationship) account for 17.2% of the variance to RRI. By odds ratios lower risk to increased RRI is associated with higher serum albumin, higher hemoglobin, and FFM; greater risk is associated with hypertension, insulin resistance (HOMA ≥ 3.0), and renal insufficiency (GFR ≤ 90); coffee, assessed by number of cups/day, reduces risk. Conclusion: Coffee use is inversely associated with RRI. Habitual coffee users have risk protection to higher RRI; lower serum albumin, insulin resistance, and renal insufficiency are associated with greater RRI.

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“…1,2 However, systolic BP (SBP) and, pulse pressure are amplified from the ascending aorta to the brachial artery where BP is traditionally measured. The magnitude of pressure amplification may vary and is influenced by several demographic variables including age, gender and height, 3 as well as clinical and physiological factors such as hypercholesterolemia, 4 recreational stimulants, 5 vasoactive medications, 6 mean arterial pressure, 3 heart rate, 7 exercise 8 and posture. 9 Thus, brachial cuff measures of BP may not reliably estimate central SBP and pulse pressure.…”

Section: Introductionmentioning

confidence: 99%

Central blood pressure measurement may improve risk stratification

et al. 2008

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Central systolic blood pressure (SBP) may differ between individuals with similar brachial SBP, which may have implications for risk assessment. This study aimed to determine the variation and potential clinical value of central SBP between patients with similar brachial SBP. Brachial SBP was measured by sphygmomanometer and central SBP by radial tonometry in 675 people (430 men), comprising healthy individuals (n ¼ 222), patients with known or suspected coronary artery disease (n ¼ 229) and diabetes (n ¼ 224). Individuals were stratified by brachial SBP in accordance with European Society of Hypertension guidelines (optimal, normal, high-normal, grades 1, 2 and 3 hypertension). The potential clinical value of central SBP was determined from the percentage of patients re-classified into different brachial SBP groups due to the difference between brachial and aortic SBP (defined as brachial SBP-central SBP). Central SBP increased with each brachial SBP level (optimal to grade 3 hypertension; Po0.001 for all). However, large variation in brachialaortic SBP difference occurred within each brachial SBP group (range 2-33 mm Hg), resulting in sizeable overlap of central SBP between brachial SBP groups. For patients with normal brachial SBP, 96% had central SBP within the range of patients with high-normal brachial SBP, as well as 64% within the range of patients with grade 1 hypertension. We conclude that wide variation in brachial-aortic SBP difference occurs between patients with similar brachial SBP. This results in a significant overlap of central SBP scores between brachial SBP risk groups. This is likely to have treatment implications but remains to be tested.

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Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections

Abstract: The present study shows, for the first time, that when smoking and caffeine intake are combined, they interact and exert a synergistic, unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis.

Cited by 131 publications

References 36 publications

Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients

Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients

Coffee, nutritional status, and renal artery resistive index

Central blood pressure measurement may improve risk stratification

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