Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients. Markers of Inflammation, Endothelial Activation, and Arterial Stiffness in Hypertensive Heart Disease and the Effects of Treatment: Results From the SILVHIA Study Effect of dark chocolate on arterial function in healthy individuals. Influence of glucose control, lipoproteins, and haemostasis function on brachial endothelial reactivity and carotid intima-media area, stiffness and diameter in Type 1 diabetes mellitus patients. Renal function is associated with arterial stiffness and predicts outcome in patients with coronary artery disease. Acute Effect of Caffeine on Arterial Stiffness and Aortic Pressure Waveform Paper-filtered coffee increases cholesterol and inflammation biomarkers independent of roasting degree: a clinical trial. Favorable effects of concord grape juice on endothelial function and arterial stiffness in healthy smokers. Effect of coffee on endothelial function in healthy subjects: the role of caffeine. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. Acute effects of coffee on endothelial function in healthy subjects Impact of acute caffeine ingestion on endothelial function in subjects with and without coronary artery disease. Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections. Caffeine increases aortic stiffness in hypertensive patients. Effects of dark chocolate and cocoa consumption on endothelial function and arterial stiffness in overweight adults. Coffee polyphenols improve peripheral endothelial function after glucose loading in healthy male adults. The influence of white-coat hypertension on left atrial phasic function
BACKGROUND Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality . OBJECTIVE This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program ( ECR ) on arterial stiffness , and on inflammatory and endothelial dysfunction biomarkers . Additionally , it was assessed two potential confounding variables , daily physical activity and dietary intake . METHODS In this parallel-group trial , 96 patients ( 56 ± 10 years ) were r and omized to either  the exercise group ( EG ) or control group (  CG ) 4 weeks after suffering acute myocardial infa rct ion ( MI ) .  ECR consisted of 8 weeks of aerobic exercise at 70 - 85 % of maximal heart rate during 3 sessions weekly , plus usual care . CG participants received only usual care . Baseline and final assessment s included arterial stiffness through carotid-femoral pulse wave velocity ( cf-PWV ) , inflammatory and endothelial dysfunction biomarkers , daily physical activity , and dietary intake . ( Clinical Trials.gov : NCT01432639 ) . RESULTS After 8 weeks , no significant changes were found between groups in cf-PWV , inflammatory and endothelial dysfunction biomarkers , daily physical activity , or dietary intake . Excluding those patients ( n = 7 ) who did not attend , at least 80 % of the exercise sessions provided similar results , excepting a significant reduction in cf-PWV in the EG compared to the CG . CONCLUSIONS A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication . Nevertheless , the decrease of cf-PWV observed in the EG , when considering only those patients who attended at least 80 % of exercise sessions , warrants further investigation Abstract : We assessed the contribution of blood pressure ( BP ) , inflammation , and endothelial activation to the development of structural vascular and cardiac changes in hypertension . Furthermore , the effects of antihypertensive therapy were studied . We studied 114 patients with hypertension and left ventricular hypertrophy and 38 matched hypertensive subjects without cardiac hypertrophy and 38 normotensive subjects . The group with hypertension and cardiac hypertrophy were r and omized to treatment with an angiotensin receptor blocker ( irbesartan ) or a beta-adrenergic receptor blocker ( atenolol ) for 48 weeks . Markers of inflammation ( high-sensitive C-reactive protein , interleukin-6 , leukocyte counts ) , vascular function ( ambulatory aortic stiffness index , arterial compliance , and pulse pressure ) , and endothelial activation ( E-selectin , intracellular adhesion molecule-1 , vascular adhesion molecule-1 ) were assessed . Markers of inflammation and arterial stiffness were lowest in the normotensive group and highest in patients with hypertensive heart disease ; endothelial markers were similar between groups . Inflammation was independently related to BP . Markers of arterial stiffness were independently related to BP and to a lesser extent to left ventricular mass . Antihypertensive treatment improved arterial compliance ; inflammatory and endothelial markers remained unchanged . In conclusion , markers of inflammation and arterial stiffness are independently related to BP . Antihypertensive therapy seems to improve arterial stiffness , but effects on markers of inflammation and endothelial activation are small BACKGROUND Epidemiologic studies suggest that high flavonoid intake confers a benefit on cardiovascular outcome . Endothelial function , arterial stiffness , and wave reflections are important determinants of cardiovascular performance and are predictors of cardiovascular risk . METHODS The effect of flavonoid-rich dark chocolate ( 100 g ) on endothelial function , aortic stiffness , wave reflections , and oxidant status were studied for 3 h in 17 young healthy volunteers according to a r and omized , single-blind , sham procedure-controlled , cross-over protocol .  Flow-mediated dilation ( FMD ) of the brachial artery , aortic augmentation index ( AIx ) , and carotid-femoral pulse wave velocity ( PWV ) were used as measures of endothelial function , wave reflections , and aortic stiffness , respectively . Plasma oxidant status was evaluated with measurement of plasma malondialdehyde ( MDA ) and total antioxidant capacity ( TAC ) . RESULTS Chocolate led to a significant increase in resting and hyperemic brachial artery diameter throughout the study ( maximum increase by 0.15 mm and 0.18 mm , respectively , P < .001 for both ) . The FMD increased significantly at 60 min ( absolute increase 1.43 % , P < .05 ) . The AIx was significantly decreased with chocolate throughout the study ( maximum absolute decrease 7.8 % , P < .001 ) , indicating a decrease in wave reflections , whereas PWV did not change to a significant extent . Plasma MDA and TAC did not change after chocolate , indicating no alterations in plasma oxidant status . CONCLUSIONS Our study shows for the first time that consumption of dark chocolate acutely decreases wave reflections , that it does not affect aortic stiffness , and that it may exert a beneficial effect on endothelial function in healthy adults .  Chocolate consumption may exert a protective effect on the cardiovascular system ; further studies are warranted to assess any long-term effects BACKGROUND The objectives of this study were to determine the influence of glucose control on lipoprotein and haemostasis variables in Type 1 diabetes mellitus patients and to evaluate the global impact of these metabolic risk factors on brachial artery reactivity and carotid artery atherosclerosis , stiffness and diameter . DESIGN Follow up of Type 1 diabetes patients r and omized to insulin-intensive conventional treatment ( ICT , n = 29 ) or insulin-st and ard treatment ( ST , n = 25 ) in the Stockholm Diabetes Intervention Study ( SDIS ) more than 14 years ago . RESULTS The intensive conventional treatment patients had lower glycosylated haemoglobin ( HbA1c ) compared with the ST patients , i.e. 7.01 ( SD 0.51 ) vs. 8.31 ( 0.97 ) , while concentrations of the lipoprotein and haemostasis variables analyzed were virtually similar . The carotid artery intima-media area was associated with high HbA1c , high serum (S)-cholesterol levels , and low high-density lipoprotein (HDL)-cholesterol levels . Carotid artery stiffness was associated with high systolic blood pressure , high HbA1c , high fibrinogen , and high HDL-cholesterol . Brachial artery endothelial reactivity was higher for women and those with low S-cholesterol . CONCLUSION In patients with Type 1 diabetes , glucose control appeared to have no effect on either lipoproteins or haemostasis variable concentrations . Poor glucose control , and high levels of S-cholesterol , systolic blood pressure and plasma fibrinogen were associated with development of atherosclerosis , thus emphasising the importance of global risk factor control in patients with Type 1 diabetes mellitus BACKGROUND Arterial stiffness ( AS ) is associated , and a predictor of , outcome in patients with cardiovascular and renal disease . AIM In this study , we estimated glomerular filtration rate ( eGFR ) and measured indices of AS in patients with suspected coronary artery disease ( CAD ) , and assessed their predictive value on outcome . DESIGN Prospect i ve cohort study . METHODS AS was measured using pulse wave velocity ( PWV ) and pulse wave analysis in patients with no known renal disease who had recently undergone coronary angiography .  Renal function was assessed using serum creatinine concentration [creat](sr ) and eGFR ( Cockcroft & Gault , C&G ) . The primary endpoint was a combination of hospitalization due to cardiovascular disease and all-cause mortality . RESULTS Two hundred eighty-four subjects ( 210 men , 74 women , mean age 62 years ) were followed-up for a mean of 1.5 years . PWV was negatively associated with eGFR ( r(2 ) = 0.09 , P < 0.001 ) , even in patients with an eGFR > or = 60 ml/min/m(2 ) ( r(2 ) = 0.04 , P < 0.01 ) . PWV was determined by age , heart rate , systolic blood pressure , body mass index and [creat](sr ) ( r(2 ) = 0.38 , P < 0.001 ) . A lower eGFR ( P < 0.01 ) , PWV above the median ( P < 0.05 ) and degree of CAD ( P < 0.001 ) predicted a shorter time to the primary endpoint . eGFR and degree of CAD remained independent determinants of outcomes ( P < 0.01 ) , even in patients with normal renal function ( P < 0.01 ) . CONCLUSION This study suggests that even minor reductions in eGFR , within the normal range , are an additional independent risk marker in patients with CAD Caffeine acutely increases blood pressure and peripheral vascular resistance , in part because of sympathetic stimulation . Its effects on large artery properties are largely unknown . In a double-blind crossover study , 7 healthy subjects 26±2.6 years of age ( mean±SEM ) were studied for 90 minutes while in the supine position on 2 occasions separated by a week in r and om order after ingestion of 250 mL caffeinated ( 150 mg ) and decaffeinated ( < 2 mg ) coffee . Compared with baseline , arterial stiffness measured by carotid femoral pulse wave velocity increased progressively from 7.2±0.41 to 8.0±0.6 m/s ( P < 0.05 ) at 90 minutes after caffeine intake , an effect that may be independent of changes in blood pressure . In addition , arterial wave reflection , measured by applanation tonometry from the aortic pressure waveform , also increased from −5.7±7.6 % to 5.28%±5.6 ( P < 0.01 ) . No such changes were seen with decaffeinated coffee intake . Although the integral of the brachial systolic and diastolic blood pressure values over the 90 minutes was larger ( P < 0.05 ) after caffeinated than decaffeinated coffee intake , the effect on aortic systolic and diastolic blood pressures was more pronounced ( P < 0.05 ) than on the brachial artery . These results show a significant effect of caffeine intake on arterial tone and function and suggest that caffeine acutely increases arterial stiffness OBJECTIVE The aim of this study was to compare the effects of medium light roast ( MLR ) and medium roast ( MR ) paper-filtered coffee on  cardiovascular risk factors in healthy volunteers . METHODS This r and omized crossover trial compared the effects of consuming three or four cups ( 150 mL ) of MLR or MR coffee per day for 4 wk in 20 healthy volunteers .  Plasma lipids , lipoprotein(a ) ( Lp[a ] ) , total homocysteine , and endothelial dysfunction-related inflammation biomarkers , serum glycemic biomarkers , and blood pressure were measured at baseline and after each intervention . RESULTS Both roasts increased plasma total cholesterol , low-density lipoprotein-cholesterol , and soluble vascular cell adhesion molecule-1 ( sVCAM-1 ) concentrations ( 10 % , 12 % , and 18 % for MLR ; 12 % , 14 % , and 14 % for MR , respectively ) ( P < 0.05 ) . MR also increased high-density lipoportein-cholesterol concentration by 7 % ( P = 0.003 ) . Plasma fibrinogen concentration increased 8 % after MR intake ( P = 0.01 ) , and soluble E-selectin increased 12 % after MLR intake ( P = 0.02 ) . No changes were observed for Lp(a ) , total homocysteine , glycemic biomarkers , and blood pressure . CONCLUSION Moderate paper-filtered coffee consumption may have an undesirable effect on plasma cholesterol and inflammation biomarkers in healthy individuals regardless of its antioxidant content BACKGROUND Smoking is associated with impaired vascular function . Concord grape juice ( CGJ ) , a rich source of flavonoids , can modify cardiovascular risk factors . Endothelial function and arterial stiffness are surrogate markers of arterial health . We examined the impact of CGJ on arterial wall properties in healthy smokers . METHODS We studied the effect of a 2-week oral treatment with CGJ in 26 healthy smokers on 3 occasions ( day 0 ( baseline ) , day 7 , and day 14 ) in a r and omized , placebo-controlled , double-blind , crossover study . Measurements were taken before ( pSm ) , immediately after ( Sm0 ) , and 20 minutes after ( Sm20 ) cigarette smoking . Endothelial function was evaluated by flow-mediated dilation ( FMD ) of the brachial artery . Carotid-femoral pulse wave velocity ( PWV ) was measured as an index of aortic stiffness . RESULTS Compared with placebo , treatment with CGJ result ed in a significant improvement in pSm values of FMD ( P = 0.02 ) and PWV ( P = 0.04 ) . At baseline , smoking decreased FMD in both the CGJ group ( P < 0.001 ) and the placebo group ( P < 0.001 ) . Compared with placebo , CGJ treatment prevented the acute smoking-induced decrease in FMD on day 7 ( P = 0.02 ) and day 14 ( P < 0.001 ) . Moreover , at baseline , smoking induced a significant elevation in PWV in both the CGJ group ( P = 0.02 ) and the placebo group ( P = 0.04 ) . Treatment with CGJ prevented the smoking-induced elevation in PWV on day 7 ( P = 0.003 ) and day 14 ( P < 0.001 ) . CONCLUSIONS CGJ consumption improved endothelial function and vascular elastic properties of the arterial tree in healthy smokers and attenuated acute smoking-induced impairment of arterial wall properties Coffee is one of the most widely used pharmacologically active beverages . The present study was design ed to evaluate the acute effect of coffee ingestion on endothelial function in healthy individuals , and the potential role of caffeine . We studied 17 healthy young adults ( 28.9+/-3.0 years old ; nine men ) , who were regular non-heavy coffee drinkers . The endothelial performance was estimated by endothelium-dependent FMD ( flow-mediated dilatation ) of the brachial artery before and 30 , 60 , 90 and 120 min after ingestion of a cup of caffeinated coffee ( 80 mg of caffeine ) or the corresponding decaffeinated beverage ( < 2 mg of caffeine ) in two separate sessions , following a r and omized single-blind cross-over design . There was no difference in baseline FMD values between the two sessions [ 7.78 compared with 7.07 % after caffeinated and decaffeinated coffee respectively ; P = NS ( not significant ) ] . Caffeinated coffee led to a decline of FMD ( 7.78 , 2.86 , 2.12 , 4.44 and 4.57 % at baseline , 30 , 60 , 90 and 120 min respectively ; P < 0.001 ) . This adverse effect was focused at 30 ( P = 0.004 ) and 60 min ( P < 0.001 ) . No significant effect on FMD was found with the decaffeinated coffee session ( 7.07 , 6.24 , 5.21 , 7.41 and 5.20 % ; P = NS ) . The composite effect of the type of coffee consumed over time on FMD was significantly different ( P = 0.021 ) . In conclusion , coffee exerts an acute unfavourable effect on the endothelial function  in healthy adults , lasting for at least 1 h after intake . This effect might be attributed to caffeine , given that decaffeinated coffee was not associated with any change in the endothelial performance OBJECTIVES The study sought to evaluate the effects of endurance exercise training ( ET ) on endothelial-dependent flow-mediated arterial dilation ( FMD ) and carotid artery stiffness , and their potential contributions to the training-related increase in peak exercise oxygen consumption ( Vo2 ) in older patients with heart failure with preserved ejection fraction ( HFPEF ) . BACKGROUND Elderly HFPEF patients have severely reduced peak Vo2 , which improves with ET , however , the mechanisms of this improvement are unclear . FMD and arterial distensibility are critical components of the exercise response and are reduced with aging . However , it is unknown whether these improve with ET in elderly HFPEF or contribute to the training-related improvement in peak Vo2 . METHODS A total of 63 HFPEF patients ( age 70 ± 7 years ) were r and omized to 16 weeks of ET ( walking , arm and leg ergometry , n = 32 ) or attention control ( CT ) ( n = 31 ) . Peak Vo2 , brachial artery FMD in response to cuff ischemia , carotid artery distensibility by high-resolution ultrasound , left ventricular function , and quality of life were measured at baseline and follow-up .  RESULTS ET increased peak Vo2 ( ET : 15.8 ± 3.3 ml/kg/min vs. CT : 13.8 ± 3.1 ml/kg/min , p = 0.0001 ) and quality of life . However , brachial artery FMD ( ET : 3.8 ± 3.0 % vs. CT : 4.3 ± 3.5 % , p = 0.88 ) , and carotid arterial distensibility ( ET : 0.97 ± 0.56 vs. CT : 1.07 ± 0.34 × 10(-3 ) mm·mm Hg(-2 ) ; p = 0.65 ) were unchanged . Resting left ventricular systolic and diastolic function were unchanged by ET . CONCLUSIONS In elderly HFPEF patients , 16 weeks of ET  improved peak Vo2 without altering endothelial function or arterial stiffness . This suggests that other mechanisms , such as enhanced skeletal muscle perfusion and /or oxygen utilization , may be responsible for the ET-mediated increase in peak Vo2 in older HFPEF patients . ( Prospect i ve Aerobic Reconditioning Intervention Study [ PARIS ] ; NCT01113840 ) Background / Objectives : Coffee is the most widely consumed beverage in the world , but its effect on the cardiovascular system has not been fully understood . Coffee contains caffeine and antioxidants , which may influence endothelial function , both of which have not yet been investigated . The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD).Subjects/ Methods : A total of 20 ( 10 males and 10 females ) healthy non-obese subjects underwent a double-blind , crossover study . Subjects ingested one cup of caffeinated ( CC ) and one cup of decaffeinated ( DC ) Italian espresso coffee in r and om order at 5- to 7-day intervals . Results : Following CC ingestion , FMD decreased progressively and significantly ( mean±s.e.m . : 0 min , 7.7±0.6 ; 30 min , 6.3±0.7 ; 60 min , 6.0±0.8 % ; ANOVA ( analysis of variance ) , P<0.05 ) , but it did not significantly increase after DC ingestion ( 0 min , 6.9±0.6 ; 30 min , 8.1±0.9 ; 60 min , 8.5±0.9 % ; P=0.115 ) . Similarly , CC significantly increased both systolic and diastolic blood pressure ; this effect was not observed after DC ingestion . Blood glucose concentrations remained unchanged after ingestion of both CC and DC , but insulin ( 0 min , 15.8±0.9 ; 60 min , 15.0±0.8 μU/ml ; P<0.05 ) and C-peptide ( 0 min , 1.25±0.09 ; 60 min , 1.18±0.09 ng/ml ; P<0.01 ) blood concentrations decreased significantly only after CC ingestion . Conclusions : CC acutely induced unfavorable cardiovascular effects , especially on endothelial function . In the fasting state , insulin secretion is also likely reduced after CC ingestion . Future studies will determine whether CC has detrimental clinical ly relevant effects , especially in unhealthy subjects Although coffee is a widely used , pharmacologically active beverage , its impact on the cardiovascular system is controversial . To explore the effect of acute caffeine ingestion on brachial artery flow-mediated dilation ( FMD ) in subjects without coronary artery disease ( CAD ; controls ) and patients with CAD , we prospect ively assessed brachial artery FMD in 40 controls and 40 age- and gender-matched patients with documented stable CAD on 2 separate mornings 1 week to 2 weeks apart . After overnight fasting , discontinuation of all medications for ≥12 hours , and absence of caffeine for > 48 hours , participants received capsules with caffeine 200 mg or placebo . One hour after drug ingestion , participants underwent brachial artery FMD and nitroglycerin-mediated dilation ( NTG ) using high-resolution ultrasound . As expected , patients with CAD were more often diabetic , hypertensive , obese , dyslipidemic , and smoked more than controls ( p < 0.01 for all comparisons ) . Aspirin , Clopidogrel , angiotensin-converting enzyme inhibitors , β blockers , and statins  were significantly more common in patients with CAD than in controls ( p < 0.01 for all comparisons ) . At baseline , FMD , but not NTG , was significantly lower in patients with CAD compared to controls . Acute caffeine ingestion significantly increased FMD ( patients with CAD 5.6 ± 5.0 % vs 14.6 ± 5.0 % , controls 8.4 ± 2.9 % vs 18.6 ± 6.8 % , p < 0.001 for all comparisons ) but not NTG ( patients with CAD 13.0 ± 5.2 % vs 13.8 ± 6.1 % , controls 12.9 ± 3.9 % vs 13.9 ± 5.8 % , p = NS for all comparisons ) and significantly decreased high-sensitivity C-reactive protein ( patients with CAD 2.6 ± 1.4 vs 1.4 ± 1.2 mg/L , controls 3.4 ± 3.0 vs 1.2 ± 1.0 mg/L , p < 0.001 for all comparisons ) in the 2 groups compared to placebo . In conclusion , acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation OBJECTIVES We investigated the acute and chronic combined effect of cigarette smoking and caffeine intake on aortic stiffness and wave reflections . BACKGROUND We have shown that smoking and caffeine separately increase arterial stiffness . Aortic stiffness and wave reflections are important determinants of the efficient performance of the cardiovascular system and prognosticators of cardiovascular risk . METHODS The acute effects of smoking ( one cigarette ) , caffeine ( 200 mg , equivalent to 2 cups of coffee ) , and smoking plus caffeine were studied in 24 healthy subjects according to a r and omized , placebo- and sham procedure-controlled crossover design . The chronic effect of smoking and caffeine was studied in a population study that enrolled 160 healthy subjects . RESULTS Acute study : there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity ( p < 0.01 ) and augmentation index ( p < 0.05 ) . When smoking followed caffeine intake , pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4 % , respectively , reaching a total of 0.85 m/s and 17.4 % , 0.17 m/s and 9.2 % in excess of the mere sum of caffeine effect ( 0.33 m/s and 4 % ) alone and smoking effect alone ( 0.35 m/s and 4.2 % ) . Population study : there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity ( p < 0.05 ) and augmentation index ( p = 0.001 ) . CONCLUSIONS The present study shows , for the first time , that when smoking and caffeine intake are combined , they interact and exert a synergistic , unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis BACKGROUND Caffeine is the most widely used pharmacologic substance . Aortic stiffness is an important factor for cardiovascular system performance and a prognosticator of cardiovascular risk . We investigated the effect of caffeine on aortic stiffness in treated hypertensive patients . METHODS We studied the effect of caffeine ( 250 mg ) in 12 treated hypertensive patients according to a r and omized , placebo-controlled  , double-blind , cross-over design during a 3-h period . Aortic stiffness was evaluated by carotid-femoral pulse wave velocity . RESULTS Systolic blood pressure ( BP ) and pulse pressure increased significantly throughout the study ( by 12.3 and 7.4 mm Hg , P = .005 and P < .01 , respectively ) , whereas diastolic BP did not change . Pulse wave velocity increased ( by 0.57 m/sec , P < .05 ) denoting an increase in aortic stiffness . This effect of caffeine lasted throughout the study ( 3 h ) , peaking at 60 min and decreasing progressively thereafter . CONCLUSIONS These results demonstrate , for the first time , that caffeine exerts an acute unfavorable effect on aortic stiffness in treated hypertensive patients . This finding has important implication s for the impact of caffeine consumption on cardiovascular risk in hypertension The consumption of cocoa and dark chocolate is associated with a lower risk of CVD , and improvements in endothelial function may mediate this relationship . Less is known about the effects of cocoa/chocolate on the augmentation index ( AI ) , a measure of vascular stiffness and vascular tone in the peripheral arterioles . We enrolled thirty middle-aged , overweight adults in a r and omised , placebo-controlled , 4-week , cross-over study . During the active treatment ( cocoa ) period , the participants consumed 37 g/d of dark chocolate and a sugar-free cocoa beverage ( total cocoa = 22 g/d , total flavanols ( TF ) = 814 mg/d ) . Colour-matched controls included a low-flavanol chocolate bar and a cocoa-free beverage with no added sugar ( TF = 3 mg/d ) . Treatments were matched for total fat , saturated fat , carbohydrates and protein . The cocoa treatment significantly increased the basal diameter and peak diameter of the brachial artery by 6 % ( + 2 mm ) and basal blood flow volume by 22 % . Substantial decreases in the AI , a measure of arterial stiffness , were observed in only women . Flow-mediated dilation and the reactive hyperaemia index remained unchanged . The consumption of cocoa had no effect on fasting blood measures , while the control treatment increased fasting insulin concentration and insulin resistance ( P= 0·01 ) . Fasting blood pressure ( BP ) remained unchanged , although the acute consumption of cocoa  increased resting BP by 4 mmHg . In summary , the high-flavanol cocoa and dark chocolate treatment was associated with enhanced vasodilation in both conduit and resistance arteries and was accompanied by significant reductions in arterial stiffness in women Brewed coffee is a widely consumed beverage , and many studies have examined its effects on human health . We investigated the vascular effects of coffee polyphenols ( CPPs ) , hypothesizing that a single ingestion of CPP during glucose loading would improve endothelial function . To test this hypothesis , we conducted a r and omized acute clinical intervention study with crossover design and measured reactive hyperemia index ( RHI ) to assess the acute effects of a 75-g glucose load with CPP in healthy , nondiabetic adult men .  Blood glucose and insulin levels were elevated after glucose loading with and without CPP , with no significant differences between treatments . The RHI did not significantly decrease after glucose loading without CPP . With CPP , however , RHI significantly ( P < .05 ) increased over baseline after glucose loading . The difference between treatments was statistically significant ( P < .05 ) . No significant changes were observed in an oxidative stress marker after glucose loading with or without CPP . These findings suggest that a single ingestion of CPP improves peripheral endothelial function after glucose loading in healthy subjects Abstract We aim ed to investigate the association between white-coat hypertension ( WCH ) and left atrial ( LA ) phasic function assessed by the volumetric and speckle tracking method . This cross-sectional study included 52 normotensive individuals , 49 subjects with WCH and 56 untreated hypertensive patients who underwent a 24-h ambulatory BP monitoring and complete two-dimensional echocardiographic examination ( 2DE ) . WCH was diagnosed if clinic blood pressure ( BP ) was elevated and 24-h BP was normal . We obtained that maximum , minimum LA and pre-A LAV volumes and volume indexes gradually and significantly increased from the normotensive subjects , throughout the white-coat hypertensive individuals to the hypertensive patients . Passive LA emptying fraction ( EF ) , representing the LA conduit function , gradually reduced from normotensive to hypertensive subjects . Active LA EF and the parameter of the LA booster pump function increased in the same direction . Similar results were obtained by 2DE strain analysis . The LA stiffness index gradually increased from normotensive controls , throughout white-coat hypertensive subjects to hypertensive patients . Clinic systolic BP was associated with LA passive EF ( β= −0.283 , p = 0.001 ) , LA active EF ( β = 0.342 , p < 0.001 ) , LA total longitudinal strain ( β= −0.356 , p < 0.001 ) , LA positive longitudinal strain ( β= −0.264 , p = 0.009 ) and LA stiffness index ( β = 0.398 , p < 0.001 ) without regard to age , BMI , left ventricular structure and diastolic function in the whole study population . In the conclusion , WCH significantly impacts LA phasic function and stiffness . Clinic systolic BP was associated with functional and mechanical LA remodeling in the whole study population
Conclusion : The results from this meta- analysis suggest a beneficial short-term effect of coffee intake on EF as measured by FMD .
Base on systematic review results acute and chronic intake of coffee products may exerts an unfavorable effect on AS .
Background : Endothelial function ( EF ) and arterial stiffness ( AS ) are predictors of cardiovascular disease .
As previous research concerning the effect of coffee intake on EF and AS was controversial , we conducted a systematic review and meta- analysis to synthesize research .