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Recommendations Summary

HTN: Caffeine 2008

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

  • Recommendation(s)

    HTN: Caffeine Intake

    For those who consume caffeine, advise blood pressure monitoring; while acute intake of caffeine increases blood pressure, the effect of chronic caffeine intake is unclear.

    Rating: Weak

    • Risks/Harms of Implementing This Recommendation


    • Conditions of Application

      Recommendation applies to those who consume caffeine.

    • Potential Costs Associated with Application


    • Recommendation Narrative

      • Five studies investigating acute effects of caffeine reported an increase in systolic or diastolic blood pressure at doses varying from 3.3mg per kg to fixed doses of 250-300 mg (Shepard et al, 2000; Watson et al, 2002; Vlachopoulos et al, 2003; Waring et al, 2003; Hartley et al, 2004), with one meta-analysis reporting a more pronounced blood pressure increase in hypertensive subjects as compared to healthy subjects (Hartley et al, 2000).  
      • Two studies investigated the effect of 1 week of caffeine consumption on blood pressure.  One randomized controlled trial reported that daily caffeine exposure did not mitigate the acute rise in systolic or diastolic blood pressure after single caffeine challenge (Watson et al, 2002), while a nonrandomized clinical trial reported only an increase in diastolic blood pressure which dissipated over seven days of continued caffeine consumption (Cavalcante et al, 2000).  
      • One meta-analysis of caffeine and coffee consumption for at least seven days reported a significant rise of ~2mm Hg in systolic blood pressure and ~1mm Hg in diastolic blood pressure. A greater effect was noted for caffeine supplement consumption than for coffee consumption (Noordzij et al, 2005).  

    • Recommendation Strength Rationale

      • Conclusion Statement is Grade III

    • Minority Opinions

      Consensus reached.