Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections
Open accessAbstract
Objectives We investigated the acute and chronic combined effect of cigarette smoking and caffeine intake on aortic stiffness and wave reflections.Background We have shown that smoking and caffeine separately increase arterial stiffness. Aortic stiffness and wave reflections are important determinants of the efficient performance of the cardiovascular system and prognosticators of cardiovascular risk.Methods The acute effects of smoking (one cigarette), caffeine (200 mg, equivalent to 2 cups of coffee), and smoking plus caffeine were studied in 24 healthy subjects according to a randomized, placebo- and sham procedure-controlled crossover design. The chronic effect of smoking and caffeine was studied in a population study that enrolled 160 healthy subjects.Results Acute study: there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity (p < 0.01) and augmentation index (p < 0.05). When smoking followed caffeine intake, pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4%, respectively, reaching a total of 0.85 m/s and 17.4%, 0.17 m/s and 9.2% in excess of the mere sum of caffeine effect (0.33 m/s and 4%) alone and smoking effect alone (0.35 m/s and 4.2%). Population study: there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity (p < 0.05) and augmentation index (p = 0.001).Conclusions The present study shows, for the first time, that when smoking and caffeine intake are combined, they interact and exert a synergistic, unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis.
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Written from the paper’s full text.
TL;DR
In healthy adults, combined caffeine and smoking produced acute synergistic worsening of aortic stiffness and wave reflections beyond the sum of their individual effects. A chronic population study also found significant interactions between coffee drinking and smoking on pulse-wave velocity, augmentation index, augmented pressure, and subendocardial viability index.
Key findings
- Acute study: significant caffeine–smoking interaction for pulse-wave velocity (p < 0.01) and heart-rate-corrected augmentation index (p < 0.05). When smoking followed caffeine, pulse-wave velocity increased further by 0.52 m/s to a total of 0.85 m/s, 0.17 m/s above the sum of caffeine alone (0.33 m/s) and smoking alone (0.35 m/s); augmentation index increased further by 13.4% to 17.4%, 9.2% above the sum of caffeine alone (4%) and smoking alone (4.2%).
- Acute central pressures also showed significant interaction: smoking after caffeine increased central systolic, diastolic, and pulse pressures further by 7.5, 4.4, and 3.1 mm Hg, reaching peak increases of 16.4, 11.7, and 4.7 mm Hg, respectively. Ejection duration decreased further by 16.2 ms to −16.6 ms, 11.7 ms less than the sum of individual effects; subendocardial viability index interaction was p < 0.001.
- Population study: among 160 subjects, chronic coffee consumption and smoking interacted significantly for pulse-wave velocity (p < 0.05), augmentation index (p = 0.001), augmented pressure (p < 0.005), and subendocardial viability index (p = 0.001). Table values showed pulse-wave velocity 6.36 m/s in coffee drinkers/smokers, 6.31 m/s in coffee drinkers/nonsmokers, and 5.80 m/s in neither (p = 0.05); augmentation index 22.7%, 21.7%, and 11.0% (p = 0.001); subendocardial viability index 145.0%, 140.8%, and 156.1% (p = 0.005).
- No effect of gender was found on any of the significant interactions.
Methods
- Acute study: randomized, placebo- and sham procedure-controlled crossover design in 24 healthy current smokers and regular caffeine consumers (>100 mg/day). Four sessions were smoking one standard cigarette (1.1 mg nicotine) over 5 min, sham smoking, caffeine 200 mg plus smoking 60 min later, and placebo plus sham smoking. Aortic stiffness was studied in 14 subjects (7 women, 7 men; age 30 ± 2 years) and wave reflections in 10 subjects (5 women, 5 men; age 33 ± 3 years).
- Population study: 160 clinically healthy employees (79% participation rate) were grouped as 97 chronic smokers and coffee drinkers, 41 chronic coffee drinkers and nonsmokers, 2 chronic smokers but not coffee drinkers (data not shown), and 20 neither coffee consumers nor smokers. Measurements were taken in the morning after an overnight fast.
- Main measures/analysis: carotid–femoral pulse-wave velocity (Complior) and augmentation index, augmented pressure, and subendocardial viability index (SphygmoCor). Multi-way analysis of covariance for repeated measurements was used, with adjustments for mean pressure, heart rate, age, and gender; Bonferroni correction was applied. Power calculation indicated 160 participants provided >0.80 power at p < 0.05.
Limitations
- Stated: the study refers to young, apparently healthy adults, and results might not be directly extendable to other population groups. The basic mechanism responsible for the interactive effect is unclear.
- Stated/evident: the population groups differed significantly in age (p = 0.001), although analyses were age-adjusted; the chronic population study is cross-sectional and cannot establish causality.
- Evident: the acute study sample was small (24 total; 14 and 10 in the two measurement groups), and all acute participants were current smokers and regular caffeine consumers, limiting generalizability.
Model-written summary. Check it against the paper before relying on it.
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Cites
Statistics
Claims the paper makes
0 of 39 cited sources checked · 0 supported · 0 flagged
- Findingown data
In the population study, there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity (p < 0.05).
“Population study: there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity (p Ͻ 0.05)”
- Also stated in: § Population study. · hedged
“Furthermore, a significant interaction was observed between chronic smoking and coffee consumption on pulse-wave velocity (p Ͻ 0.05), indicating a synergistic effect of the two habits.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Also stated in: § Population study. · hedged
- Findingown data
In the population study, there was a significant interaction of chronic coffee consumption and smoking regarding augmentation index (p = 0.001).
“and augmentation index (p ϭ 0.001)”
- Also stated in: § Population study. · plain
“In addition, a significant interaction was observed between chronic smoking and coffee consumption on the augmentation index and augmented pressure (p ϭ 0.001 and p Ͻ 0.005, respectively) after correction for height and HR.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Also stated in: § Population study. · plain
- Findingown data
In the acute study, there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity (p < 0.01).
“there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity (p Ͻ 0.01)”
- Also stated in: § Acute study. · plain
“There was a significant interaction (p Ͻ 0.01) between caffeine and smoking regarding pulse-wave velocity, indicating a synergistic effect of the two interventions leading to a significant deterioration in aortic stiffness.”
Quote in the paperSubstantial claim- Rests on an assumption: The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
- Also stated in: § Acute study. · plain
- Findingown data
In the acute study, there was a significant interaction between caffeine and smoking with regard to augmentation index (p < 0.05).
“and augmentation index (p Ͻ 0.05)”
- Also stated in: § 2, diamonds). · plain
“There was a significant interaction (p Ͻ 0.05) between caffeine and smoking with regard to augmentation index corrected for changes in HR, indicating a synergistic effect of the two interventions leading to a significant increase in wave reflections.”
Quote in the paperSubstantial claim- Rests on an assumption: The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
- Also stated in: § 2, diamonds). · plain
- Findingreasoning
The increase in aortic stiffness when smoking was added to caffeine was proportionally larger than the respective increase in blood pressure.
“This is also corroborated by the fact that the increase in the aortic stiffness when smoking was added to caffeine was proportionally larger than the respective increase in blood pressure.”
Quote in the paperSubstantial claim
- Findingown data
In the population study, there was a significant interaction between chronic smoking and coffee consumption on augmentation index (p = 0.001) after correction for height and heart rate.
“In addition, a significant interaction was observed between chronic smoking and coffee consumption on the augmentation index and augmented pressure (p ϭ 0.001 and p Ͻ 0.005, respectively) after correction for height and HR.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Findingown data
In the population study, there was no effect of gender on any of the interactions.
“There was no effect of gender on any of these interactions.”
Quote in the paperNot a substantial claim - Findingown data
In the population study, there was a significant interaction between chronic smoking and coffee consumption on subendocardial viability index (p = 0.001) after correction for heart rate.
“Furthermore, a significant interaction was observed between chronic smoking and coffee consumption on the subendocardial viability index (p ϭ 0.001) after correction for HR.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Findingown data
In the population study, coffee consumers/nonsmokers and coffee consumers/smokers had increased pulse wave velocity levels compared with non-coffee consumers/nonsmokers (p < 0.05 for both).
“Coffee consumers/nonsmokers, as well as coffee consumers/smokers, had increased pulse wave velocity levels compared with non-coffee consumers/nonsmokers (p Ͻ 0.05 for both).”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Findingown data
In the population study, there was a significant interaction between chronic smoking and coffee consumption on augmented pressure (p < 0.005) after correction for height and heart rate.
“In addition, a significant interaction was observed between chronic smoking and coffee consumption on the augmentation index and augmented pressure (p ϭ 0.001 and p Ͻ 0.005, respectively) after correction for height and HR.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Findingown data
In the acute study, there was no effect of gender on any of the significant interactions.
“There was no effect of gender on any of the significant interactions.”
Quote in the paperNot a substantial claim - Findingown data
In the population study, the interaction between chronic smoking and coffee consumption on pulse-wave velocity remained significant after correction for mean pressure.
“The interaction was still significant (p Ͻ 0.05) after correction for mean pressure.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Interpretationown data
When smoking and caffeine intake are combined, they interact and exert a synergistic, unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis.
“The present study shows, for the first time, that when smoking and caffeine intake are combined, they interact and exert a synergistic, unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis.”
- Also stated in: § DISCUSSION · hedged
“The present study is the first, to the best of our knowledge, to show that when smoking and caffeine consumption are combined they have both an acute and chronic detrimental effect on arterial stiffness and wave reflections, which, most importantly, is synergistic.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
- Rests on an assumption: The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
- Also stated in: § DISCUSSION · hedged
- Premisecitation
Smoking and caffeine have an unfavorable interaction on blood pressure and cardiovascular risk.
“Studies have shown that smoking and caffeine have an unfavorable interaction on blood pressure and cardiovascular risk (20 -23).”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [20] Freestone, 1982, Effect of coffee and cigarette smoking on the blood pressure of untreated and diuretic treated hypertensive patients, Am J Med source
Not checked in the free run.
- cites [21] Narkiewicz, 1995, Interactive effect of cigarettes and coffee on daytime systolic blood pressure in patients with mild essential hypertension, J Hypertens source
Not checked in the free run.
- cites [22] Freestone, 1995, Effect of coffee and cigarette smoking on the blood pressure of patients with accelerated (malignant) hypertension, J Hum Hypertens
Not checked in the free run.
- cites [23] D'Avanzo, 1993, Coffee consumption and risk of acute myocardial infarction in Italian males, Ann Epidemiol source
Not checked in the free run.
- Interpretationown data
The present study provides an explanatory mechanism for previous investigations in which combined cigarette smoking and coffee consumption were shown to have an acute unfavorable synergistic effect on blood pressure.
“Accordingly, our study provides an explanatory mechanism for the results of previous investigations in which combined cigarette smoking and coffee consumption were shown to have an acute unfavorable synergistic effect on blood pressure (20,22).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [20] Freestone, 1982, Effect of coffee and cigarette smoking on the blood pressure of untreated and diuretic treated hypertensive patients, Am J Med source
Not checked in the free run.
- cites [22] Freestone, 1995, Effect of coffee and cigarette smoking on the blood pressure of patients with accelerated (malignant) hypertension, J Hum Hypertens
Not checked in the free run.
- Interpretationown data
The interaction between caffeine and smoking remained significant after adjustment for changes in mean pressure, indicating the contribution of an active effect on the intrinsic properties of the aorta.
“Furthermore, the fact that interaction between caffeine and smoking remained significant after adjustment for changes in mean pressure indicates the contribution of an active effect on the intrinsic properties of the aorta.”
Quote in the paperSubstantial claim - Premisecitation
Habitual cigarette and coffee consumption increase the risk of acute myocardial infarction.
“Furthermore, case-control studies have shown that habitual cigarette and coffee consumption increase systolic blood pressure (21) and the risk of acute myocardial infarction (23).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] D'Avanzo, 1993, Coffee consumption and risk of acute myocardial infarction in Italian males, Ann Epidemiol source
Not checked in the free run.
- Premisecitation
Habitual cigarette and coffee consumption increase systolic blood pressure.
“Furthermore, case-control studies have shown that habitual cigarette and coffee consumption increase systolic blood pressure (21) and the risk of acute myocardial infarction (23).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Narkiewicz, 1995, Interactive effect of cigarettes and coffee on daytime systolic blood pressure in patients with mild essential hypertension, J Hypertens source
Not checked in the free run.
- Study design and conductown data
There were no differences in baseline characteristics between the four study sessions in the aortic stiffness and pulse-wave analysis groups.
“There were no differences in all baseline characteristics between the four study sessions in aortic stiffness and pulse-wave analysis groups (Tables 1 and 2).”
Quote in the paperSubstantial claim - Premisecitation
Smoking has a direct, pressure-independent effect on the aortic wall.
“However, using appropriate high-fidelity methodology we have shown previously that smoking has a direct, pressure-independent effect on the aortic wall (13,14).”
Quote in the paperSubstantial claim0 of 2 sources checked
- May combine two claims. 9
- Classified as probably not a substantial claim. 11
May combine two claims.
Findingown dataWhen smoking followed caffeine intake, augmentation index increased further by 13.4%, reaching a total increase of 17.4%, which is 9.2% in excess of the sum of the caffeine effect alone (4%) and the smoking effect alone (4.2%).
“When smoking followed caffeine intake, pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4%, respectively, reaching a total of 0.85 m/s and 17.4%, 0.17 m/s and 9.2% in excess of the mere sum of caffeine effect (0.33 m/s and 4%) alone and smoking effect alone (0.35 m/s and 4.2%).”
- Also stated in: § 2, diamonds). · plain
“When smoking followed caffeine intake, the augmentation index increased to 17.4%, 9.2% in excess of the mere sum of caffeine effect (4%) alone and smoking effect alone (4.2%) (Fig. 3, diamonds).”
Quote in the paperSubstantial claim- Rests on an assumption: The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
- Also stated in: § 2, diamonds). · plain
May combine two claims.
Findingown dataWhen smoking followed caffeine intake, pulse-wave velocity increased further by 0.52 m/s, reaching a total increase of 0.85 m/s, which is 0.17 m/s in excess of the sum of the caffeine effect alone (0.33 m/s) and the smoking effect alone (0.35 m/s).
“When smoking followed caffeine intake, pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4%, respectively, reaching a total of 0.85 m/s and 17.4%, 0.17 m/s and 9.2% in excess of the mere sum of caffeine effect (0.33 m/s and 4%) alone and smoking effect alone (0.35 m/s and 4.2%).”
- Also stated in: § DISCUSSION · plain
“When smoking followed caffeine intake, pulse wave velocity reached a total increase of 0.85 m/s, 0.17 m/s in excess of the mere sum of caffeine effect (0.33 m/s) alone and smoking effect alone (0.35 m/s) (Fig.”
Quote in the paperSubstantial claim- Rests on an assumption: The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
- Also stated in: § DISCUSSION · plain
May combine two claims.
Findingown dataIn the population study, coffee consumers/nonsmokers and coffee consumers/smokers had lower subendocardial viability index levels compared with non-coffee consumers/nonsmokers (p < 0.005 and p < 0.05, respectively) after correction for heart rate.
“Coffee consumers/nonsmokers, as well as coffee consumers/smokers, had lower subendocardial viability index levels compared with non-coffee consumers/nonsmokers (p Ͻ 0.005 and p Ͻ 0.05, respectively) after correction for HR.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
May combine two claims.
Findingown dataIn the population study, there were significant interactions between chronic smoking and coffee consumption regarding peripheral diastolic pressure, peripheral and central mean pressure, central systolic pressure, and central diastolic pressure (p < 0.05), whereas central pulse pressure showed a marginal trend (p = 0.07).
“Significant interactions between chronic smoking and coffee consumption were also observed regarding peripheral diastolic pressure (p Ͻ 0.05), peripheral and central mean pressure (p Ͻ 0.05), central systolic pressure (p Ͻ 0.05), and central diastolic pressure (p Ͻ 0.05), whereas central pulse pressure showed a marginal trend (p ϭ 0.07).”
Quote in the paperSubstantial claim- Rests on an assumption: The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationLarge-artery stiffness and wave reflections have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk.
“Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”
Quote in the paperSubstantial claim0 of 9 sources checked- cites [4] Nichols, 1998
Not checked in the free run.
- cites [5] Vlachopoulos, 2000, Genesis of the normal and abnormal arterial pulse, Curr Probl Cardiol source
Not checked in the free run.
- cites [6] Kelly, 1992, Effect of reduced aortic compliance in cardiac efficiency and contractile function of in situ canine left ventricle, Circ Res source
Not checked in the free run.
- cites [7] Watanabe, 1993, Coronary circulation in dogs with an experimental decrease in aortic compliance, J Am Coll Cardiol source
Not checked in the free run.
- cites [8] Blacher, 1999, Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients, Hypertension source
Not checked in the free run.
- cites [9] Stefanadis, 2000, Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease, Eur Heart J source
Not checked in the free run.
- cites [10] Laurent, 2001, Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients, Hypertension source
Not checked in the free run.
- cites [11] London, 2001, Arterial wave reflections and survival in end-stage renal failure, Hypertension source
Not checked in the free run.
- cites [12] Weber, 2004, Arterial stiffness, wave reflections, and the risk of coronary artery disease, Circulation source
Not checked in the free run.
May combine two claims.
PremisecitationActive and passive smoking and caffeine separately increase arterial stiffness and wave reflections.
“We and others have previously shown that active and passive smoking (13)(14)(15) and caffeine (16 -19) increase arterial stiffness and wave reflections.”
Quote in the paperSubstantial claim0 of 5 sources checked- cites (13)(14)(15)
Not checked in the free run.
- cites [16] Vlachopoulos, 2001, Pressure-altering agents affect central aortic pressures more than is apparent from upper limb measurements in hypertensive patients: the role of arterial wave reflections, Hypertension source
Not checked in the free run.
- cites [17] Vlachopoulos, 2003, Caffeine increases aortic stiffness in hypertensive patients, Am J Hypertens source
Not checked in the free run.
- cites [18] Vlachopoulos, 2003, Effect of caffeine on aortic elastic properties and wave reflection, J Hypertens source
Not checked in the free run.
- cites [19] Mahmud, 2001, Acute effect of caffeine on arterial stiffness and aortic pressure waveform, Hypertension source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationLarge-artery stiffness and wave reflections are important determinants of left ventricular function, coronary blood flow, and mechanical integrity of arteries.
“Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”
Quote in the paperSubstantial claim0 of 9 sources checked- cites [4] Nichols, 1998
Not checked in the free run.
- cites [5] Vlachopoulos, 2000, Genesis of the normal and abnormal arterial pulse, Curr Probl Cardiol source
Not checked in the free run.
- cites [6] Kelly, 1992, Effect of reduced aortic compliance in cardiac efficiency and contractile function of in situ canine left ventricle, Circ Res source
Not checked in the free run.
- cites [7] Watanabe, 1993, Coronary circulation in dogs with an experimental decrease in aortic compliance, J Am Coll Cardiol source
Not checked in the free run.
- cites [8] Blacher, 1999, Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients, Hypertension source
Not checked in the free run.
- cites [9] Stefanadis, 2000, Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease, Eur Heart J source
Not checked in the free run.
- cites [10] Laurent, 2001, Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients, Hypertension source
Not checked in the free run.
- cites [11] London, 2001, Arterial wave reflections and survival in end-stage renal failure, Hypertension source
Not checked in the free run.
- cites [12] Weber, 2004, Arterial stiffness, wave reflections, and the risk of coronary artery disease, Circulation source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductcitationAugmentation index was measured using a validated, commercially available system (SphygmoCor).
“The augmentation index was measured by using a validated, commercially available system (SphygmoCor; AtCor Medical, Sydney, Australia) that employs the principle of applanation tonometry and appropriate acquisition and analysis software for noninvasive recording and analysis of the arterial pulse.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [4] Nichols, 1998
Not checked in the free run.
- cites [27] Karamanoglu, 1993, An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man, Eur Heart J source
Not checked in the free run.
- cites [28] Chen, 1997, Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure, Circulation source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductcitationAugmentation index was corrected for changes in heart rate.
“Because the augmentation index is influenced by changes in heart rate (HR), it was also accordingly corrected (26).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [26] Cameron, 1998, Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension, J Am Coll Cardiol source
Not checked in the free run.
May combine two claims.
Interpretationown dataNeither smoking nor caffeine exhausts the capacity of the vessel's elastic properties to deteriorate; there is room for further deterioration when a harmful intervention is added.
“Another interesting interpretation of the results of our study is that neither stimulus”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningGiven the frequent combination of smoking and caffeine intake, the effects on arterial function may have important implications for human health.
“Consequently, given the frequent combination of smoking and caffeine intake, these effects on arterial function may have important implications for human health.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductcitationPulse-wave velocity was measured using a validated noninvasive device (Complior).
“using a validated noninvasive device (Complior; Artech Medical, Pantin, France) that allows online pulse-wave recording and automatic calculation of pulse-wave velocity (25).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25] Asmar, 1995, Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies, Hypertension source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningBonferroni correction was used to account for multiple comparisons.
“However, because of multiple comparisons, we used the Bonferroni correction in order to account for the increase in type I error.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductown dataStatistical analysis adjusted for mean pressure and heart rate in multivariate regression models.
“To take into account the potential effect of pressure changes on pulse-wave velocity and of HR changes on subendocardial viability index, we adjusted in multivariate regression models for mean pressure and HR, respectively.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationnone givenThe study's results refer to young, apparently healthy adults and might not be directly extendable to other population groups.
“Our study refers to young, apparently healthy adults, and results might not be directly extendable to other population groups.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationWave reflection indices may be influenced by changes in heart rate and by height, and subendocardial viability index by changes in heart rate.
“Wave reflection indices may be influenced by changes in HR and by height and subendocardial viability index by changes in HR.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [26] Cameron, 1998, Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension, J Am Coll Cardiol source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe acute study used a randomized, placebo-and sham procedure-controlled crossover design.
“The study was carried out using a randomized placebo-and sham procedurecontrolled crossover design.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductown dataThe population study analyses were adjusted for age and gender.
“The involvement of the interaction between chronic coffee intake and smoking on the investigated parameters was evaluated using multi-way analysis of covariance after adjusting for age and gender.”
- Also stated in: § Population study. · plain
“Because the age of the participants differed significantly in the groups of the study, all the analyses carried out were age-adjusted.”
Quote in the paperSubstantial claim- Also stated in: § Population study. · plain
The paper relies on this without support.
The observed associations between chronic smoking/coffee consumption and arterial stiffness are not due to unmeasured confounding.
“The involvement of the interaction between chronic coffee intake and smoking on the investigated parameters was evaluated using multi-way analysis of covariance after adjusting for age and gender.”
The paper relies on this without support.
The acute effects of smoking and caffeine on arterial stiffness are not affected by carryover effects between the four study sessions.
“Each subject was studied fasting on four separate days before and after 1) smoking one standard cigarette (1.1 mg nicotine) over 5 min, 2) sham smoking, 3) caffeine intake (200 mg, a dose equivalent to 2 cups of coffee) plus smoking one standard cigarette (1.1 mg nicotine) 60 min after caffeine intake, and 4) placebo (to caffeine) and sham smoking 60 min after placebo intake.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence from experimental studies indicates that coffee acutely increases circulating concentrations of (nor)epinephrine, raises systolic and diastolic blood pressure, increases arterial stiffness, and impairs endothelium-dependent vasodilation.
“Evidence from experimental studies indicates that coffee acutely increases circulating concentrations of (nor)epinephrine, 2 raises systolic and diastolic blood pressure, 3 increases arterial stiffness, 5,6 and impairs endothelium-dependent vasodilation.7”
From Coffee and acute ischemic stroke onset: The Stroke Onset Study (2010) · cites this paper as [5]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Pulse pressure does not match systolic minus diastolic pressure in the smoking session
MinorIn Table 2's smoking session, peripheral systolic pressure minus diastolic pressure is 50.4 mm Hg, not the reported pulse pressure of 51.2 mm Hg.
Reported 51.2 · recomputed 50.4
“| Peripheral SP (mm Hg) | 120.4 Ϯ 2.5 | 118.4 Ϯ 2.4 | 119.4 Ϯ 2.9 | 122.3 Ϯ 2.5 | NS | | Peripheral DP (mm Hg) | 70.3 Ϯ 1.4 | 70.2 Ϯ 2.4 | 69.0 Ϯ 2.5 | 68.2 Ϯ 1.4 | NS | | Peripheral PP (mm Hg) | 50.2 Ϯ 1.9 | 48.1 Ϯ 1.9 | 51.2 Ϯ 2.3 | 53.3 Ϯ 1.3 | NS |”
Cites
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Cigarette smoking among adults — United States, 1988
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McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles
Vlachopoulos, C., O'Rourke, M., & Nichols, W. W. (2011) · doi:10.1201/b13568 · Cited by 1,613 · see citing works
Self-citationAortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients
Blacher, J., Asmar, R., Djane, S., London, G. M., & Safar, M. E. (1999) · Hypertension · doi:10.1161/01.hyp.33.5.1111 · Cited by 1,493 · see citing works
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Clinical applications of arterial stiffness; definitions and reference values
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Self-citationArterial stiffness, wave reflections, and the risk of coronary artery disease
Weber, T., Auer, J., O’Rourke, M. F., Kvas, E., Lassnig, E., Berent, R., & Eber, B. (2004) · Circulation · doi:10.1161/01.cir.0000105767.94169.e3 · Cited by 1,081 · see citing works
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Arterial wave reflections and survival in end-stage renal failure
London, G. M., Blacher, J., Pannier, B., Guérin, A. P., Marchais, S. J., & Safar, M. E. (2001) · Hypertension · doi:10.1161/01.hyp.38.3.434 · Cited by 853 · see citing works
Experimental Subendocardial Ischemia in Dogs with Normal Coronary Arteries
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Central Pulse Pressure and Mortality in End-Stage Renal Disease
Safar, M. E., Blacher, J., Pannier, B., Guérin, A. P., Marchais, S. J., Guyonvarc’h, P.-M., & London, G. M. (2002) · Hypertension · doi:10.1161/hy0202.098325 · Cited by 800 · see citing works
Effects of Caffeine on Plasma Renin Activity, Catecholamines and Blood Pressure
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Coronary circulation in dogs with an experimental decrease in aortic compliance
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McDonaldʼs Blood Flow in Arteries
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Self-citationAcute Effect of Caffeine on Arterial Stiffness and Aortic Pressure Waveform
Mahmud, A., & Feely, J. (2001) · Hypertension · doi:10.1161/01.hyp.38.2.227 · Cited by 192 · see citing works
Coffee consumption and the incidence of coronary heart disease.
LaCroix, A. Z., Mead, L. A., Liang, K.-Y., Thomas, C. B., & Pearson, T. A. (1986) · New England Journal of Medicine · doi:10.1056/nejm198610163151601 · Cited by 183 · see citing works
Unfavorable effect of smoking on the elastic properties of the human aorta
Stefanadis, C., Tsiamis, E., Vlachopoulos, C., Stratos, C., Toutouzas, K., Pitsavos, C., Marakas, S., Boudoulas, H., & Toutouzas, P. (1997) · Circulation · doi:10.1161/01.cir.95.1.31 · Cited by 177 · see citing works
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“Because the augmentation index is influenced by changes in heart rate (HR), it was also accordingly corrected ( 26 ).”
BackgroundMethodUnfavorable effects of passive smoking on aortic function in men
Stefanadis, C., Vlachopoulos, C., Tsiamis, E., Diamantopoulos, L., Toutouzas, K., Giatrakos, N., Vaina, S., Tsekoura, D., & Toutouzas, P. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-6-199803150-00002 · Cited by 132 · see citing works
Evidence for an Antagonism Between Caffeine and Adenosine in the Human Cardiovascular System
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Genesis of the normal and abnormal arterial pulse
Vlachopoulos, C., & O'Rourke, M. (2000) · Current Problems in Cardiology · doi:10.1067/mcd.2000.104057 · Cited by 125 · see citing works
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Vlachopoulos, C., Hirata, K., & O’Rourke, M. F. (2001) · Hypertension · doi:10.1161/hy1201.098767 · Cited by 102 · see citing works
Self-citationEffect of Caffeine on Aortic Elastic Properties and Wave Reflection
Vlachopoulos, C., Hirata, K., & O'Rourke, M. F. (2003) · Journal of Hypertension · doi:10.1097/00004872-200303000-00022 · Cited by 79 · see citing works
Self-citationCigar smoking has an acute detrimental effect on arterial stiffness
Vlachopoulos, C. (2004) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2003.12.014 · Cited by 76 · see citing works
Self-citationNarkiewicz, K., Maraglino, G., Biasion, T., Rossi, G., Sanzuol, F., & Palatini, P. (1995) · Journal of Hypertension · doi:10.1097/00004872-199509000-00005 · Cited by 74 · see citing works
Caffeine increases aortic stiffness in hypertensive patients
Vlachopoulos, C. (2003) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)03155-2 · Cited by 55 · see citing works
Self-citationDiastolic pressure, systolic pressure, or pulse pressure?
Vlachopoulos, C., & O’Rourke, M. F. (2000) · Current Hypertension Reports · doi:10.1007/s11906-000-0010-6 · Cited by 53 · see citing works
Self-citationFreestone, S. H., Yeo, W. W., & Ramsay, L. E. (1995) · PubMed · Cited by 24 · see citing works
Coffee consumption and risk of acute myocardial infarction in Italian males
D'Avanzo, B., La Vecchia, C., Tognoni, G., Franceschi, S., Grazia Franzosi, M., Nobili, A., Santoro, L., & Scarsi, G. (1993) · Annals of Epidemiology · doi:10.1016/1047-2797(93)90081-e · Cited by 16 · see citing works
HYPOTHESES. Coffee, catecholamines and cardiac arrhythmia
Wennmalm, Å., & Wennmalm, M. (1989) · Clinical Physiology · doi:10.1111/j.1475-097x.1989.tb00972.x · Cited by 14 · see citing works
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Mechanical Factors in Arterial Aging
O’Rourke, M. F., & Hashimoto, J. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.12.050 · Cited by 1,245 · see citing works
Vlachopoulos, C., Dima, I., Aznaouridis, K., Vasiliadou, C., Ioakeimidis, N., Aggeli, C., Toutouza, M., & Stefanadis, C. (2005) · Circulation · doi:10.1161/circulationaha.105.535435 · Cited by 492 · see citing works
Self-citationThe impact of coffee on health
Cano-Marquina, A., Tarín, J. J., & Cano, A. (2013) · Maturitas · doi:10.1016/j.maturitas.2013.02.002 · Cited by 332 · see citing works
“Similar results were found by other groups, when investigatng coffee alone [36] or its synergy with smoking [37].”
BackgroundResultCoffee Consumption and Coronary Heart Disease in Men and Women: A Prospective Cohort Study
Lopez-Garcia, E., van Dam, R. M., Willett, W. C., Rimm, E. B., Manson, J. E., Stampfer, M. J., Rexrode, K. M., & Hu, F. B. (2006) · Circulation · doi:10.1161/circulationaha.105.598664 · Cited by 215 · see citing works
Electronic Cigarette Smoking Increases Aortic Stiffness and Blood Pressure in Young Smokers
Vlachopoulos, C. V., Ioakeimidis, N., Abdelrasoul, M., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.03.569 · Cited by 186 · see citing works
“The transapical-based procedure with this valve has been described previously (1).”
BackgroundMethodSelf-citationFranzen, K. F., Willig, J., Talavera, S. C., et al. (2018) · Vascular Medicine · doi:10.1177/1358863x18779694 · Cited by 182 · see citing works
Acute and long-term cardiovascular effects of coffee: Implications for coronary heart disease
Riksen, N. P., Rongen, G. A. P. J. M., & Smits, P. (2008) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2008.10.006 · Cited by 166 · see citing works
“Vlachopoulos et al. have shown in two cross-sectional studies that coffee consumption is associated with an increased augmentation index of the aortic pressure waveform and with an increased pulse wave velocity in healthy subjects (Vlachopoulos et al., 2004, 2005).”
BackgroundLong‐term follow‐up of DYT1 dystonia patients treated by deep brain stimulation: An open‐label study
Cif, L., Vasques, X., González, V., Ravel, P., Biolsi, B., Collod‐Béroud, G., Tuffery‐Giraud, S., Fertit, H. E., Claustres, M., & Coubes, P. A. (2010) · Movement Disorders · doi:10.1002/mds.22802 · Cited by 157 · see citing works
Davies, J. E., Whinnett, Z. I., Francis, D. P., Willson, K., Foale, R. A., Malik, I. S., Hughes, A. D., Parker, K. H., & Mayet, J. (2005) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00751.2005 · Cited by 154 · see citing works
“Similarly, subjects were required to abstain from coffee (34) and alcohol (33) for 12 h before the study.”
BackgroundPharmacological Modulation of Arterial Stiffness
Boutouyrie, P., Lacolley, P. J., Briet, M. B., Regnault, V., Stanton, A. V., Laurent, S., & Mahmud, A. (2011) · Drugs · doi:10.2165/11593790-000000000-00000 · Cited by 147 · see citing works
Rhee, M., NA, S., Kim, Y. H., LEE, M., & Kim, H. (2007) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2006.12.017 · Cited by 132 · see citing works
The acute effect of green tea consumption on endothelial function in healthy individuals
Alexopoulos, N. A., Vlachopoulos, C. V., Aznaouridis, K. A., Baou, K., Vasiliadou, C., Pietri, P., Xaplanteris, P., Stefanadi, E., & Stefanadis, C. (2008) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e3282f4832f · Cited by 131 · see citing works
Self-citationRourke, M. F. O., & Adji, A. I. (2005) · Current Opinion in Cardiology · doi:10.1097/01.hco.0000166595.44711.6f · Cited by 122 · see citing works
Pietri, P. G., Vyssoulis, G. P., Vlachopoulos, C. V., Zervoudaki, A., Gialernios, T. P., Aznaouridis, K. A., & Stefanadis, C. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000249701.49854.21 · Cited by 118 · see citing works
Self-citationThe effect of chronic tobacco smoking on arterial stiffness
Rehill, N., Beck, C., Yeo, K. R., et al. (2006) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2006.02630.x · Cited by 117 · see citing works
Ethnic Differences in Arterial Wave Reflections and Normative Equations for Augmentation Index
Chirinos, J. A., Kips, J. G., Roman, M. J., Medina‐Lezama, J., Li, Y., Woodiwiss, A. J., Norton, G. R., Yasmin, Y., Bortel, L. M. V., Wang, J., et al. (2011) · Hypertension · doi:10.1161/hypertensionaha.110.166348 · Cited by 114 · see citing works
Acute Mental Stress Has a Prolonged Unfavorable Effect on Arterial Stiffness and Wave Reflections
Vlachopoulos, C. V., Kosmopoulou, F., Alexopoulos, N. A., Ioakeimidis, N., Siasos, G., & Stefanadis, C. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000203171.33348.72 · Cited by 109 · see citing works
Self-citationHepatic and Cardiovascular Consequences of Familial Hypobetalipoproteinemia
Sankatsing, R. R., Fouchier, S. W., de Haan, S., Hutten, B. A., de Groot, E., Kastelein, J. J. P., & Stroes, E. S. G. (2005) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/01.atv.0000176191.64314.07 · Cited by 106 · see citing works
“43 AST (U/L) 30 (23-35) 30 (23-35) 25 (22-30) 0.”
InfluentialConklin, D. J., Schick, S. F., Blaha, M. J., Carll, A. P., DeFilippis, A. P., Ganz, P., Hall, M. E., Hamburg, N. M., O’Toole, T. E., Reynolds, L. M., et al. (2019) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00591.2018 · Cited by 98 · see citing works
Caffeine in tea Camellia sinensis — Content, absorption, benefits and risks of consumption
Gramza‐Michałowska, A. (2013) · The journal of nutrition health & aging · doi:10.1007/s12603-013-0404-1 · Cited by 87 · see citing works
“…behavior born in mind (46). caffeine effect on human health is mainly based on arousal effect on cardiovascular system (11, 61), heart rate variability (121), ischemic stroke as a result of arrhythmias (77), aerial stiffness, further elevating the arterial pressure (110), and miscarriages (39).”
Attenuation of Wave Reflection by Wave Entrapment Creates a “Horizon Effect” in the Human Aorta
Davies, J. E., Alastruey, J., Francis, D. P., Hadjiloizou, N., Whinnett, Z. I., Manisty, C., Aguado‐Sierra, J., Willson, K., Foale, R. A., Malik, I. S., et al. (2012) · Hypertension · doi:10.1161/hypertensionaha.111.180604 · Cited by 88 · see citing works
“Smokers were asked to refrain from smoking for 24 hours.(7) Similarly, subjects were required to refrain from coffee(7,8) and alcohol(9) for 12 hours before study and fasted for 9 hours before the study.”
MethodCentral blood pressure measurement may improve risk stratification
Sharman, J. E., Stowasser, M., Fassett, R. G., Marwick, T. H., & Franklin, S. S. (2008) · Journal of Human Hypertension · doi:10.1038/jhh.2008.71 · Cited by 85 · see citing works
Holland, D. J., Sacre, J. W., McFarlane, S. J., Coombes, J. S., & Sharman, J. E. (2008) · American Journal of Hypertension · doi:10.1038/ajh.2008.253 · Cited by 86 · see citing works
Nichols, W. W., Estrada, J. C., Braith, R. W., Owens, K., & Conti, C. R. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.04.094 · Cited by 86 · see citing works
Siasos, G., Tousoulis, D., Kokkou, E., Oikonomou, E. K., Kollia, M. E., Verveniotis, A., Gouliopoulos, N., Zisimos, K., Plastiras, A., Maniatis, K., et al. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt176 · Cited by 84 · see citing works
Self-citationClinical appraisal of arterial stiffness: the Argonauts in front of the Golden Fleece
Vlachopoulos, C. V., Aznaouridis, K., & Stefanadis, C. (2005) · Heart · doi:10.1136/hrt.2005.067025 · Cited by 81 · see citing works
“Lifestyle characteristics are important determinants of arterial stiffness. Cigarette smoking,”
BackgroundSelf-citationExercise, Vascular Stiffness, and Tissue Transglutaminase
Steppan, J., Sikka, G., Jandu, S. K., Barodka, V. M., Halushka, M. K., Flavahan, N. A., Belkin, A. M., Nyhan, D. P., Butlin, M., Avolio, A. P., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.113.000599 · Cited by 76 · see citing works
“Assessments of arterial stiffness, such as pulse wave velocity (PWV), indices of wave reflection, and augmentation of central aortic BP, are increasingly being recognized as critical indicators to predict cardiovascular morbidity and mortality in the clinical setting(11) and are associated with other risk factors, suc…”
BackgroundCoffee and acute ischemic stroke onset: The Stroke Onset Study
Mostofsky, E., Schlaug, G., Mukamal, K. J., Rosamond, W. D., & Mittleman, M. A. (2010) · Neurology · doi:10.1212/wnl.0b013e3181fb443d · Cited by 75 · see citing works
Therapeutic modification of arterial stiffness: An update and comprehensive review
Wu, C.-F. (2015) · World Journal of Cardiology · doi:10.4330/wjc.v7.i11.742 · Cited by 72 · see citing works
Siasos, G., Tousoulis, D., Vlachopoulos, C. V., Antoniades, C. A., Stefanadi, E., Ioakeimidis, N., Andreou, I., Zisimos, K., Papavassiliou, A. G., & Stefanadis, C. (2007) · International Journal of Cardiology · doi:10.1016/j.ijcard.2007.04.057 · Cited by 68 · see citing works
Self-citationDimitriadis, K. S., Narkiewicz, K., Leontsinis, I., Konstantinidis, D., Mihas, C. C., Andrikou, I., Thomopoulos, C., Tousoulis, D. M., & Tsioufis, K. P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063237 · Cited by 66 · see citing works
“1 mg icotine, smoke an EC or simulate smoking with a drinking straw with a filter (sham smoking), in line w th previous methodology [16,17,27].”
MethodCardiovascular autonomic effects of electronic cigarette use: a systematic review
Garcia, P. D., GORNBEIN, J. A., & Middlekauff, H. R. (2020) · Clinical Autonomic Research · doi:10.1007/s10286-020-00683-4 · Cited by 64 · see citing works
Effects of smoking on central blood pressure and pressure amplification in hypertension of the young
Saladini, F., Benetti, E., Fania, C., Mos, L., Casiglia, E., & Palatini, P. (2016) · Vascular Medicine · doi:10.1177/1358863x16647509 · Cited by 61 · see citing works
Alcohol and Acute Ischemic Stroke Onset
Mostofsky, E., Burger, M. R., Schlaug, G., Mukamal, K. J., Rosamond, W. D., & Mittleman, M. A. (2010) · Stroke · doi:10.1161/strokeaha.110.580092 · Cited by 58 · see citing works
Kakafika, A., & Mikhailidis, D. P. (2007) · Circulation Journal · doi:10.1253/circj.71.1173 · Cited by 54 · see citing works
Szostak, J., Wong, E. T., Titz, B., Lee, T., Wong, S. K., Low, T., Lee, K. M., Zhang, J., Kumar, A., Schlage, W. K., et al. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00613.2019 · Cited by 54 · see citing works
Insulin Resistance, Arterial Stiffness and Wave Reflection
Yki‐Järvinen, H., & Westerbacka, J. (2006) · KARGER eBooks · doi:10.1159/000096746 · Cited by 54 · see citing works
Arastoo, S., Haptonstall, K. P., Choroomi, Y., et al. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00192.2020 · Cited by 51 · see citing works
“Alternatively, TC smokers compared with nonsmokers are known to have decreased arterial compliance, thus rendering them more susceptible to pressor stimuli (41).”
BackgroundResidential proximity to greenness mitigates the hemodynamic effects of ambient air pollution
Riggs, D. W., Yeager, R. A., Conklin, D. J., DeJarnett, N. K., Keith, R. J., DeFilippis, A. P., Rai, S. N., & Bhatnagar, A. (2021) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00689.2020 · Cited by 52 · see citing works
Siasos, G., Tousoulis, D., Vlachopoulos, C., Antoniades, C. A., Stefanadi, E., Ioakeimidis, N., Zisimos, K., Siasou, Z., Papavassiliou, A. G., & Stefanadis, C. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.57 · Cited by 48 · see citing works
Self-citationAcute Effect of Black and Green Tea on Aortic Stiffness and Wave Reflections
Vlachopoulos, C., Alexopoulos, N., Dima, I., Aznaouridis, K., Andreadou, I., & Stefanadis, C. (2006) · Journal of the American College of Nutrition · doi:10.1080/07315724.2006.10719535 · Cited by 49 · see citing works
“However, tea contains significant amounts of caffeine too, which, as we [7–11] and others [12] have shown, results in an acute and chronic increase in arterial stiffness and wave reflections.”
BackgroundSelf-citationSiasos, G., Oikonomou, E. K., Chrysohoou, C. A., Tousoulis, D., Panagiotakos, D. B., Zaromitidou, M., Zisimos, K., Kokkou, E., Marinos, G., Papavassiliou, A. G., et al. (2013) · Vascular Medicine · doi:10.1177/1358863x13480258 · Cited by 47 · see citing works
Self-citationPhillips, A. A., Matin, N., Jia, M., Squair, J. W., Monga, A., Zheng, M. M. Z., Sachdeva, R., Yung, A. C., Hocaloski, S., Elliott, S., et al. (2017) · Journal of Neurotrauma · doi:10.1089/neu.2017.5188 · Cited by 46 · see citing works
“Similar transient elevations in blood pressure as those demonstrated in the present study occur in response to chronic caffeine consumption, high-intensity interval exercise,(5) defecation, exaggerated blood pressure responses to mental stress, and drug abuse.(3,7,28,29) The observed endothelial dysfunction and profib…”
Milan, A., Tosello, F., Fabbri, A., Vairo, A., Leone, D., Chiarlo, M., Covella, M., & Veglio, F. (2011) · High Blood Pressure & Cardiovascular Prevention · doi:10.2165/11588020-000000000-00000 · Cited by 43 · see citing works
“Smoking, obesity and an excessive alcohol intake can determine an arterial compliance reduction, associatedwith an increase in pulse pressure and systolic stress.([34-36]) Evaluation of arterial stiffness as cfPWV could provide an integrated description of arterial alterations generated by the action in the time of se…”
Orabona, R., Sciatti, E., Vizzardi, E., Bonadei, I., Valcamonico, A., Metra, M., & Frusca, T. (2015) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.14838 · Cited by 42 · see citing works
Gkaliagkousi, Ε., & Δούμα, Σ. (2009) · Europe PMC (PubMed Central) · Cited by 41 · see citing works
Vlachopoulos, C. V., Aznaouridis, K. A., Dima, I., Ioakeimidis, N., Vasiliadou, C., Zervoudaki, A., Gialernios, T. P., & Stefanadis, C. (2007) · International Journal of Cardiology · doi:10.1016/j.ijcard.2006.11.099 · Cited by 40 · see citing works
“Carotid–femoral pulse wave velocity (PWV), an established index of aortic stiffness [8,9,11,16–19], was calculated from measurements of pulse transit time and the distance travelled between two recording sites (pulse wave velocity=distance [meters] / transit time [seconds]) using a validated non-invasive device (Compl…”
MethodSelf-citationSassalos, K., Vlachopoulos, C. V., Alexopoulos, N. A., Gialernios, T. P., Aznaouridis, K. A., & Stefanadis, C. (2006) · PubMed · Cited by 38 · see citing works
Self-citationSmoking cessation strategies in pregnancy: Current concepts and controversies
Ioakeimidis, N., Vlachopoulos, C. V., Katsi, V. K., & Tousoulis, D. M. (2018) · Hellenic Journal of Cardiology · doi:10.1016/j.hjc.2018.09.001 · Cited by 38 · see citing works
Self-citationChanges in aortic root function after valve replacement in patients with aortic stenosis
Barbetseas, J. D., Alexopoulos, N. A., Brili, S. V., Aggeli, C., Marinakis, N., Vlachopoulos, C. V., Vyssoulis, G. P., & Stefanadis, C. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2005.07.023 · Cited by 34 · see citing works
Self-citationPatel, U. K., Patel, N., Khurana, M., et al. (2022) · Neurology International · doi:10.3390/neurolint14020037 · Cited by 34 · see citing works
“[52] Increase aortic stiffness and increase blood pressure Neurol.”
RetractedRelationship of fibrinogen with arterial stiffness and wave reflections
Vlachopoulos, C. V., Pietri, P. G., Aznaouridis, K. A., Vyssoulis, G. P., Vasiliadou, C., Bratsas, A., Tousoulis, D., Xaplanteris, P., Stefanadi, E., & Stefanadis, C. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3282dc25da · Cited by 34 · see citing works
Self-citationXue, C., Chen, Q. Z., Bian, L., Yin, Z. F., Xu, Z., Zhang, A. L., Xie, Y. S., Zhang, H. L., Du, R., & Wang, C. Q. (2019) · Angiology · doi:10.1177/0003319719853458 · Cited by 30 · see citing works
Arterial Stiffness: Determinants and Relationship to the Metabolic Syndrome
Achimastos, A. D., Efstathiou, S. P., Christoforatos, T., et al. (2007) · Angiology · doi:10.1177/0003319706295477 · Cited by 30 · see citing works
To sip or not to sip: the potential health risks and benefits of coffee drinking
Taylor, S. R., & Demmig‐Adams, B. (2007) · Nutrition & Food Science · doi:10.1108/00346650710838063 · Cited by 27 · see citing works
Giacomin, E., Palmerini, E., Ballo, P., Zacà, V., Bova, G., & Mondillo, S. (2008) · Cardiovascular Ultrasound · doi:10.1186/1476-7120-6-9 · Cited by 30 · see citing works
“This may indicate that caffeine assumption does not alter the acute effect of cigarette smoking on LV function, suggesting that the synergistic effect between smoke and caffeine previously demonstrated for blood pressure [11,28,29] cannot be extended to LV function.”
BackgroundEfficacy and Safety of Electronic Cigarettes for Smoking Cessation: A Critical Approach
Ioakeimidis, N., Vlachopoulos, C. V., & Tousoulis, D. (2016) · Hellenic Journal of Cardiology · doi:10.1016/s1109-9666(16)30011-2 · Cited by 27 · see citing works
Self-citationArterial stiffening and systemic endothelial activation induced by smoking
Vlachopoulos, C. V., Aznaouridis, K. A., Bratsas, A., Ioakeimidis, N., Dima, I., Xaplanteris, P., Stefanadis, C., & Tousoulis, D. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.04.029 · Cited by 27 · see citing works
Self-citationVlachopoulos, C., Vyssoulis, G. P., Alexopoulos, N. A., Zervoudaki, A., Pietri, P. G., Aznaouridis, K., & Stefanadis, C. (2006) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602577 · Cited by 27 · see citing works
“…hypertensive patients (Vlachopoulos et al., 2001, 2003a, b, 2004a), and that chronic coffee consumption is associated with increased aortic stiffness and wave reflections in healthy normotensive subjects without cardiovascular risk factors, except from smoking (Vlachopoulos et al., 2004a, 2005a).”
BackgroundMethodInfluentialSelf-citationPhillips, A. A., Bredin, S. S. D., Coté, A. T., Drury, C. T., & Warburton, D. E. R. (2012) · European Journal of Applied Physiology · doi:10.1007/s00421-012-2489-3 · Cited by 26 · see citing works
Effect of dark chocolate on arterial function in healthy individuals: Cocoa instead of ambrosia?
Vlachopoulos, C. V., Alexopoulos, N. A., & Stefanadis, C. (2006) · Current Hypertension Reports · doi:10.1007/s11906-006-0052-5 · Cited by 26 · see citing works
“With green tea, the initial stiffening effect on the aorta (produced by the rapidly absorbed caffeine it contains) is thereafter counteracted by the beneficial effect of its flavonoids, which take more time to be absorbed [ 18 ,41,42].”
BackgroundSelf-citationBourouki, E., Oikonomou, E. K., Moschos, M. M., Siasos, G., Σιάσου, Γ., Gouliopoulos, N., Deftereos, S. G., Miliou, A., Zacharia, E. M., & Tousoulis, D. (2019) · Journal of Glaucoma · doi:10.1097/ijg.0000000000001303 · Cited by 24 · see citing works
Minami, J., Ishimitsu, T., Ohrui, M., et al. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.62 · Cited by 23 · see citing works
The Combined Effect of Hypertension and Smoking on Arterial Stiffness
Scallan, C. J., Doonan, R. J., & Daskalopoulou, S. S. (2010) · Clinical and Experimental Hypertension · doi:10.3109/10641960903443558 · Cited by 21 · see citing works
Siasos, G., Tousoulis, D., GIALAFOS, E. J., Oikonomou, E. K., Zaromitidou, M., Aggeli, C., Korompelis, P., Kallianos, A., Rapti, A., Zisimos, K., et al. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.30 · Cited by 21 · see citing works
Self-citationAzad, B. J., Heshmati, J., Daneshzad, E., & Palmowski, A. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2020.1750343 · Cited by 23 · see citing works
“Impairment of vascular function, vascular rigidity and endothelial dysfunction have been described as markers of CVD, and they are independent predictors of cardiovascular risk (Vlachopoulos et al. 2004; Maruhashi et al. 2018).”
InfluentialCoffee, nutritional status, and renal artery resistive index
Trovato, G. M., Pirri, C., Martines, G. F., Trovato, F. M., & Catalano, D. (2010) · Renal Failure · doi:10.3109/0886022x.2010.516853 · Cited by 21 · see citing works
Vascular function and ocular involvement in sarcoidosis
Siasos, G., Paraskevopoulos, T., GIALAFOS, E. J., Rapti, A., Oikonomou, E. K., Zaromitidou, M., Mourouzis, K., Σιάσου, Γ., Gouliopoulos, N., Tsalamandris, S., et al. (2015) · Microvascular Research · doi:10.1016/j.mvr.2015.03.008 · Cited by 18 · see citing works
“b) Augmentation index (AIx) of the central (aortic) pressure waveform was measured as an index of wave reflection (Vlachopoulos et al., 2004).”
MethodSelf-citationIoakeimidis, N., Tzifos, V., Vlachopoulos, C., Terentes-Printzios, D., Georgakopoulos, C., & Tousoulis, D. (2018) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2017.1422700 · Cited by 19 · see citing works
“Central (aortic) pressures and augmentation index (AIx), a composite index of wave reflections and arterial stiffness (Vlachopoulos et al. 2004; Vlachopoulos et al. 2005a; Nichols et al. 2011), were calculated using a validated, commercially available system (SphygmoCorR ; AtCor Medical, Sydney, Australia), which empl…”
Self-citationCardiovascular Sequelae of Tobacco Smoking
Rempher, K. J. (2006) · Critical Care Nursing Clinics of North America · doi:10.1016/j.ccell.2005.10.006 · Cited by 19 · see citing works
“Aortic elasticity and wave reflections are known determinants of left ventricular function and coronary artery blood flow [67–69].”
BackgroundThe association between glaucoma, vascular function and inflammatory process
Siasos, G., Tousoulis, D., Σιάσου, Γ., Moschos, M. M., Oikonomou, E. K., Zaromitidou, M., Marinos, G., Korompelis, P., Papavassiliou, A. G., & Stefanadis, C. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.09.083 · Cited by 18 · see citing works
Self-citationVlachopoulos, C. V., Alexopoulos, N. A., & Stefanadis, C. (2007) · Artery Research · doi:10.1016/s1872-9312(07)70003-0 · Cited by 17 · see citing works
“Active and passive smoking result acutely in stiffening of elastic and muscular type arteries and in enhancement of wave reflections [4,26,27].”
BackgroundInfluentialSelf-citationCardiovascular Risk Factors, Atherosclerosis and Pulse Pressure
Amar, J., & Chamontin, B. (2006) · KARGER eBooks · doi:10.1159/000096732 · Cited by 17 · see citing works
Vizzardi, E., Sciatti, E., Bonadei, I., Menotti, E., Prati, F., Scodro, M., Dallapellegrina, L., Berlendis, M., Poli, P., Padoan, R., et al. (2019) · Echocardiography · doi:10.1111/echo.14375 · Cited by 16 · see citing works
The Relationship Between Dietary Choices and Health and Premature Vascular Ageing
Mozos, I. M., Jianu, D., Stoian, D. L., Mozos, C., Gug, C., Pricop, M. O., Mărginean, O., & Luca, C. T. (2021) · Heart Lung and Circulation · doi:10.1016/j.hlc.2021.07.009 · Cited by 16 · see citing works
Roux, A., Motreff, P., Perriot, J., et al. (2010) · Cardiology · doi:10.1159/000319596 · Cited by 15 · see citing works
“It induces atherosclerosis and contributes to arterial stiffness [ , , , , ,”
BackgroundCentral Hemodynamics for Management of Arteriosclerotic Diseases
Hashimoto, J. (2017) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.40717 · Cited by 15 · see citing works
Püşüroğlu, H., Akgül, Ö., Ertürk, M., et al. (2014) · Kardiologia Polska · doi:10.5603/kp.a2014.0044 · Cited by 15 · see citing works
Tabara, Y., Takahashi, Y., Setoh, K., et al. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.03.028 · Cited by 14 · see citing works
Bonapace, S., Rossi, A., Cicoira, M., Targher, G., Marino, P. N., Benfari, G., Mugnai, G., Arcaro, G., & Vassanelli, C. (2016) · Echocardiography · doi:10.1111/echo.13230 · Cited by 14 · see citing works
“Sudden stressors may further operate on an already stiff arterial system transiently worsening the elastic properties of the large arteries determining an acute increase in the systolic burden to the left ventricle.(40,41) Enlarged left ventricles are unable to use the TABLE IV”
BackgroundÖsterreichischer Blutdruckkonsens 2019
Hypertensiologie, Ö. G. F., Weber, T., Atherosklerosegesellschaft, Ö., Gesellschaft, Ö. D., Angiologie, Ö. G. F. I., Nephrologie, Ö. G. F., Gesellschaft, Ö. K., Neurologie, Ö. G. F., Schlaganfall-Gesellschaft, Ö., Allgemeinmedizin, Ö. G. F., et al. (2019) · Wiener klinische Wochenschrift · doi:10.1007/s00508-019-01565-0 · Cited by 15 · see citing works
HEREDITARY AND ENVIRONMENTAL INFLUENCES ON ARTERIAL FUNCTION
Hayward, C. S., & Bénétos, A. (2007) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/j.1440-1681.2007.04656.x · Cited by 13 · see citing works
“The most obvious of these is smoking, with independent effects not only on endothelial function,(72) but also on arterial distensibility,(73) acutely and across a population.(74) This last study extended into the common practice of combination caffeine and smoking, demonstrating a synergistic adverse effect on arteria…”
BackgroundJUUL™ing and Heating Lead to a Worsening of Arterial Stiffness
Benthien, J., Meusel, M., Talavera, S. C., et al. (2022) · Medicines · doi:10.3390/medicines9040028 · Cited by 12 · see citing works
Rodríguez-Vargas, G.-S., Santos-Moreno, P., Rubio-Rubio, J.-A., Bautista-Niño, P.-K., Echeverri, D., Gutiérrez-Castañeda, L.-D., Matamoros, F. A. S., Navarrete, S., Aparicio, A., Sáenz, L., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.894577 · Cited by 11 · see citing works
Increased aortic stiffness in patients with coronary artery ectasia
Koşar, F., Sıncer, İ., Aksoy, Y., Topal, E., & Cehreli, S. (2005) · Coronary Artery Disease · doi:10.1097/00019501-200512000-00008 · Cited by 11 · see citing works
Notara, V., Panagiotakos, D. B., Kouvari, M., Tzanoglou, D., Kouli, G., Mantas, Y., Kogias, Y., Stravopodis, P., Papanagnou, G., Zombolos, S., et al. (2015) · International Journal of Food Sciences and Nutrition · doi:10.3109/09637486.2015.1077795 · Cited by 11 · see citing works
“Smoking and coffee has been proposed to have a synergistic aggravating impact on cardiac function (i.e. aortic stiffness) (Vlachopoulos et al., 2004); indeed, in the present study, the normotensive patients were more likely to smoke.”
ResultSelf-citationVizzardi, E., Sciatti, E., Bonadei, I., et al. (2014) · IJC Heart & Vessels · doi:10.1016/j.ijchv.2014.04.003 · Cited by 10 · see citing works
“is an open access article under the C valve [6–10].”
BackgroundCardiovascular functions and arterial stiffness after JUUL use
Gernun, S., Franzen, K. F., Mallock, N., Benthien, J., Luch, A., Mortensen, K., Drömann, D., Pogarell, O. M., Rüther, T., & Rabenstein, A. (2022) · Tobacco Induced Diseases · doi:10.18332/tid/144317 · Cited by 10 · see citing works
Heart Rate and Blood Pressure: “Connecting the Dots” in Epidemiology and Pathophysiology
Kouvas, N., Tsioufis, C. P., Vogiatzakis, N., Sanidas, E. A., Konstantinidis, D., Kintis, K., Dimitriadis, K. S., Kakosaiou, Z., Tsioufis, P., Kouremeti, M., et al. (2017) · Angiology · doi:10.1177/0003319717746524 · Cited by 10 · see citing works
“Moreover, lifestyle practices such as tobacco smoking and caffeine consumption have also been associated with increased aortic stiffness and enhanced pulse wave reflections, rendering them detrimental for CV function.(36) It is of interest that antihypertensive drugs may differentially affect aortic stiffness as repor…”
Awwad, S. H., Abu-zaiton, A. S., Issa, R., et al. (2023) · Pharmacia · doi:10.3897/pharmacia.70.e90495 · Cited by 8 · see citing works
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“Nevertheless, some studies showed that caffeine has significant effects(11,23) or no effect on the lipid profile.(22) It can be concluded that feedback from studies”
BackgroundInfluentialOptimal Treatment of Hypertension with Diastolic Heart Failure
Sušić, D., & Frohlich, E. D. (2008) · Heart Failure Clinics · doi:10.1016/j.hfc.2007.10.002 · Cited by 8 · see citing works
Rosilawati, Y., Rafique, Z., & Sudiwijaya, E. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301291 · Cited by 19 · see citing works
Coffee and cardiovascular health: looking through the steaming cup
Terentes-Printzios, D. G., & Vlachopoulos, C. V. (2022) · Cardiovascular Research · doi:10.1093/cvr/cvac045 · Cited by 7 · see citing works
Self-citationGöksu, K., Vural, A., Kahraman, A. N., & Aslan, I. K. (2024) · Tobacco Induced Diseases · doi:10.18332/tid/185300 · Cited by 5 · see citing works
“Vlachopoulos et al. 14 showed that smoking and caffeine consumption both cause a significant increase in arterial wall stiffness in a similar study.”
ResultKola, S., George, M., Srinivasamurthy, S. K., et al. (2014) · Pharmacology & Pharmacy · doi:10.4236/pp.2014.54050 · Cited by 4 · see citing works
“Smoking and caffeine can adversely affect vascular stiffness both acutely and chronically [17].”
BackgroundJames, J. E. (2010) · Springer eBooks · doi:10.1007/978-1-4419-0338-9_26 · Cited by 4 · see citing works
Levels of caffeine and its metabolites among U.S. smokers and nonsmokers
Jain, R. B. (2015) · Environmental Toxicology and Pharmacology · doi:10.1016/j.etap.2015.02.002 · Cited by 3 · see citing works
Aortic Stiffness and Distensibility Among Hypertensives
Meenakshisundaram, R., Kamaraj, K., Murugan, S. J., & Thirumalaikolundusubramanian, P. (2009) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.04958.x · Cited by 3 · see citing works
Caffeine and Cardiovascular Outcomes: Current Evidence and Clinical Perspectives
Neshat, N., Frishman, W. H., & Aronow, W. S. (2026) · Cardiology in Review · doi:10.1097/crd.0000000000001252 · Cited by 2 · see citing works
- Authors
- Vlachopoulos, C., Kosmopoulou, F., Panagiotakos, D., Ioakeimidis, N., Alexopoulos, N., Pitsavos, C., & Stefanadis, C.
- Affiliations
- Hippocration General Hospital (GR)
- Corresponding author
- Vlachopoulos, Charalambos
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2004-11
- Volume
- 44
- Issue
- 9
- Pages
- 1911-1917
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2071910605
- Semantic Scholar
- 4e6712e7fbc3b420c12593d52083904871b3359f
- Cited by
- 135
- References
- 41
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 6 · 2015: 9 · 2014: 7 · 2013: 6 · 2012: 3
- FWCI
- 7.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- cigarette smoking, caffeine, coffee consumption, aortic stiffness, arterial stiffness, wave reflection, pulse wave velocity, augmentation index, synergistic interaction, cardiovascular risk
- MeSH terms
- Adult, Central Nervous System Stimulants, Aortic Diseases, Blood Flow Velocity, Blood Pressure, Caffeine, Drug Synergism, Female, Heart Rate, Humans, Male, Myocardial Contraction, Pulsatile Flow, Smoking, Statistics as Topic, Stroke Volume, Cross-Over Studies
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