Pre-Exercise Caffeine as a Modulator of Exercise-Induced Acute Cardiometabolic Responses: A Narrative Review

Caffeine is among the most widely used supplements in sports nutrition, with substantial evidence supporting its efficacy for enhancing athletic performance. However, the relevance of pre-exercise caffeine supplementation extends beyond its ergogenic effects. Exercise itself acts as an acute cardiometabolic stressor, eliciting dynamic responses in blood pressure, heart rate, vascular tone, substrate utilization, and glucose regulation. Caffeine may further modify the magnitude, temporal profile, and recovery kinetics of these responses. This focused narrative review examines the acute cardiometabolic responses associated with pre-exercise caffeine supplementation and its potential regulatory effects. It outlines the underlying biological mechanisms, including adenosine receptor antagonism, hemodynamic and vascular pathways, and metabolic and substrate-utilization pathways, while synthesizing current evidence from the literature. Available evidence indicates that the acute effects of caffeine are highly context dependent. In some exercise settings, caffeine may promote lipolysis and fat oxidation; in others, particularly among susceptible individuals or under specific exercise conditions, it may be associated with greater acute cardiovascular or autonomic load, reflected by higher peripheral vascular resistance and blood pressure, altered vascular reactivity, or delayed post-exercise autonomic recovery. Its effects may vary according to dose, timing, supplement form, exercise modality and intensity, training status, habitual caffeine intake, genotype, sex, and hormonal status. Overall, pre-exercise caffeine should not be regarded solely as a uniformly beneficial ergogenic aid, but rather as a physiological modulator that may reshape the acute cardiometabolic milieu during and after exercise. Future studies should integrate hemodynamic, vascular, metabolic, and individual-variability measures over extended observation periods to support more evidence-based and individualized guidance on the appropriate use of pre-exercise caffeine.