Caffeine and Your Arteries

Dr. Caldwell Esselstyn’s heart disease reversal diet is a strict, low-fat WFPB diet that forbids: meat, fish, poultry, eggs, dairy, oil, nuts, seeds and avocado.

During one of his lectures at Plant Stock 2013, Dr Esselstyn revealed that he has added caffeine to his list of foods/substances that he forbids his CAD patients from consuming.

One of the studies that concerns Dr. Esselstyn was published in the European Journal of Clinical Nutrition in 2010.1

The objective of the study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD). In essence, the study authors wanted to see if both caffeinated coffee and decaffeinated coffee damaged the endothelial cells (inner lining) of arteries by looking to see if blood flow was hampered soon after consumption.

What were the basic results?

After drinking caffeinated coffee, the participants’ systolic and diastolic blood pressure increased. At both 30 and 60 minutes, systolic blood pressure had increased from 113 to 116 (2.7% increase) and diastolic blood pressure increased from 68 to 72 (5.9% increase) (p<0.05).

Arterial flow decreased after drinking caffeinated coffee, to an average maximum of 22.1% at 60 minutes (p<0.05).

They did not see this effect with decaffeinated coffee.

How did the researchers interpret the results?

The researchers conclude that: “caffeinated coffee induces significant endothelial dysfunction”. They suggest that coffee may have unfavorable acute cardiovascular and metabolic effects on endothelial function.

An article critiquing the study entitled “Coffee and Blood Flow” was published on the “NHS Choices” web site. You can click here for the entire article. The article contains the following facts about the study:

  •  the actual effect was modest and unlikely to have any adverse     health effects.
  • the researchers did not assess whether these changes persisted beyond an hour or how long it took for blood flow to return to its starting point.
  •  the study was in only 20 people, and with such a small number of participants, there is an increased likelihood that the results are due to chance alone.
  • the study does not provide any evidence for the long-term effects of coffee on health.

 The article goes on to say “Larger studies and further research is needed to assess the effect of coffee on circulation, and the long-term effects of coffee consumption on health.”

I agree that larger studies are necessary in order to discover caffeine’s long term effect on artery health. 

However, I also agree that Dr. Esselstyn is correct in erring on the side of caution by placing caffeine on his list of foods/substances that CAD patients should avoid.  The health of the endothelial lining of arteries is extremely important in protecting people from heart attacks and strokes.  Click here for information about arterial endothelial cells.

 I think it is reasonable to assume that daily damage to endothelial cells caused by long term caffeine consumption, could increase a person’s risk for suffering a heart attack or stroke – especially if the person is a CAD patient.

 Once you transition from the Standard American Diet to a WFPB diet, you won’t need caffeine to keep you alert throughout the day. I suggest that you consider kicking caffeine to the curb.

If you quit caffeine “cold turkey”, you will probably experience caffeine withdrawal symptoms such as headaches, drowsiness and tiredness. These discomforts usually subside in 4-7 days.

1.Acute effects of coffee on endothelial function in healthy subjects

S Buscemi, S Verga, J A Batsis, M Donatelli, M R Tranchina, S Belmonte, A Mattina, A Re and G Cerasola

Eur J Clin Nutr 64: 483-489; advance online publication, February 3, 2010; doi:10.1038/ejcn.2010.9



  1. Excellent references! Esselstyn’s article with factual health consequences and financial reasoning for current and future costs has got to make sense to people. Especially now, with regards to coverage-may it be the impetus to propel change in the direction of prrvention and reversal of heart disease.

    Thank you Dominic- keep writing!

  2. It looks like Dr. Esselstyn may be overdoing it here. He has been following his patients for 25 years or so without eliminating coffee. If it hasn’t aversely affected his patient in that time, how could it possibly have a significant effect?

    Another, earlier study that appears more comprehensive, suggests simply removing cafestol, an oil compound in coffee using a paper filter eliminates what can cause the cholesterol level to increase.

    • Dominic Marro RD CDN says:

      Thanks for sharing!

    • My Mother-in-law will be 103 years old April 2015. Still drinks 1 cup of regular coffee a day. Takes very little medicine, walks fine with a walker. Mind is sharp and says she feels fine no aches or pains. Always cheerful. Enjoys following The Cleveland Indians.
      I roast fresh coffee for local Amish Cheese stores and believe there are more benefits to drinking coffee than abstaining, unless it has adverse effects on you, then stop.
      Live Long, Drink Schloneger’s Fresh Roasted Coffee!

  3. Levi Wallach says:

    Here’s a study that shows green tea did not have an effect (or possibly a positive one) on endothelial function:

    And an article by Dr. Greger addressing caffeine. His take is that it’s not the caffeine but other substances that cause the dysfunction…

    • I agree, the last legal drug 😉 that nobody wants to give up has all kinds of “stuff” and chemicals and substances in it that did not exist when 100 year old granny (of course all here friends and relative are dead so isn’t it really dodge ball – not healthy living?)

      wheat, dairy, and all kinds of things are a different brew or concoction then it was 20 or 30 years ago.

      A modern analysis of all kinds of products are in order. I think coffee has possibly become like the new cigarette and so have many other modern “foods” that you can even eat less of and exercise like a triathalete and STILL feel hungry and get fat!!!!!!

      Look at US?

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