Coffee and blood pressure: exciting news!

A growing number of epidemiological studies have reported the beneficial effects of habitual coffee consumption on incident cardiovascular disease (CVD), and mortality. However, the effects of coffee on arterial hypertension are still objects of active discussion mainly because of the debated effects of caffeine on blood pressure and cardiovascular system. In particular, the negative impact of caffeine would involve the whole cardiovascular system and could be responsible for an excess in the relative risk of new onset of hypertension and a worsening of blood pressure control. Recent evidence has been published excluding a significant effect of coffee consumption on hypertension development and blood pressure control in treated and untreated hypertensive supporting a protective role for the antioxidant components of coffee that may counteract the claimed negative effect of caffeine. The presence and amount of caffeine and cardio-protective chemical constituents of coffee is largely dependent on the type, production, and method of preparation and this can partially explain the divergent opinions on the effects of coffee intake on blood pressure and cardiovascular system. In addition, some genetic aspect of caffeine metabolism can contribute to the heterogeneity of published evidence while the most recent cardiovascular guidelines largely endorse coffee consumption in hypertension and CV disease. The purpose of this short review is to briefly summarise some of the recent information available in the literature on coffee and blood pressure.Key points  According to the considerable amount of observational evidence we can suggest that:  • While acute coffee administration in non-habitual users may induce a blood pressure rise, habitual coffee consumption in medium-high dosages (from 3 to 5 cups/day), has neutral or even beneficial impact on blood pressure values and the new onset of hypertension.   • The same intake significantly reduces the incidence of cardiovascular disease, as well as all-cause mortality.   • The consumption of coffee is compatible with a correct and balanced lifestyle and should therefore not be discouraged in subjects with hypertension and cardiovascular diseases.