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Caffeinated Coffee
Often people ask me about caffeinated coffee. There was recently
a one page article in the American Journal of Medicine in July 2009 which posed
the patient's question of, "Hey, Doc, is it OK for me to drink coffee?" They
gave a nice summary about consuming caffeinated coffee. Here is brief rendition
of their comments with a few additions of my own:
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Caffeinated coffee causes only minor or slight increases in
blood pressure in people who only occasionally drink coffee. When coffee is
drank on a routine basis the body adjusts to it rapidly and there is no
increase in blood pressure from caffeine whatsoever. Caffeinated coffee does
not cause high blood pressure. So, no more excuses about coffee raising your
blood pressure when you see me.
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Caffeinated coffee does not cause heart attacks or increase
angina pectoris in people with established coronary artery disease.
Caffeinated coffee appears to decrease the risk of developing coronary
artery disease.
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Caffeinated coffee does not cause the blood levels of total
cholesterol or LDL cholesterol (the bad stuff) to rise.
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Caffeinated coffee does not increase heart rhythm problems.
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Caffeinated coffee does not cause diabetes, worsen diabetic
control or increase the risk of diabetic complications. This of course
assumes you don't fill your cup with sugar or eat a lot of other junk with
your coffee such as cookies, candy, cake and/or doughnuts. Caffeinated
coffee may actually decrease your risk of diabetes according to one study.
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Caffeinated coffee has not been shown to increase your risk
of any particular cancer. There is also no evidence that coffee increases
the risk of breast fibrocystic disease.
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Caffeinated coffee can cause a mild to moderate disturbance
of your sleep. When you use coffee routinely you can develop tolerance to
this effect and won't notice it after a period of continuous use.
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Use of caffeinated coffee continuously will result in
tolerance to the effects of caffeine. This may result in a withdrawal
syndrome, marked headache may come on when coffee is not taken in on a
routine basis. This may happen to people who, for example, drink coffee all
week long at work, then slack off on it for the weekend.
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Caffeinated or decaffeinated coffee can cause marked
heartburn in some people, and I would be one of those people.
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I have noticed that coffee can indicate to people when they
are depressed, the coffee no longer gets them going anymore and they wonder
what's wrong.
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Caffeinated coffee or any other form of caffeine can
seriously wreck up a stress when you are being given a medicine such as
Adenosine or Lexiscan for the agent used to stress you for the test. When
ever you have a stress test please clarify this issue with me or your doctor
before the test. You will likely need to be caffeine free for 24 hours
before the test. It's a good idea to be caffeine free even if you don't
"plan" on a test using adenosine or lexiscan, you never know when there
might be a change in plan.
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Caffeinated coffee is a diuretic, it may cause you to
urinate more during the day and at night.
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You can overdose yourself with caffeine and have toxic
effects that are not very pleasant. One of my medical school professors did
this accidentally while working on a big project, he had a rather miserable
day in a hospital bed recovering.
I hope this answers the myths or realities about coffee that you
were wondering about.
Reference: American Journal of Medicine, July 2009, Joseph
S Alpert, "Hey, Doc, Is It OK for Me to Drink Coffee?"
American Journal of Medicine, Vol 124(4), 2011, DJ Pelchovitz
and JJ Goldberger, Caffeine and Cardiac Arrhythmias: A Review of the Evidence
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