Caffeine and its effects on the heart: The lowdown

my name is Sanjay Gupta I'm a consultant cardiologist from York today I wanted to do a video on the subject of caffeine and its effects on the heart now there is a perception amongst healthcare professionals and patients that the ingestion of caffeine can trigger off heart rhythm disturbances and this leads to an almost universal recommendation whenever a patient goes to their doctor with palpitations in this video I wanted to look at what evidence is out there to support this recommendation the first thing to say is caffeine is a stimulant it is found in a variety of different concentrations and many commercially available beverages these include coffee tea green tea black tea soda sir Coca Cola that kind of thing and also energy drinks to give you an idea a 375 ml can of coca-cola would probably contain about 32 milligrams of caffeine a cup of green tea would contain about 35 milligrams of caffeine cup of coffee would probably contain about 95 milligrams of caffeine an expresso shot espresso shot would probably contain about 106 milligrams of caffeine and a lot of energy drinks can contain up to 500 milligrams of caffeine caffeine has a half-life of 5.7 hours it reaches maximum concentrations within an hour of consumption and this is nearly 100% by available so everything you drinking gets into your system caffeine has four main effects on our heart okay two of them can be proven make and trigger of heart rhythm disturbance and two of these effects can actually be anti - rhythmic which means reduce the chances of heart rhythm disturbances and I'll go through with them one by one the first thing is that caffeine has a sympathetic effect meaning that it causes sympathetic activation it causes off flight or fright response to built up if you give someone 250 milligrams of caffeine their adrenaline levels will go up by about two hundred and seven percent then noradrenaline levels will go up by 75% at very very high doses caffeine is prarit Megan this has been shown in rat models where rats were fed to very very high concentrations of caffeine and they developed arrhythmias and they actually develop in tricular fibrillation and died so certainly in rat models it seems that very high levels of caffeine can be very dangerous another effect that caffeine has is that increases the amount of calcium within ourselves it increases our heart rate by both its sympathetic activation and also by increasing the levels of calcium within ourselves so there's a two of the causes by which caffeine can be proven that can trigger of heart rhythm disturbances however caffeine has an inhibitory effect on our adenosine receptors so we have a generous Essene receptors within the heart a Desna scene itself can trigger things like atrial fibrillation so caffeine because it inhibits these adenosine receptors actually could possibly have an auntie rhythmic effect as well finally caffeine is an antioxidant antioxidants can sometimes be very helpful in producing a heart rhythm hot air muscle irritability so those are two things that's effects on the adenosine receptor and the fact that it's an antioxidant they're both they both have anti destroyed nikka pets the sympathetic activation and the increase in the amount of calcium can both make it pro rhythmic so I'm going to talk about the different heart rhythm disturbances to try and see if there's any evidence which has been shown to actually tell us what effect caffeine has on heart rhythm disturbances you know water does the research tell us so if we look at a trill dysrhythmias these are atrial tachycardia it will act to be atrial fibrillation lab based experimental studies have failed to show a consistent relationship between caffeine and the development of atrial dysrhythmias or the induce ability of hatred destroyed Mia's population studies have actually shown that you get a reduction in the amount of atrial fibrillation with ingestion of caffeine there was one interesting study in which they looked at 57,000 patients or participants and they found that those people who drank coffee actually lower incidence of atrial fibrillation so very interesting there have been about 11 major studies that studied almost 350,000 participants and then indeed one very small study was it found that the coffee was actually detrimental to atrial dysrhythmias which is again really interesting and points to this antioxidant effect and the effect it has on the demoscene receptors in three studies of these 11 studies it was shown that actually coffee reduced atrial dysrhythmias in the rest there was no real benefit or harm it's worth noting that what we get from studies may not necessarily apply to the individual patient because I recently put a poll on my Facebook page asking patients who had atrial fibrillation I said look you know do you find that coffee is a trigger for atrial fibrillation I've got about 600 answers and 45% of patients said yes coffee did trigger off the atrial fibrillation so that's again interesting you know what we read and publications may not necessarily apply to the individual which is again really interesting and I think that if the patient has noticed a temporal relationship a close temporal relationship between coffee and heart palpitations then it's obviously best to avoid drinking the coffee or caffeine irrespective of what the researchers because you know why do you want the symptoms what about ventricular dysrhythmias what is the effect of coffee on ventricular dysrhythmias and there is really again no good evidence which points to the fact that coffee increases ventricular dysrhythmias like ventricular ectopy ventricular tachycardia etc there have been almost five placebo control studies again small studies which are shared that even drinking up to six cups of coffee per day didn't seem to trigger of heart rhythm disturbances coming from the ventricle so again really interesting there are some very old small studies which suggested that if you drank more than nine cups of coffee a day then there was a propensity to having more ventricular dysrhythmias but in moderate quantities coffee doesn't sink just try and tricular dysrhythmias as the research suggests so what about tea tea also contains caffeine tea contains less caffeine than coffee the question really that I wanted to try and look into was this tea increased the risk of heart rhythm disturbances tea contains as I said less caffeine but is rich in something called EGCG EGCG stands for something called FP gallo Kotecha made gal H I have no idea but this is what EGCG stands for and this compound has anti-inflammatory effects in fact they gave a bunch of rabbits this compound and they found those rabbits got less AF compared to rabbits who weren't given this compound there have been some studies small case control studies that the ingestion of green tea in particular is actually beneficial for episodes of Heth it reduces they're--the and it also reduces ventricular dysrhythmias there was one study where they looked at all the studies to do with tea and they found that if you drank three cups of tea a day green tea a day there was a lower risk of cardiac death so that's again interesting finally what about energy drinks now energy drinks as I say contain so much more caffeine than coffee or anything else the problem with energy drinks is that they have a lot of other energy boosting substances so they'll have sugar they'll have a third row they'll have guarana they'll have your him beat and therefore there's a much higher risk of causing heart rhythm disturbances and the G drinks are often taken with alcohol they're taken with enlisted drugs and this makes for a very unhealthy combination there are lots of case reports now coming out that the ingestion of energy drinks increases heart rhythm disturbances increases topics increases the presence of atrial fibrillation supraventricular tachycardia and even ventricular tachycardia in fact 75 percent of patients who have had more than two energy drinks in a day will complain of palpitations compared to those who that than two energy drinks in a day in addition it's worth knowing that the that energy drinks have been associated with prolongation of the QT interval remember when the QTc interval goes up there's a much higher risk of heart rhythm disturbances and very dangerous heart rhythm disturbances there's some note that energy drinks can unmask conditions like the Brugada syndrome again that potentially very very dangerous lethal condition we also have are beginning to see that energy drinks can actually trigger off a pro crackable state so they can actually increase the plotting of the body promoting blood clots and that again points to this real worry about energy drinks so in summary what I would say is that it appears that coffee is probably okay in moderate quantities tea is probably beneficial in moderate quantities the energy drinks are probably harmful even in moderate quantities so I think the first thing to say again is I would highly recommend that you pay attention to your own triggers and you say that okay well if I do this this happen so I'm not going to do it when it comes to energy drinks I definitely don't recommend them because of the risks associated with them and because evidence is still beginning you just begin to accrue so 10 years down the line we may find that they're far more harmful than we thought so I hope you found this useful the message is everything in moderation including moderation itself thank you so much for all that you do for me all the best

Channel: York Cardiology

Views: 126,610

Rating: 4.9366231 out of 5

Keywords: Heart palpitations anxiety, Heart palpitations after eating, Heart palpitations causes, Heart palpitations symptoms, Heart palpitations treatment, Heart palpitations cure, Ventricular ectopics, Heart disease symptoms, Heart racing, Heart flutter causes, Heart palpitations at night, caffeine, energy drinks, coffee, tea, green tea, AF, afib, atrial fibrillation

Id: f4VKAMAb76c

Length: 10min 18sec (618 seconds)

Published: Fri Nov 01 2019