title: Critical review of dietary caffeine and blood pressure: a relationship that should be taken more seriously.
abstract: OBJECTIVE
  This review aims to determine whether, and to what extent, dietary caffeine may be a risk to cardiovascular health.
  
  
  METHODS
  A critical review of the relevant experimental and epidemiologic literature was conducted, with particular reference to studies of caffeine and blood pressure (BP).
  
  
  RESULTS
  There is extensive evidence that caffeine at dietary doses increases BP. However, concern that the drug may contribute to cardiovascular disease appears to have been dampened by (1) the belief that habitual use leads to the development of tolerance, and (2) confusion regarding relevant epidemiologic findings. When considered comprehensively, findings from experimental and epidemiologic studies converge to show that BP remains reactive to the pressor effects of caffeine in the diet. Overall, the impact of dietary caffeine on population BP levels is likely to be modest, probably in the region of 4/2 mm Hg. At these levels, however, population studies of BP indicate that caffeine use could account for premature deaths in the region of 14% for coronary heart disease and 20% for stroke.
  
  
  CONCLUSIONS
  Current evidence supports the conclusion that the BP-elevating effects of dietary caffeine may be contributing appreciably to population levels of cardiovascular mortality and morbidity. Accordingly, strategies for encouraging reduced dietary levels of caffeine deserve serious consideration.
authors.affiliation: Department of Psychology, National University of Ireland, Galway, Ireland. j.james@nuigalway.ie
authors.forename: Jack E
authors.initials: JE
authors.lastname: James
mesh_terms: D000241:Adenosine / Q000037:antagonists & inhibitors; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002110:Caffeine / Q000009:adverse effects / Q000494:pharmacology*; D004032:Diet; D004361:Drug Tolerance; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology; D014666:Vasomotor System / Q000187:drug effects
chemical_list: D002110:Caffeine; D000241:Adenosine