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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Caffeine &#40;CAF&#41; is a methylxanthine and is one of the most frequently consumed psychostimulant substances&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> It occurs naturally in coffee beans&#44; tea leaves&#44; cocoa beans&#44; and kola nuts&#44; and is also added to foods and beverages&#44; including caffeinated soda &#40;cola-type&#41; and energy drinks&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> North America had the highest average country annual total volume sales of caffeine-per capita &#40;348 L&#47;capita&#41;&#44; followed by Europe &#40;200 L&#47;capita&#41;&#44; Latin America and the Caribbean &#40;153 L&#47;capita&#41;&#44; Asia and the Pacific &#40;126 L&#47;capita&#41;&#44; and Africa &#40;90 L&#47;capita&#41; in 2017 according to the Euromonitor Passport Global Market Information Database&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Caffeine-containing products have a range of doses per serving&#44; from 1 mg in milk chocolate up to &#62;300 mg in some dietary supplements&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> It is argued that up to 400 mg CAF&#47;day in healthy adults is not associated with adverse effects&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> However&#44; this should be reassessed&#46; Importantly&#44; caffeine-containing food supplements are marketed for weight loss and sports performance&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Moreover&#44; the International Olympic Committee in its consensus statement on dietary supplements confirmed the ergogenic properties of CAF across a broad range of exercise modalities&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;6</span></a> Caffeine was a banned substance in sports and its use was prohibited in competition between 1984 and 2004&#46; However&#44; the World Anti-Doping Agency decided to remove CAF from the list of banned substances with effect from January 1&#44; 2004&#44; and moved it to the monitoring program&#46; Despite the fact that the scientific evidence for CAF ergogenic properties has been increasing over the years&#44; there are still many unanswered questions regarding the use of CAF in sports including the effects of CAF on post-exercise recovery&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> It is noteworthy that the recovery of cardiovascular system after exercise occurs across a period of minutes to hours&#44; during which many characteristics of the system&#44; even how it is controlled&#44; change over time&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> This cardiovascular recovery includes hemodynamic adjustments &#40;e&#46;g&#46;&#44; regional vascular changes&#41;&#44; autonomic contributions &#40;e&#46;g&#46;&#44; baroreflex resetting&#41; and histamine signaling pathway&#44; about which very little is known&#46; Although some of these changes may be necessary for long-term adaptation to exercise training&#44; some can lead to cardiovascular instability during recovery&#46; These changes are not as well documented following resistance exercise as they are for aerobic exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The impact of CAF on recovery of the cardiovascular system after exercise has been under the spotlight as CAF has well established cardiovascular effects&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> At low CAF concentrations&#44; positive chronotropic and ionotropic effects appear to result from inhibition of presynaptic adenosine receptors in sympathetic nerves increasing catecholamine release at nerve endings&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> Higher concentrations &#40;&#62;10 &#956;M&#44; 2 mg&#47;ml&#41;&#44; which are associated with phosphodiesterase inhibition and increase in cAMP&#44; may result in increased calcium influx&#46; Moreover&#44; at even higher concentrations &#40;&#62;100 &#956;&#1052;&#41; the sequestration of calcium by the sarcoplasmic reticulum is impaired&#46; Therefore&#44; ordinary consumption of coffee and caffeine-containing beverages usually produces slight tachycardia&#44; an increase in cardiac output and an increase in peripheral resistance&#44; raising blood pressure slightly&#46; In sensitive individuals&#44; consumption of a few cups of coffee may result in arrhythmias&#46; In large doses&#44; CAF may also relax vascular smooth muscle with the exception of cerebral blood vessels&#46; Importantly&#44; caffeine acts as a sympathetic stimulus during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> However&#44; research findings are mixed on the impact of CAF on the autonomic recovery post-exercise&#46; For example&#44; it was recently shown that CAF increases resting cardiac autonomic modulation and accelerates post-exercise autonomic recovery after a bout of anaerobic exercise in recreationally active young men&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> No differences were observed between CAF doses on cardiac autonomic reactivity&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> However&#44; Benjamim et al&#46; &#40;2021&#41; published a manuscript entitled &#8220;Caffeine slows heart rate autonomic recovery following strength exercise in healthy subjects&#8221; showing that CAF delayed recovery of heart rate&#44; blood pressure and heart rate variability indices following strength exercise&#46; This suggests that CAF delayed parasympathetic cardiac control following exercise&#46; It is not always straightforward to compare results across studies because of differences between CAF dosages&#44; physical exercise protocols and the physical status of the subjects&#46; Nonetheless&#44; Benjamim et al&#46; &#40;2021&#41;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> shed further light on the impact of CAF on cardiac autonomic control in physically active individuals&#44; which needs to be further analyzed within active or athletic populations&#46; This paper also highlights the importance of assessing the benefits of cardiovascular recovery after exercise&#44; or minimizing the vulnerabilities of this state&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> In fact&#44; recovery from exercise can be envisioned as a vulnerable period in which individuals are at increased risk of adverse cardiovascular events&#44; or a window of opportunity in which the positive adaptations to training can be potentially augmented&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> Finally&#44; it is of utmost importance to continuously monitor the cardiovascular safety of CAF intake in the context of physical activity and sports&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This work was funded by National Funds via FCT &#40;Foundation for Science and Technology&#41; through the Strategic Project UIDB&#47;04539&#47;2020 and UIDP&#47;04539&#47;2020 &#40;CIBB&#41;&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Editorial comment
Keep an eye on the impact of caffeine on the recovery of the cardiovascular system after exercise
Vigiar o impacto da cafeína na recuperação do sistema cardiovascular após o exercício
Frederico C. Pereiraa,b,c
a Institute of Pharmacology and Experimental Therapeutics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
b Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
c Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Caffeine &#40;CAF&#41; is a methylxanthine and is one of the most frequently consumed psychostimulant substances&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> It occurs naturally in coffee beans&#44; tea leaves&#44; cocoa beans&#44; and kola nuts&#44; and is also added to foods and beverages&#44; including caffeinated soda &#40;cola-type&#41; and energy drinks&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> North America had the highest average country annual total volume sales of caffeine-per capita &#40;348 L&#47;capita&#41;&#44; followed by Europe &#40;200 L&#47;capita&#41;&#44; Latin America and the Caribbean &#40;153 L&#47;capita&#41;&#44; Asia and the Pacific &#40;126 L&#47;capita&#41;&#44; and Africa &#40;90 L&#47;capita&#41; in 2017 according to the Euromonitor Passport Global Market Information Database&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Caffeine-containing products have a range of doses per serving&#44; from 1 mg in milk chocolate up to &#62;300 mg in some dietary supplements&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> It is argued that up to 400 mg CAF&#47;day in healthy adults is not associated with adverse effects&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> However&#44; this should be reassessed&#46; Importantly&#44; caffeine-containing food supplements are marketed for weight loss and sports performance&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Moreover&#44; the International Olympic Committee in its consensus statement on dietary supplements confirmed the ergogenic properties of CAF across a broad range of exercise modalities&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;6</span></a> Caffeine was a banned substance in sports and its use was prohibited in competition between 1984 and 2004&#46; However&#44; the World Anti-Doping Agency decided to remove CAF from the list of banned substances with effect from January 1&#44; 2004&#44; and moved it to the monitoring program&#46; Despite the fact that the scientific evidence for CAF ergogenic properties has been increasing over the years&#44; there are still many unanswered questions regarding the use of CAF in sports including the effects of CAF on post-exercise recovery&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> It is noteworthy that the recovery of cardiovascular system after exercise occurs across a period of minutes to hours&#44; during which many characteristics of the system&#44; even how it is controlled&#44; change over time&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> This cardiovascular recovery includes hemodynamic adjustments &#40;e&#46;g&#46;&#44; regional vascular changes&#41;&#44; autonomic contributions &#40;e&#46;g&#46;&#44; baroreflex resetting&#41; and histamine signaling pathway&#44; about which very little is known&#46; Although some of these changes may be necessary for long-term adaptation to exercise training&#44; some can lead to cardiovascular instability during recovery&#46; These changes are not as well documented following resistance exercise as they are for aerobic exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The impact of CAF on recovery of the cardiovascular system after exercise has been under the spotlight as CAF has well established cardiovascular effects&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> At low CAF concentrations&#44; positive chronotropic and ionotropic effects appear to result from inhibition of presynaptic adenosine receptors in sympathetic nerves increasing catecholamine release at nerve endings&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> Higher concentrations &#40;&#62;10 &#956;M&#44; 2 mg&#47;ml&#41;&#44; which are associated with phosphodiesterase inhibition and increase in cAMP&#44; may result in increased calcium influx&#46; Moreover&#44; at even higher concentrations &#40;&#62;100 &#956;&#1052;&#41; the sequestration of calcium by the sarcoplasmic reticulum is impaired&#46; Therefore&#44; ordinary consumption of coffee and caffeine-containing beverages usually produces slight tachycardia&#44; an increase in cardiac output and an increase in peripheral resistance&#44; raising blood pressure slightly&#46; In sensitive individuals&#44; consumption of a few cups of coffee may result in arrhythmias&#46; In large doses&#44; CAF may also relax vascular smooth muscle with the exception of cerebral blood vessels&#46; Importantly&#44; caffeine acts as a sympathetic stimulus during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> However&#44; research findings are mixed on the impact of CAF on the autonomic recovery post-exercise&#46; For example&#44; it was recently shown that CAF increases resting cardiac autonomic modulation and accelerates post-exercise autonomic recovery after a bout of anaerobic exercise in recreationally active young men&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> No differences were observed between CAF doses on cardiac autonomic reactivity&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> However&#44; Benjamim et al&#46; &#40;2021&#41; published a manuscript entitled &#8220;Caffeine slows heart rate autonomic recovery following strength exercise in healthy subjects&#8221; showing that CAF delayed recovery of heart rate&#44; blood pressure and heart rate variability indices following strength exercise&#46; This suggests that CAF delayed parasympathetic cardiac control following exercise&#46; It is not always straightforward to compare results across studies because of differences between CAF dosages&#44; physical exercise protocols and the physical status of the subjects&#46; Nonetheless&#44; Benjamim et al&#46; &#40;2021&#41;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> shed further light on the impact of CAF on cardiac autonomic control in physically active individuals&#44; which needs to be further analyzed within active or athletic populations&#46; This paper also highlights the importance of assessing the benefits of cardiovascular recovery after exercise&#44; or minimizing the vulnerabilities of this state&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> In fact&#44; recovery from exercise can be envisioned as a vulnerable period in which individuals are at increased risk of adverse cardiovascular events&#44; or a window of opportunity in which the positive adaptations to training can be potentially augmented&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> Finally&#44; it is of utmost importance to continuously monitor the cardiovascular safety of CAF intake in the context of physical activity and sports&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This work was funded by National Funds via FCT &#40;Foundation for Science and Technology&#41; through the Strategic Project UIDB&#47;04539&#47;2020 and UIDP&#47;04539&#47;2020 &#40;CIBB&#41;&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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