Coffee safe for those with history of raised blood pressure

I’m a coffee drinker, and believe this beverage has done little to deserve its quite unhealthy reputation. Much of the negativity concerning coffee comes from the fact that it’s generally rich in caffeine. One effect of caffeine is to raise blood pressure – and raised blood pressure has links with heart disease and stroke. Perhaps, not surprisingly, those seeking to reduce their risk of ‘cardiovascular events’ such as heart attacks and strokes are advised to limit their consumption of coffee. Such advice is generally offered even more strenuously to people who have a history of high blood pressure (hypertension), for obvious reasons.

This week, the American Journal of Clinical Nutrition published a paper on-line which assessed relevant evidence regarding the effect of coffee drinking on blood pressure and cardiovascular disease in individuals with a history of high blood pressure [1]. The review looked at three lines of evidence. Here’s a summary of each type of evidence and the findings of the review.

1. Studies where individuals consumed the equivalent of 200-300 mg of caffeine (1.5 – 2 cups of filter coffee) in the short term

Putting several studies together revealed that this does increase blood pressure for up to 3 hours. Rise in blood pressure was about 8 and 6 mmHg in the systolic (higher) and diastolic (lower) blood pressure values, respectively.

2. Studies where individuals consumed coffee over a 2 week period

These studies showed that, overall, coffee did not increase blood pressure. Some of the explanation here is that individuals can become ‘habituated’ to caffeine, with its effects on the body lessening in time.

3. Studies looking at the link between coffee consumption and cardiovascular disease over time

These studies showed that, overall, higher intakes of coffee were not associated with increased risk of cardiovascular disease.

In short, coffee seems like a generally safe option for people with a history of raised blood pressure.

One of the points the authors of this paper make is that while caffeine can have adverse effects on markers for disease (such as blood pressure), other elements in coffee can have beneficial effects. For example the compounds chlorogenic acid and trigonelline and the mineral magnesium improve glucose metabolism, reduce inflammation and enhance the healthy functioning of the inside of the blood vessels.

While I’m a fan of coffee, I do recommend some caution. Too much caffeine, in addition to effects on the cardiovascular system, can do other things too such as disrupt sleep, which can have implications for health and wellbeing. Some people metabolise caffeine (in the liver) very quickly and throw back a double espresso after dinner and still sleep like babies. Others, though, are not so fortunate, and can be tripped up by caffeine consumed hours before. If you think you’re caffeine-sensitive, then I’d advise keeping coffee intake generally low and confining it to the morning only.

I’ve found in my experience that most individuals who over-drink coffee tend to drink it indiscriminately. In other words, they will drink instant coffee, machine coffee, coffee served in meetings etc. whether they want it or like it or not. For most of these people, coffee-quaffing is just habit. I suggest a more discerning approach:

If you really like coffee, have something you really like.

Brewing some decent coffee for yourself in the morning might be an approach here. Another is only to take coffee from places where you can be sure of the quality. Here in London we have a ton of coffee shops including several chains. The three chains with the most presence are Starbucks, Costa and Nero’s. I think Nero’s serve the best coffee, so I have a ‘Nero’s or nothing’ policy. This makes it very difficult for me to drink much coffee in any given day. I don’t drink much coffee, but the ones I have I really savour.


1. Mesas AE, et al.The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Am J Clin Nutr epub 31 August 2011

13 Responses to Coffee safe for those with history of raised blood pressure

  1. Alex 1 September 2011 at 7:24 pm #

    Amen to that: Nero is by far the best coffee around. Starbucks I wouldn’t drink if I was dying of thirst.

  2. George Phillips 2 September 2011 at 2:27 pm #

    Nero definitely. Good coffee plus they don’t sweeten the whipped cream with vanilla syrup. (all the rest, Starbucks, Costa serve sweetened cream.)

    My favourite is a Nero ‘super’ con panna. That’s a normal 2 shot con panna but served in a regular cup with as much whipped cream as possible piped into the cup!!

    A middle age spread guy seeing me ordering this asked me “How can you have that yet be so lean?”

    I looked at his skinny latte and low fat muffin and just smiled and said “It must be my genes.”

    (never told him that in my ‘no saturated fat’ days I was 50 pounds heavier!)

  3. John Briffa 2 September 2011 at 3:00 pm #


    Your comment made me laugh. Also, I had no idea this coffee existed, and will be giving it a whirl at the next opportunity for sure.

  4. Ivan McCullagh 2 September 2011 at 5:22 pm #

    Your advice ties in with my experience. I used to drink coffee by the gallon – the stuff only had to resemble coffee – a lot of it was awful. Then I got my own espresso machine on a bit of a strange whim – nothing fancy, just a cheap thing – and one thing led to another – quality not quantity.

  5. Barry 2 September 2011 at 6:07 pm #

    Quality not quantity is absolutely right. You don’t need anything flash I make mine simply in an earthenware jug and only use fresh cold water not pre boiled, it does make a difference.

  6. JJ Lothin 2 September 2011 at 8:01 pm #

    Nero and double espresso – a big YES to both!

  7. ValerieH 2 September 2011 at 8:05 pm #

    I feel the same way about tea. There aren’t any tea shops close to me (Chicago burbs), so I order it online.

    Since I found a source of grass-fed dairy, I am starting to have the same opinion about milk and cream. I don’t want crap factory farm dairy anymore. I bought an ice cream maker so I can make healthy ice cream. Everything else pales in comparison.

  8. Steve Pretty 2 September 2011 at 8:26 pm #

    Given the wide range of coffees on offer in coffee shops – what do you consider to be the healthiest option based on your dietary advice? Given milk is in the “avoid” category, I guess cappucino and latte are out. I am guessing an espresso with a glass of water (as they do on the continent) or a black americano? Definitely no added sugar.

    Trouble with these coffee chains is they offer far to many unhealthy cake and pastry temptations!

  9. John Briffa 2 September 2011 at 8:39 pm #


    As you suggest, espresso and black Americano are probably the best options, though I think I might have the occasional ‘con panna’ (see comments 2 and 3 above).

  10. Donald G 2 September 2011 at 8:59 pm #

    To savor the best espresso have it in Italy, Spain or Portugal (not France).

  11. jayney godard 2 September 2011 at 11:30 pm #

    Amen to quality over quantity! I have the same policy about chocolate – the lowest I’ll go is 85% cacao, but usually opt for 90% upwards. I’m working in the US at the moment and it is really easy to nip to the healthfood store here to get raw cacao – waaaay too easy in fact. Yum!

  12. Lara Just 6 September 2011 at 9:34 pm #

    It all comes down to moderation and true enjoyment. As discussed in the article different individuals metabolise various chemical compounds differently, part of their predisposing genetics as well as part of current and accumulative environmental influences on their genetics.

    However, other factors in how liberal or ‘cautious’ we may like to remain with clients/patients in advising the consumption of coffee may be their current state of health and wellbeing (e.g. adrenal health, thyroid health, weight loss goals, general load on liver biotransformation mechanisms.

    Often what we may forget is the emotional psychological health around all this. How stressed is someone, and are they downing liters of coffee to just keep their eyes open, or do they have negative feelings of I ‘shouldn’t’ be drinking this or eating that or should be eating/ drinking this or that. Addictive and obsessive behaviours may result from certain ‘restrictions’ we put on ourselves, which then appear too hard for us to comply to, ‘kick ‘bad’ habits’ and could get us into a negative spiral.

    It’s important as you say that if we decide to go for something to really enjoy and savor it. 🙂

  13. Dino N 10 September 2011 at 1:46 am #

    If you think that coffee chains serve good coffee you may change your mind after this. A book has been published called “The London Coffee Guide 2011- the definitive guide to the 100 best coffee venues in London”. if you ignore references to the chains in this book (I think they sponsored the publication) the remaining coffee shops in the book can offer a coffee experience – you may have one close to your home or work! The book even provides information on the coffee roaster used, the make of their coffee machine and grinder and the name of the barista. Most importantly a description of the place and a grading for the coffee and the atmosphere. I have tried a few of these and I was not disappointed. [P.S. I am a home coffee enthousiast with professional equipment and have attended a few courses on coffee]

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