Efeitos agudos da ingestão de café sobre a pressão arterial e função endotelial em indivíduos hipertensos em tratamento medicamentoso

Abstract

Systemic arterial hypertension (SAH) is the main cause of cardiovascular disease (CVD) in the world and adequate control of blood pressure (BP) can reduce cardiovascular risk in hypertensive patients. Coffee, despite being rich in caffeine, a substance with an acute pressor effect, also has chlorogenic acids (ACGs) that can help reduce BP. Currently, the acute effects of coffee on BP and endothelial function in hypertensive patients have not been established. The aim of this study was to evaluate the acute effects of coffee intake on vascular function in hypertensive patients under drug treatment and with habitual coffee intake. A randomized, controlled, crossover clinical trial was carried out with hypertensive patients aged 40-65 years with habitual coffee intake. Participants underwent 3 intervention visits, 1 week apart, in which they randomly drank one of 3 beverages: caffeinated espresso coffee (CC) (61.42 mg ACGs; 135mg caffeine), decaffeinated espresso coffee (DC) (68.07 mg ACGs; 5 mg caffeine) and water. Peripheral BP was continuously assessed for 15 minutes before and for 90 minutes after drinking the beverages by digital photoplethysmography (Finometer Pro). Before and 90 minutes after drinking the beverages, central hemodynamic parameters were assessed by applanation tonometry (SphygmoCor) and endothelial function was assessed by peripheral arterial tonometry (PAT) using the Endo-PAT2000® equipment. The ANOVA test for repeated measures was used to assess intra- and inter-beverarages changes. Sixteen participants were included and 14 completed the study, being included in statistical analyses, presenting 58±6 years old, 50% men. The effects of the 3 beverages on peripheral BP and heart rate were not significantly different, with an increase in BP (mmHg) that was significant after CC (10±4/7±2) and CD (8±4/7±2) and not significant after water (6±4/4±2). Aortic systolic BP (mmHg) increased (p<0.01) after CC (19±3), CD (15±4) and water (13±3), with no significant difference between beverages. Changes in aortic pulse pressure (PP) and augmentation pressure (AP) were not significantly different between beverages, with elevation (p<0.01) in aortic PP after the 3 drinks and in AP after CC and water. The increment index (AIx; %) and AIx@75 (%) increased significantly only after CC ingestion (10±3 and 9±3, respectively), with a difference (p<0.01) between the 3 drinks, being higher after CC compared to CD. Endothelial function, evaluated by the reactive hyperemia index (RHI), presented a significant reduction after CC and CD, but there was no significant difference between the 3 beverages. In conclusion, CC compared to CD and water did not promote a more accentuated increase in BP (peripheral and central) nor a more accentuated impairment in endothelial function, despite increasing pulse wave reflection in hypertensive patients under drug treatment with habitual coffee intake.