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咖啡和咖啡因摄入对高血压患者心房颤动的影响。

Influence of coffee and caffeine consumption on atrial fibrillation in hypertensive patients.

机构信息

Department of Biomedical Science, Section of Cardiology, University of Modena and Reggio Emilia, Via del pozzo, 71, 41100 Modena, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2011 Jun;21(6):412-7. doi: 10.1016/j.numecd.2009.11.003. Epub 2010 Feb 18.

DOI:10.1016/j.numecd.2009.11.003
PMID:20167459
Abstract

BACKGROUND AND AIMS

Coffee and caffeine are widely consumed in Western countries. Little information is available on the influence of coffee and caffeine consumption on atrial fibrillation (AF) in hypertensive patients. We sought to investigate the relationship between coffee consumption and atrial fibrillation with regard to spontaneous conversion of arrhythmia.

METHODS AND RESULTS

A group of 600 patients presenting with a first known episode of AF was investigated, and we identified 247 hypertensive patients. The prevalence of nutritional parameters was assessed with a food frequency questionnaire. Coffee and caffeine intake were specifically estimated. Left ventricular hypertrophy was evaluated by electrocardiogram (ECG) and echocardiogram. Coffee consumption was higher in normotensive patients. High coffee consumers were more frequent in normotensive patients compared with hypertensive patients. On the other hand, the intake of caffeine was similar in hypertensive and normotensive patients, owing to a higher intake in hypertensive patients from sources other than coffee. Within normotensive patients, we report that non-habitual and low coffee consumers showed the highest probability of spontaneous conversion (OR 1.93 95%CI 0.88-3.23; p=0.001), whereas, within hypertensive patients, moderate but not high coffee consumers had the lowest probability of spontaneous conversion (OR 1.13 95%CI 0.67-1.99; p=0.05).

CONCLUSION

Coffee and caffeine consumption influence spontaneous conversion of atrial fibrillation. Normotensive non-habitual coffee consumers are more likely to convert arrhythmia within 48h from the onset of symptoms. Hypertensive patients showed a U-shaped relationship between coffee consumption and spontaneous conversion of AF, moderate coffee consumers were less likely to show spontaneous conversion of arrhythmia. Patients with left ventricular hypertrophy showed a reduced rate of spontaneous conversion of arrhythmia.

摘要

背景和目的

咖啡和咖啡因在西方国家被广泛消费。关于咖啡和咖啡因的摄入对高血压患者心房颤动(AF)的影响,信息很少。我们试图研究咖啡消费与心律失常自发转复之间的关系。

方法和结果

研究了一组 600 名首次出现 AF 的患者,我们确定了 247 名高血压患者。通过食物频率问卷评估营养参数。具体估计咖啡和咖啡因的摄入量。通过心电图(ECG)和超声心动图评估左心室肥厚。在正常血压患者中,咖啡的消耗量较高。与高血压患者相比,正常血压患者中高咖啡消费者更为常见。另一方面,由于高血压患者从咖啡以外的来源摄入更多的咖啡因,高血压和正常血压患者的咖啡因摄入量相似。在正常血压患者中,我们报告说非习惯性和低咖啡消费者显示出最高的自发性转化概率(OR 1.93 95%CI 0.88-3.23;p=0.001),而在高血压患者中,只有中度而非高咖啡消费者自发性转化的可能性最低(OR 1.13 95%CI 0.67-1.99;p=0.05)。

结论

咖啡和咖啡因的摄入会影响心房颤动的自发性转化。正常血压的非习惯性咖啡消费者在症状发作后 48 小时内更有可能使心律失常恢复正常。高血压患者的咖啡摄入量与 AF 的自发性转化之间呈 U 形关系,中度咖啡消费者发生心律失常的自发性转化的可能性较小。左心室肥厚的患者心律失常的自发转化率降低。

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