Coronary precautions: should caffeine be restricted in patients after myocardial infarction?

The effect of caffeine on heart rate, blood pressure, and cardiac rhythm has long been a controversial issue. A review of the literature reveals numerous articles evaluating the effects of caffeine on normal subjects, fewer evaluating the effects of caffeine on patients with cardiac disease and patients after myocardial infarction. Although the findings for the various populations have been inconsistent, recent studies with large cohorts have clarified the issue. Moderate consumption of caffeine does not significantly increase the risk of a coronary event nor increase the frequency of cardiac arrhythmias. This conclusion applies to healthy persons, patients with ischemic heart disease, and those with serious ventricular ectopy. Patients with cardiac disease should be allowed to consume four to five cups of caffeinated beverages per day while in the coronary care unit or progressive care unit under the surveillance of nursing staff.