Caffeine Tolerance is Incomplete: Persistent Blood Pressure Responses in the Ambulatory Setting
Open accessAbstract
BACKGROUND: Caffeine in dietary doses is a well-established pressor agent. Tolerance to this pressor effect occurs in only about half of regular consumers in acute laboratory tests. The clinical significance of this incomplete tolerance depends on whether the pressor effect is maintained throughout the day with repeated intake. Therefore, we examined the ability of a standard dose of caffeine (250 mg x 3) to maintain a blood pressure (BP) elevation during 18 hours of ambulatory BP monitoring (ABPM) after 5 days of regular daily intake of varying background doses. METHODS: Eighty-five men and women completed a four-week double blind, crossover trial. During each week, subjects consumed capsules totaling 0, 300, or 600 mg/day of caffeine in 3 divided doses. On day 6, they consumed capsules with either 0 or 250 mg at 9:00 am and 1:00 pm, in the laboratory, and again at 6:00 pm during ABPM. Tolerance was defined as a reduction in the diastolic BP response to two challenge doses given in the lab in response to increasing daily intake. Data were analyzed using multivariate repeated measures analysis of variance. RESULTS: BP responses to caffeine above those found on placebo-placebo (P-P) week were found for both tolerance groups when caffeine was consumed after a week of receiving a placebo. However, only the low tolerance group showed increases, above those found on P-P week, after 300 mg/day in systolic/diastolic BP during the waking hours (mean +/- standard error of the mean = 2.8 +/- 1.1, P = .01/2.2 +/- 0.9, P = .02) and in systolic BP during sleep (2.3 +/- 1, P = .03). CONCLUSIONS: Persistent elevations in BP occurring on a daily basis in some habitual caffeine consumers may hold clinical significance.
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Routine caffeine use produces tolerance to its pharmacological actions, which weakens its acute hemodynamic effects.
“Regular caffeine consumption causes tolerance to its pharmacologic effects, reducing caffeine’s acute hemodynamic effects with routine consumption [43, 44].”
From Habitual preexercise caffeine supplementation prevents exercise training-induced attenuation of exercising systolic blood pressure and double product (2025) · cites this paper as [44]
The Discussion reports that five days of daily caffeine intake reduced the blood-pressure response to a caffeine challenge, supporting a weakening of that acute effect. But tolerance was incomplete and varied substantially: about half the subjects had little or no reduction in their ambulatory blood-pressure response. The claim presents tolerance as a general result of regular use without that qualification. (LLM, conf=0.86)
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- Authors
- FARAG, N., VINCENT, A., SUNG, B., WHITSETT, T., WILSON, M., & LOVALLO, W.
- Affiliations
- Oklahoma City VA Medical Center (US)
- University of Oklahoma Health Sciences Center (US)
- Kaleida Health (US)
- Corresponding author
- FARAG, N
- ORCID
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-05
- Volume
- 18
- Issue
- 5
- Pages
- 714-719
- ISSN
- 0895-7061 (ISSN-L)
- PMC
- PMC2257873
- OpenAlex
- W2073501949
- Cited by
- 29
- References
- 28
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 1 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 4 · 2014: 2
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Heart, Lung, and Blood Institute (HL-32050-S2, HL32050, T32HL007640, R01HL032050)
- National Center for Research Resources (M01 RR-14467, M01RR014467)
- 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, caffeine tolerance, blood pressure response, ambulatory blood pressure monitoring, pressor response, dose-response relationship, sleep blood pressure, hypertension
- MeSH terms
- Adult, Blood Pressure, Caffeine, Double-Blind Method, Drug Tolerance, Female, Humans, Male, Cross-Over Studies, Blood Pressure Monitoring, Ambulatory
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