Caffeine effects on several indices of cardiovascular activity at rest and during stress

Controlling for caffeine in cardiovascular research: A critical review

Caffeine, the most widely consumed drug in the world, exerts numerous effects on cardiovascular activity. Thus, it is important and advisable to control for caffeine consumption in studies examining caffeine and/or cardiovascular activity and reactivity. This paper 1) reviews the literature concerning caffeine's effects on cardiovascular parameters; 2) summarizes the widely varying protocols used to control for the drug in extant cardiovascular literature, and 3) provide guidelines for caffeine control procedures to minimize potentially confounding acute and withdrawal effects of the drug. An abstention period equal to the average half-life of the drug is recommended for creation of methodological controls for caffeine. Additional methodological recommendations are described concerning factors that moderate the half-life of caffeine. When feasible, researchers should consider and aim to control for caffeine's acute and extended psychophysiological effects. This understudied issue has fundamental implications for caffeine-related investigations and research in psychophysiology and behavioral medicine.

Cardiovascular hemodynamic effects of Red Bull® Energy Drink during prolonged, simulated, monotonous driving

Purpose

The purpose of this study was to investigate the cardiovascular hemodynamic effects of Red Bull® Energy Drink during prolonged, simulated, monotonous driving.

Methods

This was a double-blind, within-subjects-design, crossover study. Twelve healthy volunteers (21.7 ± 0.8 years old) experienced each of three conditions at various times: 1) consumption of Red Bull® Energy Drink; 2) consumption of placebo-controlled drink; and 3) no test drink. All subjects undertook 90-min periods of simulated monotonous driving, during which physiological measurements were made. The variables recorded were cardiovascular indices, i.e., mean blood pressure (MBP), cardiac output (CO), electrocardiogram RR interval (RR), total peripheral-vascular resistance (TPR: = MBP/CO), and normalized pulse volume (NPV). Additional parameters were the standard deviation of lateral position, i.e., the weaving of the car, and subjective rating of sleepiness.

Results

CO, RR, and TPR during the monotonous task were significantly different in those consuming the energy drink as compared with those receiving the placebo and as compared with no drink values. The energy drink elicited a cardiac-dominant reaction pattern, while the other conditions demonstrated the vascular-dominant reaction pattern typically observed in monotonous driving tasks. The observed differences indicate the cardiovascular system being more aroused with the energy drink.

Conclusion

The effects of Red Bull® Energy Drink were reflected in cardiovascular hemodynamic phenomena especially to the heart function, and we conclude that consumption of this drink before long-distance driving in non-sleepy drivers could facilitate more physiologically active, and possibly safer, driving.

Caffeine and blood pressure response: sex, age, and hormonal status

PURPOSE

The pressor effect of caffeine has been established in young men and premenopausal women. The effect of caffeine on blood pressure (BP) remains unknown in postmenopausal women and in relation to hormone replacement therapy (HRT) use.

MATERIALS AND METHODS

In a randomized, 2-week cross-over design, we studied 165 healthy men and women in 6 groups: men and premenopausal women (35-49 yrs) vs. men and postmenopausal women (50-64 yrs), with postmenopausal women divided into those taking no hormone replacements (HR), estrogen alone, or estrogen and progesterone. Testing during one week of the study involved 6 days of caffeine maintenance at home (80 mg, 3x/day) followed by testing of responses to a challenge dose of caffeine (250 mg) in the laboratory. The other week involved ingesting placebos on maintenance and lab days. Resting BP responses to caffeine were measured at baseline and at 45 to 60 min following caffeine vs placebo ingestion, using automated monitors.

RESULTS

Ingestion of caffeine resulted in a significant increase in systolic BP in all 6 groups (4 +/- .6, p < 0.01). Diastolic BP significantly increased in response to caffeine in all (3 +/- .4, p < 0.04) but the group of older men (2 +/- 1.0, p = 0.1). The observed pressor responses to caffeine did not vary by age.

CONCLUSIONS

Caffeine resulted in an increase in BP in healthy, normotensive, young and older men and women. This finding warrants the consideration of caffeine in the lifestyle interventions recommended for BP control across the age span.

Caffeine tolerance is incomplete: persistent blood pressure responses in the ambulatory setting

BACKGROUND

Caffeine in dietary doses is a well-established pressor agent. Tolerance to this pressor effect occurs in only about half of regular consumers in acute laboratory tests. The clinical significance of this incomplete tolerance depends on whether the pressor effect is maintained throughout the day with repeated intake. Therefore, we examined the ability of a standard dose of caffeine (250 mg x 3) to maintain a blood pressure (BP) elevation during 18 hours of ambulatory BP monitoring (ABPM) after 5 days of regular daily intake of varying background doses.

METHODS

Eighty-five men and women completed a four-week double blind, crossover trial. During each week, subjects consumed capsules totaling 0, 300, or 600 mg/day of caffeine in 3 divided doses. On day 6, they consumed capsules with either 0 or 250 mg at 9:00 am and 1:00 pm, in the laboratory, and again at 6:00 pm during ABPM. Tolerance was defined as a reduction in the diastolic BP response to two challenge doses given in the lab in response to increasing daily intake. Data were analyzed using multivariate repeated measures analysis of variance.

RESULTS

BP responses to caffeine above those found on placebo-placebo (P-P) week were found for both tolerance groups when caffeine was consumed after a week of receiving a placebo. However, only the low tolerance group showed increases, above those found on P-P week, after 300 mg/day in systolic/diastolic BP during the waking hours (mean +/- standard error of the mean = 2.8 +/- 1.1, P = .01/2.2 +/- 0.9, P = .02) and in systolic BP during sleep (2.3 +/- 1, P = .03).

CONCLUSIONS

Persistent elevations in BP occurring on a daily basis in some habitual caffeine consumers may hold clinical significance.

On-site training in applied muscle tension to reduce vasovagal reactions to blood donation

Vasovagal reactions significantly complicate the blood collection process and, more importantly, discourage people who might otherwise donate blood many times from returning. Applied muscle tension is a simple behavioral technique that may reduce vasovagal reactions by maintaining blood pressure. It has been successfully used to treat patients with blood and injury phobias, but has not been applied in the more general, time-limited context of blood collection clinics. Thirty-seven inexperienced blood donors (maximum number of prior donations = 2) attending mobile blood collection clinics were asked to practice applied tension after watching a 2-min instructional video presented on a notebook computer. They were compared with 94 untreated donors with similar donation experience and 47 more experienced blood donors. Treatment reduced the number of symptoms reported on a postdonation questionnaire. It also significantly reduced the amount of medical treatment required (chair reclining) among those who practiced applied tension for the entire period they were in the donation chair.

Breakfast cereal and caffeinated coffee: effects on working memory, attention, mood, and cardiovascular function

This study examined the effects of breakfast cereal and caffeinated coffee on working memory, attention, mood, and cardiovascular function. One hundred and forty-four volunteers (72 male, 72 female, mean age 21 years) were assigned to one of the groups formed by combining breakfast (cereal versus no breakfast) and caffeine (caffeinated versus decaffeinated coffee) conditions. The volunteers completed a baseline session between 0800 and 0845 h. The breakfast/caffeine administration took place between 0845 and 0915 h. They then completed another test session (starting at 0945) and had a coffee break at 1045, followed by a final session starting at 1145. The results showed that those who consumed breakfast cereal had a more positive mood at the start of the test sessions, performed better on a spatial memory task, and felt calmer at the end of the test session than those in the no breakfast condition. Ingestion of caffeine had no effect on initial mood or working memory, but it did improve encoding of new information and counteracted the fatigue that developed over the test session. Caffeine increased blood pressure and pulse rate, whereas breakfast cereal consumption only had an effect on pulse. Overall, these results confirm previous findings on the effects of breakfast and caffeine, and demonstrate distinct profiles for two common examples of early-morning food and drink, breakfast cereal and caffeinated coffee.

Caffeine raises blood pressure at work

OBJECTIVE

The study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate during workday activities.

METHODS

Healthy, nonsmoking, habitual coffee drinkers (N = 21) received daily doses of 100 mg and 500 mg of caffeine on 2 days in a crossover design. Treatment order was random and counterbalanced, and administration was double-blind. Ambulatory monitoring was conducted for 6 to 9 hours during normal workday activities and diary entries were completed at each measurement. Ambulatory data were analyzed for the effects of caffeine dose, controlling for variations in posture, physical activity, and perceived stress.

RESULTS

The average workday blood pressure and heart rate were significantly higher when the higher dose of caffeine was consumed. Controlling for other factors, dose-related differences were 4 mm Hg for systolic and 3 mm Hg for diastolic blood pressure, and were 3 bpm for heart rate.

CONCLUSIONS

Results support earlier evidence that caffeine raises blood pressure at work, and demonstrate that these pressor effects are independent of changes in posture, physical activity, or stress. Daily blood pressure increases associated with caffeine consumption could increase the risk of developing cardiovascular diseases. In addition, caffeine consumption effects might confound ambulatory investigations of the cardiovascular effects of other psychosocial, personality, or health-behavior factors.

The effects of caffeine on ambulatory blood pressure, heart rate, and mood in coffee drinkers

The present study examined the effects of caffeine, as typically ingested through coffee, on ambulatory systolic and diastolic blood pressure (BP), heart rate, and mood. Normotensive coffee drinkers wore a BP monitor for two 24-hr periods, consuming decaffeinated coffee. Each cup was supplemented with 125 mg caffeine or cornstarch. Systolic and diastolic BPs were elevated on the day caffeine was consumed (maximum, 3.6 and 5.6 mm Hg, respectively), most notably shortly after ingestion. Heart rate was higher overnight following caffeine consumption. Negative Affectivity was also increased by caffeine, but Positive Affectivity and tiredness were unaffected.

Illustrating caffeine's pharmacological and expectancy effects utilizing a balanced placebo design

Caffeine consumption, a ubiquitous cultural phenomenon with significant health implications may be governed by some of the same principles which affect other drug use [1]. We hypothesized that pharmacological and expectancy effects may be two of those principles. A balanced placebo design was used with 100 male undergraduates to separate caffeine's active drug effects from the expectancy of having consumed caffeine on mood, performance, and physiological measures. The manipulation of expectancies was highly effective on subjects' judgments of caffeine dosage, regardless of actual caffeine content. As predicted, expectancy set and caffeine content appeared equally powerful, and worked additively, to affect subjects' ratings of how much the coffee influenced their mood and performance. Main effects on systolic and diastolic blood pressure, pulse rate, and a fatigue measure were found for caffeine vs. no caffeine groups only. Additional increases in diastolic blood pressure for smokers were noted within the caffeine-receiving conditions. Results are discussed with heuristic and health implications.

Effects of caffeine deprivation on complex human functioning

Twenty-five managers who reported an average daily caffeine consumption of 575 mg participated in two complex simulations. A double-blind cross-over design was employed to assess the effects of normal caffeine consumption versus caffeine deprivation upon seven validated measures of managerial effectiveness. Data from a Caffeine Withdrawal Questionnaire indicated discomfort upon deprivation. Systolic blood pressure increased during "normal" caffeine consumption levels but fell quickly and remained lower during deprivation. Several measures of managerial performance indicated decreased effectiveness upon caffeine deprivation. In contrast to prior research from simpler task settings, cognitive effectiveness (during complex task performance) was diminished. However, a measure of strategic performance which requires a relatively high level of cognitive effort showed no impact of caffeine deprivation.

Acute dose-effect relationships of caffeine and mental performance, EEG, cardiovascular and subjective parameters

The present study investigated the dose-effect relationship of caffeine on mental performance using a caffeine-sensitive rapid information processing task (RIP) in a pre/post cross-over design. Twenty female nonsmoking regular coffee drinkers received 0, 1.5, 3 and 6 mg/kg caffeine in a balanced order and the measurements were extended to cardiovascular, EEG and mood parameters. Surprisingly, the dose-effect curves for the different parameters were rather heterogeneous. Whereas increasing effects with increasing caffeine doses were observed for alpha- and beta-EEG frequencies, anxiety, wakefulness, and some coffee ratings, negative dose-effect relationships were obtained for RIP processing rate and blood pressure. No apparent dose-effect relationships were seen for reaction time and motor activity. Thus, it was concluded that the dose-response relationships are rather shallow and heterogeneous and that the different parameters have different ranges in which they are sensitive to caffeine. The caffeine doses which might have beneficial behavioral effects are at the lower end of the tested dose range and comparable to those found in caffeine-containing beverages.

Cardiovascular responses to the combination of caffeine and mental arithmetic, cold pressor, and static exercise stressors

The present study examined cardiovascular responses to the combination of caffeine (250mg) and mental arithmetic, cold pressor, and static exercise stressors in 48 healthy males. Subjects were tested in a within-subject, placebo-controlled, double-blind design. Repeated measurements of heart rate, finger temperature, respiratory sinus arrhythmia, forearm blood flow, and blood pressure were obtained during a pre-drug resting baseline, a post-drug resting baseline, the three stressor tasks, and a recovery baseline. The primary analyses were 2(Drug) x 5(Period) x 6(Stress Order) MANCOVAs using pre-drug baseline values as covariates. Significant period main effects were observed for all measures. Significant drug main effects were observed for blood pressure, finger temperature, respiratory sinus arrhythmia, and forearm blood flow. The significant changes in blood pressure and finger temperature produced by caffeine combined in an additive fashion with the effects produced by the stressors. Significantly greater increases in forearm blood flow and heart rate during mental arithmetic on the caffeine day suggested a potentiation of sympathetic, beta-adrenergic activity. Questionnaires administered during baseline periods to assess psychological responses to stress and caffeine revealed a potentiation of anxiety and anger responses to stress on the caffeine day.

Caffeine and novelty: effects on electrodermal activity and performance

Caffeine has been shown to affect both physiological functioning and certain aspects of performance. These effects are typically attributed to a simple increase in general arousal. The present study was based on the theory that the effects of caffeine are actually multidimensional. Specifically, we hypothesized that the drug raises arousal, acts to maintain elevated arousal under conditions otherwise conductive to habituation, and enhances the impact of situational and psychological sources of arousal. Subjects were given caffeine (300 mg) or placebo and white noise or no noise and exposed to a series of pure tones and two Backwards Recall Tasks, one novel, the other repetitive. Electrodermal activity (EDA) and task performance were recorded. Caffeine increased arousal as measured by EDA. It also acted to slow habituation during repetitive stimulation, thus maintaining heightened arousal. Finally, it enhanced the effects of novel stimulation, which also independently raised arousal. These results support a multidimensional theory of caffeine effects and provide some understanding of the popularity of caffeine as a psychotropic agent.