CAFFEINE EFFECTS ON STRESS REACTIVITY

咖啡因对应激反应的影响

• 批准号: 6363531
• 负责人: James D. Lane
• 金额: $ 33.91万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-05-01 至 2003-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6363531
• 关键词: blood pressure; caffeine; cardiovascular disorder prevention; cardiovascular pharmacology; catecholamines; clinical research; clinical trials; cortisol; drug interactions; drug withdrawal; human subject; hypertension; neuroendocrine system; smoking; stress; urinalysis; blood pressure; caffeine; cardiovascular disorder prevention; cardiovascular pharmacology; catecholamines; clinical research; clinical trials; cortisol; drug interactions; drug withdrawal; human subject; hypertension; neuroendocrine system; smoking; stress; urinalysis

Caffeine is the most widely consumed drug in the U.S., yet questions remain about the long-term health consequences of habitual consumption, especially with regard to cardiovascular diseases. Caffeine is known to raise blood pressure (BP), and research shows that it can potentiate cardiovascular and neuroendocrine stress reactivity. Both effects could increase the risks of developing cardiovascular diseases including hypertension and heart disease. The long-term objectives of this project are to investigate caffeine's effects, determine their implications for cardiovascular health and disease, and characterize the individuals who are most at risk. The specific aim of this application is to explore the potential cardiovascular health benefits that hypertensive individuals could obtain from the cessation of habitual caffeine consumption. Two hypotheses will be tested. (1) Caffeine cessation results in clinically significant reductions in BP in hypertensive individuals. (2) Caffeine cessation reduces activation of the neuroendocrine stress pathways that can mediate BP elevations. This clinical intervention trial includes groups of habitual coffee drinkers who have blood pressures in the high normal or mild hypertensive range and those who are currently receiving medication for established hypertension. Subjects will complete 7-day periods of ad lib caffeine consumption or experimental caffeine abstinence followed by a day of ambulatory monitoring. The effects of caffeine cessation on BP will be evaluated using both casual (office) and ambulatory measurements collected during the activities of the normal day. The effects of cessation on activation of neuroendocrine stress response pathways will be investigated in ambulatory measures of urinary catecholamine and cortisol excretion in the same environment. Hypertensive individuals could receive an immediate benefit if we learn that caffeine cessation reduces blood pressure. Those with high normal BP or mild hypertension might avoid or postpone the need for anti-hypertensive medications by adding caffeine cessation to a program of dietary and lifestyle management. Hypertensive patients already receiving pharmacological treatment might lower BP even more by caffeine cessation, further reducing their risk of long-term complications and perhaps reducing their need for medication. Although caffeine cessation may not be necessary for everyone, it may clearly contribute to BP management in hypertensive individuals and thereby reduce the risks for heart disease, stroke, and kidney disease that are the consequences of this disease.

咖啡因是美国最广泛消费的药物，但有关习惯消费的长期健康后果的问题，尤其是在心血管疾病方面。 众所周知，咖啡因会升高血压（BP），研究表明它可以增强心血管和神经内分泌应激的反应性。 两种影响都可能增加患心血管疾病在内的风险，包括高血压和心脏病。 该项目的长期目标是研究咖啡因的作用，确定其对心血管健康和疾病的影响，并表征最有风险的人。 该应用的具体目的是探索高血压个体可以从习惯性咖啡因消耗中获得的潜在心血管健康益处。将检验两个假设。 （1）咖啡因戒烟导致高血压个体的BP临床显着降低。 （2）咖啡因戒烟减少了可以介导BP升高的神经内分泌应激途径的激活。这项临床干预试验包括一群习惯性饮用者，这些饮酒者的血压在高正常或轻度高血压范围内以及目前正在接受既定高血压药物的药物。 受试者将完成7天的AD Lib咖啡因消耗或实验性咖啡因戒烟，然后进行一次卧床监测。咖啡因戒烟对BP的影响将使用正常日活动期间收集的休闲（办公室）和卧床测量进行评估。 在同一环境中，戒烟对神经内分泌应激反应途径激活的影响将在尿中儿茶酚胺和皮质醇排泄的情况下进行研究。如果我们得知咖啡因戒烟会降低血压，高血压患者可能会立即获得好处。 BP高或轻度高血压的人可能会避免或推迟需要通过在饮食和生活方式管理计划中添加咖啡因来抗抗高血压药物。已经接受药理治疗的高血压患者通过咖啡因停止可能会降低BP，从而进一步降低其长期并发症的风险，并可能减少对药物的需求。 尽管咖啡因可能并不是每个人都需要的，但它可能显然会导致高血压个体的BP管理，从而降低这种疾病后果的心脏病，中风和肾脏疾病的风险。