Timing of Blood Pressure Measurement Related to Caffeine Consumption

Objective: To determine whether patients should wait 30 minutes after caffeine consumption to have their blood pressure measured. Data Sources: Literature was obtained by searching MEDLINE (1980–September 2007), International Pharmaceutical Abstracts (1980–September 2007), and the Cochrane Database of Systematic Reviews (1994–September 2007). Search terms included caffeine and blood pressure. Literature was also obtained from citations in relevant articles. Study Selection and Data Extraction: Articles that examined caffeine's acute effect on blood pressure were reviewed, with additional focus on caffeine tolerance and hypertensive status. Data Synthesis: Caffeine appears to affect blood pressure through adenosine receptor inhibition and an increased release of select neurotransmitters. Caffeine levels peak 30–120 minutes after oral intake and caffeine's half-life is 3–6 hours. The effect of caffeine on blood pressure has been examined for decades, with variable results depending on factors such as population examined (eg, hypertensive status, physical stressors, age) and study design (eg, acute effects, chronic ingestion, retrospective epidemiologic review). Caffeine tolerance diminishes the acute effect of caffeine on blood pressure, and hypertensive individuals are more susceptible to blood pressure changes. Reviews of caffeine's acute effect on blood pressure indicate changes of 3–15 mm Hg systolic and 4–13 mm Hg diastolic. Typically, blood pressure changes occur within 30 minutes, peak in 1–2 hours, and may persist for more than 4 hours. Conclusions: Having a patient abstain from caffeine for 30 minutes prior to blood pressure monitoring is not adequate to avoid caffeine's potential effects. An alternative approach to blood pressure monitoring would be to ask the patient about recent caffeine consumption and interpret the blood pressure reading based on this information. In addition, healthcare practitioners should provide education regarding caffeine's effects.

[1]  J. E. James.  Critical Review of Dietary Caffeine and Blood Pressure: A Relationship That Should Be Taken More Seriously , 2004, Psychosomatic medicine.

[2]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, Journal of the American Medical Association (JAMA).

[3]  Michael F. Wilson,et al.  Blood Pressure Response to Caffeine Shows Incomplete Tolerance After Short-Term Regular Consumption , 2004, Hypertension.

[4]  I. Macdonald,et al.  Blood pressure, plasma catecholamine and renin responses to caffeine in elderly hypertensives. , 1993, Journal of human hypertension.

[5]  D. Grobbee,et al.  Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials , 2005, Journal of hypertension.

[6]  Michael F. Wilson,et al.  Hypertension risk status and effect of caffeine on blood pressure. , 2000, Hypertension.

[7]  Lawrence J Appel,et al.  Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. , 2005, Hypertension.

[8]  E. Peleg,et al.  The effect of caffeine on ambulatory blood pressure in hypertensive patients. , 1998, American journal of hypertension.

[9]  M. al’Absi,et al.  Prolonged increase in blood pressure by a single oral dose of caffeine in mildly hypertensive men. , 1994, American journal of hypertension.

[10]  R. Korpela,et al.  Coffee, caffeine and blood pressure: a critical review , 1999, European Journal of Clinical Nutrition.

[11]  Brian McCrindle,et al.  Recommendations for blood pressure measurement in human and experimental animals; part 1: blood pressure measurement in humans. , 2006, Hypertension.

[12]  J. Suls,et al.  The effects of caffeine on ambulatory blood pressure, heart rate, and mood in coffee drinkers , 1996, Journal of Behavioral Medicine.

[13]  Daniel W. Jones,et al.  Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. , 2003, Hypertension.

[14]  W. Lovallo,et al.  Acute blood pressure elevations with caffeine in men with borderline systemic hypertension. , 1996, The American journal of cardiology.

[15]  M. Myers.  Effect of caffeine on blood pressure beyond the laboratory. , 2004, Hypertension.

[16]  Michael F. Wilson,et al.  Caffeine tolerance is incomplete: persistent blood pressure responses in the ambulatory setting. , 2005, American journal of hypertension.