Is It Safe to Drink Coffee if You Have High Blood Pressure?

Coffee and high blood pressure have a complicated relationship. Here's what cardiologists want you to know.

Some people claim they can’t function completely without drinking their morning cup of coffee first. And although there are benefits to drinking coffee, the research on coffee intake and blood pressure is conflicting and inconclusive, says Barbara George, MD, the director of the Center for Cardiovascular Health Medicine at NYU Winthrop Hospital on Long Island in New York.

When it comes to blood pressure, it’s important to know your numbers. The top number of your blood pressure reading, systolic blood pressure, measures the force the heart exerts on the walls of arteries as it beats. The bottom number, diastolic blood pressure, measures the force when the heart is at rest. A blood pressure of less than 120/80 mm Hg is considered normal. A reading of  130/80 mm Hg or higher is high blood pressure.

Here’s what experts need you to know about the research on coffee and high blood pressure and any precautions you should take.

(Related: 7 Surprising Health Benefits of Coffee)

The relationship between coffee and high blood pressure

Drinking one to two cups of plain black coffee, depending on your body weight, doesn’t seem to be harmful, according to Health Canada. And coffee even has some surprising potential health benefits, including better focus, reduced inflammation, and lower risk of depression. As far as coffee intake and cardiovascular disease risk factors go, such as high blood pressure, information is mixed.

What does coffee do to blood pressure in the short term?

Caffeine, the main ingredient in coffee, constricts blood vessels, and raises blood pressure in the short term, according to Dr. George. “Recent studies have shown that all types of coffee can increase blood pressure slightly, but remain in the healthy range and is temporary,” she says. “There are other ingredients in coffee called antioxidants that have a protective effect on blood vessels.” In fact, a study published in the 2013 journal Antioxidants found that coffee has more antioxidants than wine and tea.

What does coffee do to blood pressure in the long term?

The long-term side effects of drinking coffee on blood pressure really depend on whether you’re a habitual or occasional coffee drinker, according to Dr. George. A 2017 review in the journal Nutrients, found that increased coffee consumption is associated with a small decrease in hypertension, or high blood pressure.

More recent studies suggest that it is safe (either no benefit or some benefit) to drink three to four cups of coffee a day for people who have hypertension, according to Dr. George. And habitual coffee drinking has been linked to a lower risk of coronary heart disease in women, per a meta-analysis in the European Journal of Epidemiology.

But that doesn’t mean more is better.

Studies, like one published in 2019 in the American Journal of Clinical Nutrition, found that people who drank more than six cups of coffee a day had a higher risk of cardiovascular disease, than moderate coffee drinkers. “Moderate intake was linked to the lowest risk of cardiovascular disease,” says Satjit Bhusri, MD and founder of Upper East Side Cardiology in New York.

“People also need to be mindful of consuming other drinks and even foods with added caffeine, including caffeinated waters, juices, energy drinks, chocolates, candies, and even potato chips,” Dr. Bhusri says.

(Related: 10 Things That Happen to Your Body When You Quit Coffee)

How much caffeine is too much?

Limiting caffeine to less than 300 milligrams (mg), or about three cups of coffee per day, can help avoid high blood pressure from reaching critical levels, Dr. Bhusri says. Green tea extract and other caffeine-related products, such as matcha, all increase the adrenaline surge, too. Coffee can make you more alert, but in doing so, it elevates blood pressures.

If you are a habitual daily coffee drinker and are consuming no more than the recommendations, it is safe, according to Dr. George. “For those that don’t typically drink coffee, there might be some intolerance resulting in things such as increased heart rate or anxiety,” Dr. George says. “For those folks, they might want to stick with decaf.”

More specific coffee intake recommendations also depend on so many individual factors. These include possible genetic predispositions, medication interactions, or an irregular heartbeat such as atrial fibrillation. Dr. George recommends discussing this with your health care provider if you’re concerned about high blood pressure and your coffee habit.

And remember always to avoid drinking coffee before having blood pressure checked since caffeine intake can temporarily raise blood pressure and provide an inaccurate reading, Dr. George notes.

(Related: Coffee vs. Tea — Which One Is Better for You?)

Watch what you put in your coffee, too

Remember what you put in your coffee also can affect your health. “What is more important is not the caffeine in coffee, but the extra ingredients folks add to spruce it up,” Dr. George says.

Sugar, artificial sweeteners, and heavy cream all can potentially add lots of calories or are linked to other risk factors, such as excess weight or type 2 diabetes, ultimately negating the benefits of coffee, according to Dr. George.

(Related: Is Bulletproof Coffee All That?)

Bottom line

Coffee may spike your blood pressure in the short term, but drinking a moderate amount may have potential benefits for heart health. Everyone, including people with high blood pressure, should be aware of their caffeine tolerance and reactions.

Get your healthy caffeine dose ideally from black coffee or tea and try your best to skip the sugar, Dr. Bhusri recommends. And if you’re concerned about your blood pressure, consult your doctor for more tailored advice.

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