Coffee & Heart THE 2ND MOST BEVERAGE OF WORLD

Water 1st ,2nd is coffee

The most important ingredients

Coffee and Cigarette 1. The enzyme CYP1A2 is encoded in the CYP1A2 gene and is responsible for 13% of

chromosome’s P450 metabolism of caffeine in the liver

2. Postulated that high CYP1A2 activity is associated with rapid caffeine metabolism, which decreases the CVD and BP effects of coffee

3. Cigarette smoking is also an important inducer of enzyme CYP1A2 activity

4. Quitting smoking leads to rapid decreases in CYP1A2 activity, which could potentiate the protective effects of coffee. This could, perhaps, explain the lower incidence of CVD and strokes in non-smokers compared with smokers in the Nurse’s Health Study of 83,076 women after 24 years of follow-up

Mechanism for the Beneficial Effects

1. The most important are caffeine, diterpene alcohols, and chlorogenic acids

2. Tmax is 30 to 45 minutes

3. In liver, the enzyme CYP1A2 metabolises into 3 components paraxanthine, theobromine, and theophylline, with paraxanthine being the most active metabolite

4. Caffeine blocks A1 and A2a receptors of adenosine1. A1 receptor :Vasoconstriction of the afferent renal arterioles leading to decrease in glomerular

filtration rate and renal blood flow and an increase in renal sodium reabsorption2. A2a receptors :Vasodilation in most vascular beds including the efferent renal arteriole

Mechanism for the Beneficial Effects

Blockade by caffeine of the A1 receptors localized in the afferent arteriole, glomerulus,proximal tubule, and collecting ducts improves glomerular filtration rate and renal blood flow and causes diuresis and natriuresis and lowers the BP. These actions of adenosine inhibitors have been shown to improve the condition of patients with HF by improving renal function and enhancing the action of diuretics.

Mechanism for the Beneficial Effects

Besides receptors A1 and A2a, 2 more adenosine receptors, A2b and A3, with vasodilatory properties have been identified, but their significance is not clearly known. Other mechanisms by which coffee could lower the BP are through the caffeine metabolites , among which are the chlorogenic acids contained in the coffee. Chlorogenic acids are potent antioxidants and improve endothelial and vascular function through increased availability of nitric oxide

Mechanism for the Beneficial Effects

Net effect is vasodilatation and protective

Coffee & cardiovascular diseases

U shape Some studies have indicated a U shape association for the incidence of hypertension and CVDs between low coffee drinkers (0 to 1 cup/day) and high coffee drinkers (10 cups/day)

Safest dose

It appears that is 3 to 6 cups/day, which represents the greatest majority of coffee drinkers

1. Rebello SA, van Dam RM. Coffee consumption and cardiovascular health: getting to the heart of the matter. Curr Cardiol Rep 2013;15:403.

2. O’Keefe JH, Bhatti SK, Patil HR, DiNicolantonio JJ, Lucan SC, Lavie CJ. Effects of habitual coffee consumption and cardiometabolic disease, cardiovascular health, and all-cause mortality. J Am Coll Cardiol 213;62:104.

3. Liu J, Sui X, Lavie CJ, Hebert JR, Earnest CP, Zhang J, Blair SN.Association of coffee consumption with all-cause and cardiovascular disease mortality. Mayo Clin Proc 2013;88:1066e1074.

Health benefits 1. Cardiovascular protective effects2. Antihypertensive effects3. Antidiabetic4. Antioxidant actions

Coffee induced dyslipidaemia is reduced Drinking filtered instead of boiled coffee that contains the diterpenes, cafestol, and kahweol, which increase the serum cholesterol

Rebello SA, van Dam RM. Coffee consumption and cardiovascular health: getting to the heart of the matter. Curr Cardiol Rep 2013;15:403.

CONCLUSION Safe to drink 3 to 4 cups/day to have favorable health effects IN 1.Normal subjects 2.Pre-existing CVDs and hypertension