Studies Explore CV Impacts of Wine, Coffee and Energy Drinks
From coffee increasing the risk of pre-diabetes in young adults with hypertension, to wine only protecting against cardiovascular disease in people who exercise, to the heart risks associated with energy drinks, several studies presented at ESC Congress 2014 provide new information about the impacts of some of these more popular beverages on cardiovascular health.
According to results from the HARVEST Study, younger people aged 18-45 with hypertension who drank more than three cups of coffee per day doubled their risk of pre-diabetes. Of the 1,180 study patients pre-diabetes was diagnosed in 24 percent. Moderate coffee drinkers (1-3 cups/day) had a 34 percent increased risk of developing pre-diabetes compared to abstainers and heavy drinkers (more than 3 cups/day) had a doubled risk. This association was even stronger in patients who were overweight or obese.
However, the risk of pre-diabetes related to coffee consumption differed according to CYP1A2 genotyping. The risk of pre-diabetes associated with coffee intake was increased only in slow caffeine metabolizers, with a hazard ratio of 2.78 (confidence interval 1.32-5.88, p=0.0076) for heavy drinkers. "We found that coffee was a risk factor for the development of sustained hypertension and that the risk was modulated by the genetic background of the individual," said Lucio Mos, MD, from Italy. "Slow metabolizers of caffeine were at increased risk of hypertension."
The coffee findings contradict previous epidemiologic studies that have advocated coffee consumption as a means to lower the risk of type 2 diabetes. Similarly, another study on wine consumption appears to contradict evidence suggesting that mild to moderate consumption of wine protects against cardiovascular disease. According to results from the In Vino Veritas (IVV) study, which looked at 146 people at low risk of cardiovascular disease, moderate consumption of either red or white wine was only protective in people who exercised. In addition, wine consumption made no difference in HDL cholesterol levels at the beginning of the study compared to one year in either the red or white wine groups.
Meanwhile, a third study presented during the Congress found that increasingly popular energy drinks can cause heart problems. "So-called 'energy drinks' are popular in dance clubs and during physical exercise, with people sometimes consuming a number of drinks one after the other," said Professor Milou-Daniel Drici from France. "This situation can lead to a number of adverse conditions including angina, cardiac arrhythmia and even sudden death."
The study analyzed adverse events reported to ANSES, the French agency for food safety, between Jan. 1, 2009 and Nov. 30 2012. During the two-year period, 95 of the 257 reported that adverse events had cardiovascular symptoms. Cardiac arrests and sudden or unexplained deaths occurred at least in eight cases, while 46 people had heart rhythm disorders, 13 had angina and three had hypertension. According to Drici, "caffeine syndrome" characterized by tachycardia, tremors, anxiety and headache was the most common problem.
"Patients with cardiac conditions including catecholaminergic arrhythmias, long QT syndrome and angina should be aware of the potential danger of a large intake of caffeine, which is a stimulant that can exacerbate their condition with possibly fatal consequences," he said. He also cautioned that energy drinks "have absolutely no place" during or after exercise and urged health care providers to warn patients with cardiac conditions about the potential dangers associated with these drinks.
Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Clinical Topic Collection: Dyslipidemia, Prevention, Implantable Devices, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD & Pediatrics and Arrhythmias, CHD & Pediatrics and Prevention, CHD & Pediatrics and Quality Improvement, Lipid Metabolism, Nonstatins, Exercise, Hypertension
Keywords: Overweight, Exercise, Diabetes Mellitus, Type 2, Death, Sudden, Risk Factors, Heart Arrest, Headache, Tremor, Food Safety, Caffeine, Epidemiologic Studies, Cardiovascular Diseases, Cholesterol, HDL, Confidence Intervals, Hypertension, Cytochrome P-450 CYP1A2, Health Personnel, Long QT Syndrome, Tachycardia, Genotype, Wine
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