Your Health: Caffeine & the Heart

for this week's your health segment we are joined by dr. Steven Pollak cardiologist at the University of Maryland st. Joseph's Medical Center dr. thanks for being here it's great to be here Jeff we've been reading about caffeine and apparently some studies that say it's okay what's really interesting is there was one study came out several weeks ago and it made the front page news of everywhere and because that's because caffeine is like the number one drink in the country it implied that study that you can drink caffeine without a heart problem the study is flawed because it goes back to 1990 when people were drinking a cup of coffee was four ounces maybe two cups of coffee was eight ounces today this is 12 ounces so that's three of those and this has close to 300 milligrams of caffeine this has close to 400 milligrams of caffeine this is a venti this is their treinta this has close to 600 milligrams of caffeine so there's no question that caffeine will is a stimulant raises pulse and blood pressure it's a drug yes and I have to be very careful because my son Jeremy and my partner Brett Roberts who's an electrophysiologist said I cannot say that caffeine is directly related to the cause of atrial fibrillation however it's directly related to the cause of atrial fibrillation anecdote didn't hear the distinction but yes anecdotally so either in my experience patients who are prone who at risk who have high blood pressure under stress you start putting that much caffeine in their body and I've never seen anyone either drink at all so they have two of these sometimes they have two of these we're talking at 600 to 800 milligrams of caffeine a day that is an irritant to the heart and particularly in older patients it will increase their risk for cardiac rhythm abnormalities including atrial fibrillation so when you say anecdotally you believe that what you're saying is in all your years of practicing you've talked to a lot of people who have hardware them abnormalities and you ask how much coffee did you have today yes and free what they'll say is I have two cups it and I go what do you mean a cup that you got in the restaurant no no they I got this at the Starbucks or I got Dunkin Donuts or I got 7:11 all of which are huge cups of coffee and a great a large amount of caffeine I happen it's just that's the mistake of that study and it's a retrospective study so it looked back no one's really done a study to take a look at two groups of people who drink all of this and who don't drink it and see if they have rhythm happening to people the people have a different level of tolerance for this stuff so I I have almost no caffeine if I drank one of those I would be awake until next Thursday yes me too and I would have heart rhythm abnormalities I think the younger population in all honesty can tolerate this the older population defined as over forty five to fifty doesn't do as well what does it do to blood pressure so what's really ironic is someone who comes into your office with blood pressure that's elevated and having trouble controlling it the first question I ask is are you adding salt to your food and the second is are you drinking caffeine because both of those raise your blood pressure so here's patient receiving a lot of drugs to lower their blood pressure and they're taking drugs to raise their blood pressure so it makes a lot of sense for me to take that out from their diet rather than give them more drugs and and somebody who you're working long hours you have a cup of coffee to wake you up but if you do that every day then you need a little bit more your body adjusts to it well there's no evidence that it develops a tolerance but you start talking to people and they need more and more caffeine now what I tell people is particularly have heart rhythm abnormalities or hypertension go ahead you can have a cup of coffee that's the cup that they serve you in the restaurant which is four ounces that's a hundred milligrams of caffeine you can't have this they make decaf also you can have all the decaf you want there's decaf isn't zero it is five to fifteen milligrams of caffeine so that's nothing you can have 200 milligrams of caffeine a day without a problem but when you start getting six hundred eight hundred thousand milligrams you're gonna have problems let me remind our viewers if you have a question about caffeine or your heart in general give us a call we'll have the number up on the screen or tweet your question to @mptnews let's broaden out to two heart health like that what what aren't we focusing enough on these days so the number one cause of death in this country is coronary artery disease blocked arteries in the heart the first symptom of that illness is death one-third of the time now that is an incredible statement and yet it's true so most of this country knows that if you're over 50 the tests you need to get is a colonoscopy that's the number six cause of death no one gets the appropriate tests for identifying coronary disease and the tragedy of that is all the advances that we've made in cart in the treatment angioplasty heart surgery medications none of that is available to you if your first symptom is dropping dead what is the appropriate test because people may think well I got a checkup every so often they do an EKG I've been tested right no the EKG doesn't tell you anything about the status of your heart arteries and it doesn't say whether or not you have blocked arteries so the best test to get is called a coronary calcium score that's a cat scan of the heart so what happens is when you put blockages inside the artery the artery doesn't like it and puts calcium around the wall that calcium is a marker for the presence of the disease so if your calcium score is elevated you are at higher risk for coronary disease you actually have coronary disease and you need to be on therapy and that's before you ever have a symptom your EKG is normal your stress test would be normal but you still have 30 40 50 percent blocked arteries all of which can cause a heart attack in fact that's the most common cause of a heart attack so somebody with no history no symptoms goes to the primary care and there what age to do so any man over the age of 45 should have a calcium score any woman over the age of 50 what is really ironic about this is insurance doesn't cover it I was going to ask what was gone you go to your primary care and say and I heard on TV from dr. I should have this done yes well what's what's he or she gonna say well I would hope they say you that you should get it done you by the way don't need a physician's order for this because it's cash out of your pocket so the test now costs anywhere between 75 and 120 dollars it's offered at st. Joe we have a program called hardware which excellent you can go online you can find out what your wrists are it pretty much pushes most people towards this score and then if your score is greater than zero really greater than 25 you should see somebody about being placed on therapy so that that therapy includes an aspirin which prevents heart attack and a statin which prevents heart attacks CT scan painless and letting anybody know died it's five minutes it's radiation it's the equivalent of about five chest x-rays or so and the interesting thing is once that test is abnormal you never get it again it's you don't do serial tests once you've identified that you have the disease you then go on therapy and receive follow from the cardiologist all right talk about the aspirin too thing a little bit more you're talking baby aspirin yes so what causes a heart attack is when this minor blockage breaks and it triggers a cascade of events that causes a blood clot aspirin prevents that a drug as simple as aspirin which by the way we didn't know in 1980 we didn't find this out until 1985 but what causes a heart attack is the broken or ruptured plaque that precipitates blood clots quick phone call Baltimore City this is Marcia Marcia thanks for the call go ahead hi I just was wondering if dr. had any comments on the energy drinks that so many young people really drink a lot of my son one of them the twenty and thirty year olds and I'm fabulous question thank you very much so the monster drinks the monster energy drinks have about a hundred and sixty milligrams of caffeine like Red Bull a hundred and fifty milligrams so that's less than one cup of coffee so you have to drink three or four of them to get the equivalent of a grande caffeine coffee from Starbucks so it's I don't recommend it but it's not as bad as having two of those and we talked about the baby aspirin focus on all the statins for a second so some side effects there yes about three percent of people will have a side effect from statins and that is muscle aches interestingly enough when they did the study the same three percent who'd weren't on the statins had muscle aches the drug is remarkable in that it prevents heart attacks it lowers the incidence of heart by 60% that is it stabilized that blockage so it doesn't rupture or break and it prevents progression so it's in essence a wonder drug and it's the standard treatment for coronary disease dr. Steven is cardiologist with the University of Maryland st. Joseph's Medical Center thank you for your time my pleasure thanks for having you take the coffee cup oh I have to your health segments are a co-production of Maryland public television and the University of Maryland Medical system you

Channel: UMMCVideos

Views: 134,388

Rating: 4.7861824 out of 5

Keywords: 4864460548001, heart attack, heart, caffeine, coffee, youtube, statins

Id: WdEppAyWi0U

Length: 9min 30sec (570 seconds)

Published: Mon May 02 2016