Habitual caffeine intake and the risk of hypertension in women
Abstract
CONTEXT: Caffeine acutely increases blood pressure, but the association between habitual consumption of caffeinated beverages and incident hypertension is uncertain. OBJECTIVE: To examine the association between caffeine intake and incident hypertension in women. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study conducted in the Nurses' Health Studies (NHSs) I and II of 155,594 US women free from physician-diagnosed hypertension followed up over 12 years (1990-1991 to 2002-2003 questionnaires). Caffeine intake and possible confounders were ascertained from regularly administered questionnaires. We also tested the associations with types of caffeinated beverages. MAIN OUTCOME MEASURE: Incident physician-diagnosed hypertension. RESULTS: During follow-up, 19,541 incident cases of physician-diagnosed hypertension were reported in NHS I and 13,536 in NHS II. In both cohorts, no linear association between caffeine consumption and risk of incident hypertension was observed after multivariate adjustment (NHS I, P for trend = .29; NHS II, P for trend = .53). Using categorical analysis, an inverse U-shaped association between caffeine consumption and incident hypertension was found. Compared with participants in the lowest quintile of caffeine consumption, those in the third quintile had a 13% and 12% increased risk of hypertension, respectively (95% confidence interval in NHS I, 8%-18%; in NHS II, 6%-18%). When studying individual classes of caffeinated beverages, habitual coffee consumption was not associated with increased risk of hypertension. By contrast, consumption of cola beverages was associated with an increased risk of hypertension, independent of whether it was sugared or diet cola (P for trend <.001). CONCLUSION: No linear association between caffeine consumption and incident hypertension was found. Even though habitual coffee consumption was not associated with an increased risk of hypertension, consumption of sugared or diet cola was associated with it. Further research to elucidate the role of cola beverages in hypertension is warranted.
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The Panel notes that different types of caffeinated beverages were differently associated with risk of incident hypertension: caffeinated coffee inversely, caffeinated tea (in one cohort) and cola beverages directly.
“The Panel also notes that different types of caffeinated beverages were differently associated with the risk of incident hypertension.Whereas caffeinated (but not decaffeinated) coffee was inversely associated with the risk of hypertension, caffeinated tea (in one cohort) and cola beverages (in both cohorts) were directly associated with that risk.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
In NHS I and II, no linear association between caffeine consumption and risk of incident hypertension was observed after multivariate adjustment.
“In both cohorts, no linear association between caffeine consumption and the risk of incident hypertension was observed after multivariate adjustment.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
In NHS I and II, categorical analysis found an inverse U-shaped association between caffeine consumption and incident hypertension; compared with the lowest quintile, the third quintile had significant 14% and 15% increased risk, whereas no increased risk was observed in the highest quintile.
“Using categorical analysis, an inverse U-shaped association between caffeine consumption and incident hypertension was found.Compared with participants in the lowest quintile of caffeine consumption (mean intakes 14.8 and 19.6 mg per day), those in the third quintile (209.3 and 174.7 mg per day) had a significant 14 % and 15 % increased risk of hypertension in NHS I and NHS II, respectively,”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
The Panel notes that the NHS study shows an inverse U-shaped relationship between total caffeine intake from dietary sources and incident hypertension.
“The Panel notes that this study shows an inverse U-shaped relationship between total caffeine intake from dietary sources and incident hypertension.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
In NHS I and II, significant inverse associations between intake of caffeinated coffee and risk of hypertension were observed in both cohorts, but not with decaffeinated coffee.
“In multivariate models including beverage type, rather than actual caffeine intake, significant inverse associations between intake of caffeinated coffee (p for trend = 0.02 and 0.03 in NHS I and NHS II, respectively) and the risk of hypertension was observed in both cohorts, but an association was not found with decaffeinated coffee (p for trend = 0.08 and 0.67 in NHS I and NHS II, respectively).”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
In NHS II, caffeinated tea intake was significantly associated with incident hypertension, but not in NHS I.
“A significant association between caffeinated tea intake and incident hypertension was found in the cohort of younger women in NHS II (p for trend = 0.01), but not in NHS I (p for trend = 0.79).”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
In NHS I and II, significant positive associations between intake of sugar-containing and sugar-free caffeinated cola drinks and incident hypertension were observed in both cohorts.
“A significant positive association between the intake of sugar-containing (p for trend = 0.03 and < 0.001 in NHS I and NHS II, respectively) and sugar-free (p for trend = 0.03 and < 0.001 in NHS I and NHS II, respectively) caffeinated cola drinks and incident hypertension was observed in both cohorts.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Winkelmayer et al., 2005
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- Authors
- Winkelmayer, W. C.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2005-11-09
- Volume
- 294
- Issue
- 18
- Pages
- 2330
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2168407586
- Cited by
- 274
- References
- 20
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 10 · 2021: 7 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 17 · 2016: 7 · 2015: 14 · 2014: 15 · 2013: 23 · 2012: 19
- FWCI
- 11.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA-87969, P01CA087969, CA 050385, R01CA050385)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK052866, R01DK066574, DK66574, DK52866)
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- caffeine consumption, hypertension, women, caffeinated beverages, coffee consumption, cola beverages, Nurses' Health Study
- MeSH terms
- Caffeine, Carbonated Beverages, Coffee, Diet Surveys, Female, Health Surveys, Humans, Hypertension, Middle Aged, Risk, United States, Cohort Studies
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