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Evaluation of the effects of expresso coffee on metabolic profile, blood pressure, arrythmias and response to exercise


Introduction:Some studies have demonstrated the effect of coffee consumption on human health and have suggested some benefits on reducing deaths from cardiovascular disease. The underlying mechanism for this effect are still being investigated but little is known about espresso itself, one of the most brewing method use today in the world and here in Brazil, the reason for this study. Aim: The aim of this study is evaluate the effects of espresso consumption, caffeinated and decaffeinated on heart rate (HR), premature ventricular and supraventricular rates, heart rate variability (HRV), blood pressure (BP), plasma lipids, total homocysteine (tHcy), Plasma lipoprotein(a) (Lp[a]), sirtuins, Rage, small- LDL-cholesterol and fasting serum glucose of the subjects. Casuístic: 30 subjects will be evaluated. Methods: On this randomized, crossover clinical trial, we will compare the effects of the consumption of 120 to 160 ml per day of caffeinated and decaf espresso for 4w each on subjects with coronary heart disease confirmed by diagnosis, and with eligibility criteria. After a washout period and after 4 wk period of espresso consumption, the subjects will undergo blood tests, exercise test and ambulatory blood pressure monitoring. Among the biomarkers, sirtuins RAGE and small-LDL-cholesterol particles will be analyzed. All the subjects will receive dietary counseling from a nutritionist, who will guide them in all phases of the study. A nespresso coffee machine will be loaned to the subjects, as well as enough coffee capsules to make 4 espressos a day for 28 days, making up to 120 capsules received in ten paper boxes. The coffee machine will be returned at the end of the study period. Eligibility criteria: presence of chronic CAD and age 20y to 80y. Nonsmoker or former smoker (>6 m) and non- alcoholics. Exclusion criteria: serum creatinine levels > 2,5 mg/dl; hemoglobin < 12 g/% for men and < 11 g/% for women; blood platelet < 100.000 or > 400.000; leucocytes > 12.000/mm3, fasting glucose > 160. Alterations of ALT, AST beyond the upper limits. Heart electrical conduction disorder. Ventricular dysfunction (EF < 45%). Physical incapacity or limitations to exercise. History of any disease that, in the investigator opinion, could be a confounder on the study results or putting the subject at additional risk. Inability to understand procedures of the study and/or sign the the written informed consent form (WICF). Through the colected and organized data on the variables of interest, all analyses will be performed using SPSS 20.0.0 version. To check the normality, the Kolmogorv-Smirnov test will be used, with Lilliefors correction. The epidemiological study carried out here will be conducted in a controlled longitudinal way and, therefore, for parametric variables, it will be used Analysis of Variance - ANOVA with repeated measures, and then paired Student t-test, with Bonferroni correction; for non-parametrics variables, Friedman test will be used and after the Mann-Whitney U test with Bonferroni correction. A two-tailed P < 0.05 (alfa) will be considered significant calculated for the average and an error margin of 20% (beta). (AU)

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