0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

The Effect of Caffeine on Exercise Tolerance and Left Ventricular Function in Patients with Coronary Artery Disease

Alan T. Hirsch, MD; Ernest V. Gervino, ScD; Shoichiro Nakao, MD; Patricia C. Come, MD; Kenneth J. Silverman, MD; and William Grossman, MD
[+] Article and Author Information

Requests for Reprints: William Grossman, MD, Cardiovascular Division, Beth Israel Hospital, 330 Brookline Avenue, Boston, MA 02215.

Current Author Addresses: Dr. Hirsch: Division of Vascular Medicine and Atherosclerosis, Brigham and Women's Hospital, Boston, MA 02115.

Drs. Gervino, Come, Silverman, and Grossman: Cardiovascular Division, Beth Israel Hospital, Boston, MA 02115.

Dr. Nakao: First Department of Internal Medicine, Kagoshima University, Kagoshima, Japan.


©1989 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1989;110(8):593-598. doi:10.7326/0003-4819-110-8-593
Text Size: A A A

Study Objective: To determine whether acute oral caffeine ingestion by patients with coronary artery disease results in decreased treadmill exercise performance or deterioration of echocardiographic measures of systolic or diastolic left ventricular function.

Design: Randomized, double-blind, placebo-controlled trial.

Setting: Referral-based cardiovascular exercise laboratory at an urban teaching hospital.

Patients: Thirteen volunteers with clinically stable coronary artery disease who had exercise tests after a 2-week caffeine-free washout period. Patients continued treatment with standard antianginal medications during the study period.

Interventions: Maximal exercise treadmill testing and exercise echocardiography were done at baseline, after acute ingestion of a placebo beverage (97% caffeine-free coffee), or after drinking an identical beverage containing 250 mg of caffeine sodium benzoate.

Measurements and Main Results: Acute ingestion of caffeine produced a serum level of 4. 50 ± 0.16 µg/mL, but had no effect on resting supine heart rate, blood pressure, left ventricular fractional shortening, posterior left ventricular wall thinning or peak rates of increase in left ventricular diastolic dimension. Despite a small increase in peak systolic blood pressure during exercise (baseline, 153 ± 8; placebo, 154 ± 8; caffeine, 161 ± 7 mm Hg; P < 0.05), exercise duration, time to onset of angina, and time to 0.1 mV ST depression did not differ after ingestion of placebo or caffeine. Rate-pressure product at onset of angina and onset of 0.1 mV of ST depression were also unchanged. In response to exercise, echocardiographic measures of left ventricular systolic and diastolic function were unchanged after caffeine compared with placebo ingestion.

Conclusions: These data suggest that patients with exercise-induced ischemia who are receiving appropriate antianginal therapy tolerate the caffeine-equivalent of three cups of coffee without detrimental effect on intensity of ischemia, myocardial function, or exercise duration.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)