CHAPTER 1

INTRODUCTION

1.1 HISTORY OF COFFEE

Coffee trees are originated in the Ethiopian province of Kaffa. The universal invention
of coffee and consumption began in the Horn of Africa. Coffee was made from coffee
cherry fruit seeds of the coffee tree. These cherries were eaten by people in Sudan followed
by Yemen and Arabia at the great harbor known as Mocha. Foremost coffee plants are
invented at the Horn of Africa along the shores of the Red Sea. Initially, the coffee beans
were consumed as food. People in East Africa crush the coffee fruits together, blending the
outcomes into an animal fat. Around the year 1000 AD, Ethiopians prepare and grow dried
beans in water to produce coffee berries wine from the seeds.
During the eleventh century, coffee was formed into a hot beverage and regularly
consumed on the Arabian Peninsula. By the sixteenth century, it was arrived at Middle East
of Persia, Turkey and northern part of Africa followed by Europe countries such as Balkans,
Italy and then to Indonesia, Malaysia and also to America (Meyers, Hannah,2005).

1.2 INTRODUCTION TO CAFFEINE

Coffee was consumed as a kick-up to start up their day worldwide. Caffeine is a bitter
substance that can be found in common beverages including coffee, tea, nuts, soft drinks,
energy drinks, chocolate, and certain medicines (Rob M et al., 2006). Caffeine is a plant
alkaloid that is naturally produced in the leaves and seeds of many plants. Within 5 to 30
minutes after coffee consumption, caffeine able to circulate in the body and blood and
caffeines effects will remain almost up to12 hours as long as it is in the blood.
Caffeine is safe to be taken in moderate amount around 200-300 mg a day for adults
(Rob M et al., 2005). Pregnant women are suggested not to consume caffeine more than
200 mg per day due to potential miscarriage and deformity of infant. However, too much of
caffeine intake could cause sleeping disorders and withdrawal symptoms such as anxiety
and headache when they stop consuming it.

1.3 INTRODUCTION TO BLOOD PRESSURE

Blood pressure defined in written ratio term and it is measured as systolic and diastolic
forms. A normal blood pressure reading is written in systolic number followed by diastolic
number, such as 120/80 mmHg. "Systolic" blood pressure records pressure of blood in artery
during heart muscle contraction when the blood is pumped. "Diastolic" blood pressure is the
pressure in artery when the heart muscle is resting between beats while heart filling up
blood. The unit used to measure blood pressure is millimetres of mercury (mmHg). High
blood pressure also can be categorized as hypertension. The risk factor of high blood
pressure (hypertension) increases with age, depending on individuals lifestyles and habits.
High blood pressure is the leading cause of human death with the ratio of 1 in 8 human
death cases around the world according to World Health Organization (WHO) (Chobanian et
al.,2003).
Blood pressure reading varies all the time. Basically blood pressure drops during sleep
and increase when the person is awake. Elevation of blood pressure experienced when a
person in excitement, depression, in stress, active in physical activities and nervous. If blood
pressure reading shows above normal reading, most probably the person is at risk of health
problem. As blood pressure readings rises, the risk of getting health problem is increases.
"Prehypertension" shows that a person is one step closer to high blood pressure, if no
preventative measure is taken. For an instance, you can have stage 2 high blood pressure
(HBP) if your blood pressure reading shows 160/80 mmHg. You will have stage 1 HBP if
your blood pressure reading shows 120/95 mmHg (National Center for Health Statistics
(2010).
When blood pressure stays high over time, it can damage the body which may lead
to heart failure due to prolonged high blood pressure condition. Arteries throughout the body
will become narrow in some places, causing vasoconstriction to occur which limits blood flow
to the main organs especially to heart and kidney. In long-term effects, it may cause heart
failure, heart attack, amputation in leg parts or stroke. Apart from that, vision problem or
blindness could be experienced if the vein in the eyes starts to bleed or burst. Arterial
changes results in angina due to blood vessel narrowing and blood flow restriction. High
blood pressure or hypertension can develop silently in an individuals body because many
people unknowingly do not realize that they have it, and consequently do not aware how
these could damage their body organs especially heart.

1.4 INTRODUCTION TO STRESS

Stress is bodys way retorting to any kind of demand. The widespread of caffeine
consumption shows caffeine has stimulatory effect on endocrine and cardiovascular system
which can trigger stress level to rise. Stress firstly established as a well-known fight-orflight response (Walter Cannon,1932). When body induced by any large amount of
substance, body produce stress hormones which can elevates pulse rate and blood
pressure. Caffeine increases stress hormone; cortisol which circles the stress response in
motion, cause tensed muscles, raise blood pressure and increase pulse lead to moodiness,
heart diseases and other health problems.
On account of harms that stress can bring about, its imperative to know your own
farthest point. However, exactly how much stress is "excessively" varies from individual to
individual as everyone is distinctive. Some individuals appear to blossom with challenge of a
high-stress life. Your capacity to endure stress relies upon numerous aspects, including the
nature of your relationships, your general point of view, your emotional knowledge, and
hereditary qualities.
The caffeine starts to stimulate body central nervous system, triggering stress
hormone production, causing fight-or-flight response in which preparing body to flee a
dangerous condition. After a while, stress response dissipates which make us feel more
hungry and tired. Many people grasp for another cup of coffee in order to stay alert and get
temporary feelings to boost energy (Gayle MS RD CDN,2013).Caffeines acute effects on
our body is to trigger bodys endocrine system, a pituitary gland in brain to produce
adrenocorticotrophic (ACTH)

hormone. Caffeine intake cause ACTHs send impulse to

adrenal gland to pump out stress hormone (Stephen Chermiske MS,2008).

1.5 ASSOCIATION OF COFFEE, BLOOD PRESSURE AND STRESS

Habitual coffee drinkers and non-habitual coffee drinkers defined based on number
of coffee they consume. Habitual coffee drinkers are those who consuming more than seven
cups per week and non-habitual coffee drinkers are those consume less than seven cups of
coffee per week.
Coffee is widely consumed, especially during stressed conditions. It is consumed by
many as a stimulating drink. A study demonstrated that caffeine induces increase in blood
pressure and stress level in regular caffeine consumer (Hartley.2006). This is because

caffeine in coffee is a natural stimulant for central nervous system and plays a vital role in
triggering stress hormone production such as cortisol, glucocorticoids and catecholamine
which increases stress level and elevates blood pressure. The production of cortisol induces
increase in stress level.
The impact of caffeine on neuroendocrine stress reactions have showed positive
result where caffeine elevates resting levels of catecholamine and more plasma renin
movement in human body(Robertson D,1978). A 2013 study by ( Liu et al.) established a
correlation between coffee consumption and mortality rate where consumption of more than
4 cups per day, which is equivalent to 28 cups per week with an increased mortality rate
among men and women younger than 55 years in all population (Liu, Junxiu;
Sui,Xuemei.,August15, 2013).
Some cross-sectional studies identified that coffee intake and blood pressure level
are positively correlated. Together with another prospective study, coffee drinking found to be
elevating blood pressure (Jee et al.,1999). As caffeine that act as natural stimulant increase,
the central nervous system eventually causes blood vessel vasoconstriction followed by
reduction in the capacity of blood supply to the heart. Besides that, caffeine also has
properties to block one of a hormone that keep arteries widening.
Individuals who frequently drink coffee have a higher blood pressure reading
compare to the individuals who drink none because those who drink caffeinated drinks
routinely create a tolerance to it (Sheldon, 2011). The prevalent of caffeine consumption
shows caffeine has effects on both endocrine and cardiovascular system. Since caffeine
consumption affects human health, this research has been conducted to investigate the
effect of caffeine after it is consumed and its impact towards human health. Respondent who
consuming high intake of caffeine shows less sensitivity to pressure-elevating effects of
caffeine. The impact of caffeine on respondents depends on amount of caffeine they
consume and frequency of caffeine intake.

1.6 RESEARCH PROBLEM STATEMENT

As per the International Coffee Organization, statistics shows that around 1.6 billion
people worldwide are consuming coffee consistently. A significant number of them drink

coffee to kick-begin their day to day activities. Caffeine is actually a psychoactive substance
or a drug that causes the brain to arouse the central nervous system (Gilbert et al.,1976).
Excessive coffee intake could cause cardiovascular disease.
People in Malaysia are getting affected by high blood pressure and hypertension day
by day according to Malaysian Society of Hypertension (MSH). Statistics show that more
than 32% of Malaysians aged 18 and above are affected by hypertension (NHMS 2011).
High blood pressure is the main risk factor for many health diseases especially the most
widespread cardiovascular diseases and peripheral vascular diseases.
As the hypertensive people in Malaysia increases gradually, the existing treatment for
high blood pressure causes a financial burden on health care, hospital budgets and the
whole nation-state economy. The current guidelines for the high blood pressure treatment
are only designed for certain ratio of population; the treatment is inadequate to curb an
outsized population with hypertension in Malaysia. Strategies to reduce blood pressure
among the population include practices in the healthcare management to reduce caffeine
intake of patients with high blood pressure. Therefore, the chief purpose of this research is to
identify the impact of caffeine on both habitual and non-habitual coffee consumers in order to
reduce the risks of cardiovascular diseases.

1.7 OBJECTIVES
1.7.1 General objective :

To investigate the impact of caffeine on blood pressure level in habitual and nonhabitual coffee consumers among working adults in Ulu Tiram, Johor.
1.7.2 Specific objective :

To analyze the changes in blood pressure over time in habitual and non-habitual

coffee consumers.
To compare the impact of caffeine between blood pressure and Body Mass Index

(BMI).
To measure stress levels after the coffee consumption among habitual and nonhabitual coffee consumers.

1.8 HYPOTHESIS

There is impact of caffeine on blood pressure level among habitual and non-habitual
coffee consumers.

CHAPTER 3
LITERATURE REVIEW
3.1 BLOOD PRESSURE
3.1.1

Definition
The blood pressure is the pressure of the blood within the arteries. It is delivered

essentially by the constriction of the heart muscle. The measurement is recorded by taking
two numbers; systolic and diastolic. Systolic pressure is measured after the heart contracts
and has a higher value. Diastolic pressure is measured before the heart contracts and has a
lower value. Elevation of blood pressure is called "hypertension".
3.1.2

Normal blood pressure reading

Table below shows the variation of blood pressure that categorized into prehypertension,
high blood pressure stages and hypertensive crisis which shows their respective systolic and
diastolic readings.
Blood Pressure
Category
Normal

Systolic
mm Hg (upper #)

Diastolic
mm Hg (lower #)

less than 120

and

less than 80

Prehypertension

120 139

or

80 89

High Blood Pressure

(Hypertension) Stage 1

140 159

or

90 99

High Blood Pressure

(Hypertension) Stage 2

160 or higher

or

100 or higher

Hypertensive Crisis
(Emergency care needed)

Higher than 180

or

Higher than 110

Table 3.1 This chart reflects blood pressure categories defined by the American Heart Association.

3.2 BLOOD PRESSURE RELATED DISEASES

When blood pressure stays high over time, it will damage the body which may lead to
heart failure if the condition is prolonged. Arteries throughout the body will start to narrow in
some places, causing vasoconstriction to occur which limits blood flow to the main organs
especially to heart and kidney. In long-term effects, it may cause heart failure, heart attack,
amputation in leg parts or stroke. Apart from that, vision problem or blindness will be
developed if the vein in the eyes starts to bleed or burst. Arterial changes results in angina
due to blood vessels narrowing and blood flow restriction.
High blood pressure or hypertension can develop silently in an individuals body
because many people do not realize that they have it, and consequently do not aware how
these could damage their body organs especially heart. High sodium intake, regular coffee
intake and reduced consumption of milk increases the risk of uncontrolled blood pressure
and thus leads to hypertension among many people. Regular and excessive consumption of
coffee also cause elevation of blood pressures because caffeine content in coffee stimulate
cardiovascular system, thus cause tightening of blood vessels and eventually increase the
pressure.

3.2.1 Pharmacoeconomics of high blood pressure in Malaysia

Hypertension is one of the most pervasive vascular diseases and is considered as a
principle risk factor for cardiovascular infections. Hypertension is incredibly predominant and
become extreme in Malaysia. The alarming factor is that the healthcare facilities for
hypertension are inadequate in the country. The location for hypertension treatmant is not
exactly palatable in Malaysia. People in Malaysia are getting affected by high blood pressure
or hypertension day by day according to Malaysian Society of Hypertension (MSH).
Statistics show that more than 32% of Malaysians aged 18 and above are affected by
hypertension (NHMS 2011). High blood pressure is the main risk factor for many health
diseases especially the most widespread cardiovascular diseases or peripheral vascular
diseases.

As the hypertensive people in Malaysia increases gradually, the existing treatment for
high blood pressure causes a financial burden on health care, hospital budgets and the
whole nation-state economy. The current guidelines for the high blood pressure treatment

are only designed for certain ratio of population; the treatment is inadequate to curb an
outsized population with hypertension in Malaysia. Strategies to reduce blood pressure
among the population include practices in the healthcare management to reduce caffeine
intake of patients with high blood pressure.

Hypertension stands as an important spot of worry for economic evaluations,

individuals and society due to the wide range of issues involved. As far as treatment
concerned, it is one of the most expensive disease as it generates higher health care
expenses than those produced by individuals that having normal blood pressure. (Hebel
JR.1990). Additionally, based on a recent study, despite the present strategies for the

treatment of hypertension, it is still inadequate to curb large number of hypertensive

individuals in Malaysia (L. Rampal.2008).
Hypertension causes major organ damages, mainly in patients with high or
uncontrolled blood pressures. According to Research Management Center of International
Islamic University Malaysia 2009, these complications add huge costs to the overall nations
health care budget adding on for research and development cost in the hypertension
treatment process. Hypertension treatment for the large number of people in Malaysia
creates an economic burden on health care budgets and the whole nation economy.

3.3 BLOOD PRESSURE AND COFFEE

According to a study, caffeine quickly increases the stiffness of the large arteries in
people with high blood pressure (Charalambos Vlachopoulos, MD, 2002). While some recent
studies have shown a link between caffeine and elevations of blood pressures, the results
are very complex which give acute effects. The study examined how the amount of coffee
consumed affects risk of developing high blood pressure. While the outcomes demonstrated
that the chances of getting hypertension was the least for the individuals who drink more
coffee, while in additionally demonstrated that the individuals who drink a considerable a lot
of coffee have very nearly the same risk to get hypertension. In a sudden turn, individuals
who drank just little measures of espresso (1-3 containers every day) appeared to have the
most astounding risk. (Hartley, T et al.,2000). (Rephrase not clear)
It has long been suspected that coffee consumption may have adverse effects on the
cardiovascular system. Some cross-sectional studies have identified a positive association
between coffee drinking and blood pressure. There is an association between blood and
coffee. According to one research done in Paris, possible link between coffee drinking and

blood pressure (BP) was studied in a cross-sectional epidemiologic survey of 6,321 adults
across the Paris region ( Am J Cardiol. 1983).
Excessive

amounts

of

coffee

can

cause

very unpleasant

and

even

life-

threatening adverse effects. Excessive amount of coffee consumption causes adverse

effects. Many of coffee's well-being risks and side effects are due to the caffeine content and
these can be prevented by consuming decaffeinated coffee. Research suggests that drinking
caffeinated coffee can cause a temporary stiffening of arterial walls. Coffee consumption
may irritate previous conditions such as arrhythmias, headaches and insomnia. It was once
believed that coffee exasperates gastroesophageal reflux malady yet recent research
suggest no link between the two (Mahmud Azra,Feely John.,2001).

3.4 CAFFIENE
3.4.1

Sources of caffeine
Caffeine, which act as a natural stimulant or pesticide is a plant alkaloid that could

execute and kill some insect paralyzes. Caffeine kill certain insects upon feeding on them.
Coffee beans are the worlds primary source of caffeine which found in the seed of the
espresso plant from which coffee is prepared (Haskell et al., 2006). Coffees caffeine amount
broadly relies on the kind of coffee bean and the system for procedure utilized. Generally,
coffee with dark-roast is less stimulant than lighter broils on the grounds as the simmering
methodology diminishes the bean's caffeine content.
Besides that, Arabica coffee ordinarily contains less caffeine compared to the robusta
mixed bag. Tea is an alternate regular origin of the stimulant. Tea, typically contains about
half as much caffeine amount every serving as compared to coffee. Caffeine content in teas
differs depends on the quality of the blend whereas green tea contains more caffeine content
than most different teas. There is little amount of caffeine derived from chocolate which has
a little bit of the stimulant.
It was observed that higher caffeine content found in dark chocolate. Some
chocolates are invigorated with extra caffeine for a jolt of energy (Benjamin et al., 2001).
Caffeine is additional ingredient of typical soda drinks. Cola is also initially equipped from
kola nuts. Other caffeinated beverages include energy drinks such as Red Bull contain
almost 80 milligrams of caffeine per serving. The caffeine contained in these beverages is
originates from the ingredients themselves or included as an additive which derived from
product of decaffeination or by chemical synthesis.

3.4.2 Origin and distribution of caffeine

Since the Stone Age, numerous anthropologists accept that caffeine has been
expanded and consumed by many peoples. Caffeine from coffee was initially extricated in
182. Ethiopian travelers discovered coffee contains caffeine through the animals that would
consume the foods grown from the ground from the trees they would have energy. The
nomads tried consuming the seeds and experienced increase of energy boost in their body.
Caffeine in coffee was started in Ethiopia and was later acquainted with Arabia and to the
rest of East Africa. Coffee was acquainted with the Europeans in 1573. The source of
caffeine was presented later in 1657 in tea consumption which was extremely famous to the
populace of Europe. Close to the end of the nineteenth century, cola drinks began was
introduced and cosumed around the globe and turned into one of the biggest consumed
stimulant beverages (Erowid, 2003).s
3.4.3

Physical and chemical properties

Figure 3.1 Molecular structure of caffeine

Systematic (IUPAC) name
Other names

1,3,7-trimethyl-1H-purine-2,6(3H,7H)-dione
1,3,7-trimethylxanthine, trimethylxanthine, theine, mateine,

guaranine and methyltheobromine.

Molecular formula
C8H10N4O2
Molar mass
194.19 g mol
Appearance
Odorless, white needles or powder
Density and phase
1.2 g/cmA and solid
Solubility in water
Slightly soluble
Melting point
237 AC
Boiling point
178 AC (sublimes)
Table 3.2 Physical and chemical properties of caffeine
Sources: (Gustavo D Pimentel 2009)

3.4.4

Metabolism of caffeine
Caffeine promptly crosses the bloodbrain barrier that divides the circulatory system

from the inner part of the brain. Basically, caffeines particle which is structurally resembles
adenosine, ties to surface of cells of adenosine receptors on the without passing through
them. Caffeine triggers the production of epinephrine (adrenaline) that causes the
stimulation of sympathetic effects such as increment in heart beat rate, blood pressure and
builds blood stream to the muscles. This substance is likewise cause the liver to consume
more sugar in order to produce high level of energy source.
Caffeine can be totally retained by the stomach and small digestive tract inside 45
minutes after consumption. Caffeine achieves and reaches its greatest concentration in the
circulatory system in 15-120 minutes. Once assimilated, caffeine is appropriately circulated
everywhere throughout the body and caffeine metabolization happens in the liver. The
process begins by the emptying of the methyl 1 and 7 gatherings in a response catalyzed by
cytochrome P450, empowering the development of three methylxanthine bunches,
paraxantine (84%), theobromine (12%) theophylline (4%). Paraxantine animate fat oxidation
and assembly of glycogen in muscle (25) and free unsaturated fat discharge (expanded
lipolysis) are enpowered from peripheral tissues.
3.4.5

Mechanism of activity of stimulant

Stimulant acts through different instruments including activity on both receptors and

channels at the cell layer, and also intracellular activity on Calcium and cAMP pathways.
However, the chief mode of activity of perk is as an opponent of adenosine receptors in the
mind. The juice atom is structurally resembles adenosine and ties to adenosine receptors on
the surface of cells without enacting them. It is called as a "foe" system of activity. In this
way, the juice goes about as an aggressive inhibitor. The decrease in adenosine action
brings about expanded movement of the neurotransmitter dopamine which to a great extent
representing the stimulatory impacts of stimulant. Stimulant, can likewise expand levels of
epinephrine/adrenaline, conceivably by means of an alternate system. Intense utilization of
caffeine likewise expands levels of serotonin, creating positive changes in temperament
(Fisone G et al., 2004). In any case, the caffeine found numerous hour in body framework
without being applied will result in a fit of anxiety.

3.4.5

Mechanism of action of caffeine

Caffeine also triggers the activity on receptors and channels at the cell film in addition

to the intracellular activity on Calcium and cAMP pathways. The vital mode of activity of
caffeine is as an opponent of adenosine receptors in the mind. The caffeine particle is also
act in antagonist mode of action which structurally resembles adenosine. It ties to
adenosine receptors on the surface of cells without initiating them. In this manner, caffeine
goes about as an aggressive inhibitor. The diminishment in adenosine movement or activity
brings about expanded action of the neurotransmitter dopamine which to a great extent
representing the stimulatory impacts of caffeine. Caffeine, likewise able to elevate levels of
epinephrine/adrenaline, perhaps through an alternate mechanism. Intense use of caffeine
additionally expand levels of serotonin, bringing about positive changes in mind-set (Fisone
G et al., 2004). On the other hand, caffeine can cause anxiety or panic attack if it stays
numerous hour in our body system.

3.4.6

Advantages and disadvantages of caffeine

Studies have demonstrated that caffeine intake is not dangerous when consumed

within tolerable limits. One of the benefits of consuming caffeine is its ability to induce and
increases alertness. Caffeine act as metabolic stimulant to central nervous system to
increase alertness and is utilized both recreationally and therapeutically to restore mental
alertness and decrease physical weakness. Juice fortifies the focal sensory system first at
the more elevated amounts, bringing about expanded readiness. Another study
demonstrated that it is profoundly workable for caffeine to prevent Parkinson's disease.
The main inhibitor of the adenosine A2 receptor is the caffeine in coffee which
enhances engine shortfalls. Adenosine receptors are localized with dopaminergic D2
receptors and this receptors repressing impacts of dopaminergic transmission. Caffeine
restrain the adenosine A2 receptor and causes the dopamine in body system to be activated
(Ronald B. Postuma 2012). Dopamine is the compound that initiates the delight that focuses
the brain. Caffeine also stimulates release of adrenaline and cortisol. These two substances
related with the body's fight-flight reaction. Caffeine causes the liver to digest more sugar
when adrenaline and cortisol are discharged into the system. (Rob M et al., 2006).

However, high consumption of caffeine causes a lot of adverse effects. The most
prominent effect of high caffeine consumption is anxiety or panic attack. Caffeine also
induces fight-flight response in human body system in order to keep us up. Anyway, after
substantial dosages of caffeine ingested in our system for several hours, the battle or-flight
intuition gets lesser to fits of panic attack (Andrew O Odegaard et al., 2008). The effects of
panic attacks includes sweaty skin, unsteady hand and anticipation or imagination of awful
things in the mind. Besides that, high caffeine intake could cause addiction of it. The body
starts to crave for energy that get from caffeine once the caffeine get into habit of getting
fixed. On the off chance, that neglect to get the measurements of stimulant that the body
adjusted to can result in fractious, drained and even discouraged. Improper digestion of
caffeine in the body may cause irritability, depression, restless feeling and tiredness.
3.4.7

Bioactivities usage of caffeine

Caffeine that acts as an antidepressant stimulates central nervous system which

enhance mood and energy. In particular, caffeine consumption stimulates the central
nervous system. Caffeine intake also increases level of mood-related neurotransmitter
serotonin and dopamine. Latest research study shows that caffeine has antioxidant
properties which has the ability to prevent cancer. The hydroxyl radical (OH) is a standout
amongst the most harming free radicals that can happen in body. Enzyme system does not
deactivate these hydroxyl radical (OH) but commonly assists antioxidant nutrients such as
melatonin or vitamin E to deal with it as caffeine specifically tying to the hydroxyl radical and
killing it. They could damage large molecules such as fatty membranes of cells,
carbohydrates, and structural protein if the hydroxyl radicals are not dissolved in circulation
(Guillermo J. Olcina 2006). Apart from that, caffeine also act as a natural antihistamine.
Caffeine may act as a regular antihistamine by reducing the amount of histamine released
resulting in a reduction of symptom in delicate tissues of body. In addition, properties of
caffeine acts as anti-cancer agent for the treatment of various sorts of tumors upon oral
administration. There is additional validation that dermal connected caffeine can shield the
skin from skin malignancy or cancer cause by exposure of sun.

3.5

STRESS AND ITS ASSOCIATION WITH COFFEE

Stress is bodys way retorting to any kind of demand. The widespread of caffeine

consumption shows caffeine has stimulatory effect on endocrine and cardiovascular system

which can trigger stress level to rise. Stress firstly established as a well-known fight-orflight response (Walter Cannon,1932). When body induced by any large amount of
substance, body produce stress hormones which can elevates pulse rate and blood
pressure. Caffeine increases stress hormone; cortisol, in which circles the stress response in
motion, causing tense muscles, raised blood pressure and increased pulse which lead to
moodiness, heart diseases and other health problems.
On account of harms that stress can bring about, its imperative to know your own
farthest point. However, exactly how much stress is "excessive" is varies from individual to
individual as everyone are distinctive. Some individuals appear to blossom with the
challenge of a high-stress way of life. Your capacity to endure stress relies upon numerous
aspects, including the nature of your relationships, your general point of view, your emotional
knowledge and hereditary qualities.
The caffeine starts to stimulate body central nervous system, triggering stress
hormone production, causing fight-or-flight response in which preparing body to flee a
dangerous condition. After a while, stress response dissipates which make us feel more
hungry and tired. Many people grasp for another cup of coffee in order to stay alert to get
temporary feelings to boost energy (Gayle MS RD CDN,2013).Caffeines acute effects on
our body is triggering bodys endocrine system, pituitary gland in brain to produce
adrenocorticotrophic (ACTH) hormone. The major effects of caffeine is ACTHs send impulse
to adrenal gland to pump out stress hormone (Stephen Chermiske MS,2008).
Coffee is actually widely consumed, especially during stress conditions. It is
consumed by many as a stimulating drink. A study demonstrated that caffeine induces
increase in blood pressure and during stress in regular caffeine consumer (Hartley.2006).
This is because caffeine in coffee is a natural stimulant for central nervous system plays a
vital role in triggering stress hormone production such as cortisol, glucocorticoids and
catecholamine which increases stress level and elevates blood pressure. The production of
cortisol induces stress level.
The impact of caffeine on neuroendocrine stress reactions have showed positive result
where caffeine elevates resting levels of catecholamine and more plasma renin movement in
human body(Robertson D,1978).A 2013 study by ( Liu et al.) established a correlation
between coffee consumption more than4 cups per day which are equivalent to 28 cups per
week with an increase of mortality rate among men and women younger than 55 years in all
population (Liu, Junxiu; Sui,Xuemei.,August15, 2013).

CHAPTER 3
METHODOLOGY

3.1 METHODS
3.1.1 Study design
Cross sectional study is used and it suits this research. Cross sectional study is a
type of observational study which draws an inference about possible outcome of the
research conducting and the data collected from a population at a defined time. This study
design suits this research because all the data is collected at a single point in time. Besides
that, this cross sectional study data can be analyzed by comparing the differences among
the variables as my questionnaire consist more variables. This research study is easy to be
conducted and cheaper in financial wise which are within my budget (Tipaporn Pongmesa et
al., 2009).
3.1.2

Location of study

The location of the study is in Ulu Tiram, Johor. The area that was selected for this research
project purpose is located in Johor Bahru state. Ulu Tiram is a centre town in Johor Bahru
Distinct. This place is located approximately 18 km from Johor Bahru. The main trunk roads
in Ulu Tiram lead to Kuantan in Pahang and Mersing in northest Johor. Besides that, this
town is easily accessible through Tebray Highway, Jalan Kota tinggi trunk road and SenaiDesaru Expressway.
Ulu Tiram is a town in Johor Bahru Distinct, Johor. There are 22 housing areas that makes
up Ulu Tiram town. The housing areas are Bandar Tiram, Taman Gunung Emas, Taman
Zamrud, Felda Ulu Tebrau, Taman Puteri Wangsa, Taman Dato Chellam, Taman Desa
Cemerlang, Taman Bukit Tiram, Taman Intan, Taman Ros, Taman Mutiara, Taman Nora,
Taman Maluri, Taman Zamrud, Taman Bestari Indah, Taman Pelangi Indah, Taman Bukit
Jaya, Taman Bistari Indah, Taman Putri Park, Taman Berlian, and Sungai Tiram.
Ulu tiram as a developing township is nearby many commercial areas and residential
developments such as Taman Gunung Emas, Taman Bukit Tiram, Taman Nora, Taman
Puteri Wangsa and so on. It is also adjoining to most of the other towns and cities consisting
more than twenty housing areas as Ulu Tiram has a familiar urban layout to Pasir Gudang,
Kluang, or Kota Tinggi with city occupying mostly with housing areas. Since there are many
commercial centres that located around different sections, this place is crucial for this
research study.
Ulu Tiram is the best area to conduct the project because this place has a lot of industrial
areas. Many of the respondents can be found here to fulfill my project. Ulu Tiram also
considered as minor close to the road to the capital city. This area is also known as a town

that is being developed now. Many adults who live in the area passing to go to work every
day to capital city that is Johor and also quite number of adults working to the adjacent
neighborhood developed country, Singapore. Thus, this area of selection is more near to my
house and easier to conduct research here.

Figure 4.1 Location of study, Ulu tiram in Johor Bahru state. (Source: Google Map 2014)
3.1.3

Sample of study
The sample of respondents are 100 of working adult in Ulu Tiram is selectively

choose for the study. This is because to get a 95% of significant level of confident and 5 %
as error of tolerance. According to The Theoretical Basis for the Life Model-Research And
Resources On Human Development"(Retrieved 2009-08-11), stated that adulthood can be
divided into early adult stage or young adult and then proceeding to middle adult stage.
Basically a person who in the range of 20-40 are young adult and then preceding to middle
range of age stages that is 41-64 years old (Erik Erikson,1999). Thus, the respondent that
are known as working adult referring to an individual who are in the age range starting
historically from 20 to 60 years.
Respondents were first grouped into habitual coffee consumer and non-habitual
coffee consumer. Habitual coffee consumer defined as a person who drinks one cup of
coffee or more than that per day, protective effect of high coffee intake are (4 or more cups
per day) and more than seven cups of coffee in a typical week. Whereas, non-habitual
coffee consumer defined as a person who drink did not drink coffee or only consume one
cup of coffee per day or less than seven cups of coffee in a typical week.
In this research, one hundred respondents are chosen for this research study, that is
fifty of them are habitual consumer and another fifty are non-habitual consumer. Here, all
respondents were required to sit and drink coffee given to them meanwhile answered the
questionnaire. Duration for this research is almost two hours.
Several inclusions and exclusion were included during this research study. During
these two hours, they are not allowed to do any exercises or taking other caffeinated
beverages. All the respondents were informed earlier to abstain themselves from any
caffeinated beverages including coffee consumption for 15 hours before the research being
completed. They are also were asked to abstain themself from any coffee or caffeine intake
before and during the research is being conducted except prepared two cups of coffee. Apart

from that, respondents with smoking habits, those who have family history of blood pressure
and other caffeinated beverages consumers were not omitted from this research study.
3.1.4

Development of questionnaire
There are closed ended and open-ended questionnaire been developed. The

closed ended questionnaire is where the respondent were supplied with a predetermined
list of questions and they are not allowing to hand written. The open-ended questionnaire is
an unstructured question without definite limits, unlike in multiple choice questionnaires.
These questionnaires allowed respondents to answers in his or her own words. The
questionnaire were developed in Bahasa Inggeris. This is as a purpose of respondent
convenient reading and answering the questions (Kenn B. Daratha et al., 2009).
There also some questions that were asked to respondents orally. This is to assess
the knowledge level of respondent about blood pressure and caffeine. Moreover, few oral
questions were asked such do they frequently drink coffee, if yes how many cups per day
and reason they consuming coffee. These oral questions to determine each respondent
whether they are habitual or non-habitual coffee consumer.

3.1.5

Primary data
Primary data is where original data were collected specially for the purpose reference

to specific objective. Primary data collection involves questionnaires, surveys, experiments

or direct observation. In this research a questionnaire were developed. This questionnaire
comprised of three parts that are demographic, preferences of caffeine intake, determining
caffeine consumption and stress scale questions.
The demographic part (Section A) consisted of usual information of respondent
including details such as age, sex, education, history and so on. It was located as first part
because as easy for respondent to answered and serve as a warm up to what follows.
These questionnaire used as a tool to collect demographic factors that are required for data
collection and data analysis. 8 items included in this part,that is age, gender, race, marital
status, smoking status, education background, working status , weight and height in order to
calculate BMI.
The second part of the questionnaires (Section B) contained item 1 to 6, comprised
that is direct factual questions and open-ended questionnaires about caffeine and blood
pressure. Level of knowledge of respondent about the preferences of caffeine intake

conducted was assessed in this part. The questions included knowledge about blood
pressure elevation in short term, diagnosis of blood pressure, cups of coffee they consumed
and last part of this section determining habitual and non-habitual coffee drinker based on
answering some caffeine consumption questions.
The stress scale part consisted respondent feelings and thoughts during taking
caffeine in coffee given and also determines their stress level according to the score. This
part determined association of coffee consumption and stress level.

3.1.6

Data collection

I.

Baseline assessment

Baseline blood pressure readings are taken before giving coffee. After record the reading,
questionnaire distributed to each respondent. Each respondent were given 10 minutes to
answer the prepared questionnaires.

II.

Coffee distribution

The coffee that selected for this study is Nescafe Classic Coffee. The quantity of caffeine per
serving in 150 ml of coffee prepared is 65mg. One teaspoon of coffee powder is mixed with
150 ml warm water. Each respondent will be given 2 servings of coffee at a time in which
total amount caffeine is 130mg in 300 ml of coffee prepared. In order to avoid bitter taste of
coffee, one teaspoon of sugar were added in coffee. Each respondent required to consume
the 2 cups of coffee within 15 minutes right after baseline of blood pressure reading is taken.
III.

Systolic, diastolic and pulse rate readings

Measurement of blood pressure was taken after every 15 minutes until reaching 120 minutes
after coffee consumption.
IV.

Anthropology measurement

Body Mass Index (BMI)

Body mass index (BMI) is a measure of weight of an individual relative to their height and is
often used to indicate an estimated the level of body fat in individuals. BMI is a screening
tool in research to classify trends within population because BMI able to determine under
and over nutrition in adults and children (Mei Z.2002).
Anthropometric measurements, such as body mass index, are used to screen body size
categories that may be lead any health problems. BMI also helps to assess physical
parameters in order to identify diet related classifications such as being underweight or
overweight. The researcher measured the weight of the subject on weighing scale in order to
gauge the BMI of a respondent after height measurement is taken. The respondents
standing height is taken using measuring tape. The BMI was determined by dividing weight
in kilograms by height squared in meters.

3.1.7 Summary of data collection

The questionnaire was distributed to selective 100 working adults in Ulu Tiram and
was collected after two hour time. Respondents required completing and answer all the
questionnaires regarding their habits, preferences towards coffee and stress. Completed
data collected after two hours. Basal blood pressure reading measured for each respondent.
Coffee consumption by each respondent and duration within 15 minutes after basal blood

pressure reading is recorded. Blood pressure reading was recorded every 15, 30, 45, 60, 75,
90, 105 and 120 minutes after two servings of coffee were given. During this research time,
respondents are not allowed to do extreme activities, they were asked not to do any physical
activities that require movements.
Raw data collections were key-in in Microsoft Excel first of all. Later it was imported
into IBM The Statistical Package for Social Scientists (SPSS) version 22.0 software. Data
imported into SPSS software because it is a advanced system to analyses data in accurate
way and can be used to analyses large number of samples. Frequencies, mean and
standard deviation can be determined and p-values for each test can be identified whether
the findings are significant (p < 0.05) or not (p>0.05) in SPSS software. Graphs and bar
charts are constructed from the data key-in in SPSS. All the results are recorded as mean
SD.

4.2 SAMPLING TECHNIQUE

4.2.1 Instruments/Tools
a)

Weighing scale (weighing machine)

Weighing scale is a machine used as measuring equipment to determine weight or mass of

an object especially body weight of a human beings. This is known as instrument for
weighing respondents weight for this research study and this measurement is important in
order to obtain respondents proper Body Mass Index (BMI).

b)

Measuring tape

Measuring tape is a flexible tape to measure the height of a respondent and it is graduated
such that the height can directly be read. Precaution must be taken that the tape is correctly
positioned at the point of measurement. This tape is very convenient and easy to measure
the height that will be also accompanying with weight to determine the Body Mass Index
(BMI).

c)

Blood pressure meter

Blood pressure monitor is a device used to measure blood pressure readings; systolic and
diastolic blood pressure together with heart rate or pulse reading. This device was used to
measure respondents blood pressure before and after consuming caffeine.

d)

Paper cups

Originally, paper cups for hot drinks and it is waterproof and it is also water-resistant paper.
These paper cups were used to give 2 servings of coffee for each respondent during the
coffee distribution.
4. 2. 2 Sampling method
Quota sampling is valuable when time is restricted particularly for cross-sectional
studies. This sampling was utilized and selected respondents were picked out of a particular
subdivision. This method also can be used when research studies meant to be within the
budget or when detailed precision is not imperative during the research.
Subdivisions are picked and after that discovering sampling used to pick individuals
from every subset. The researcher decided what number of every classification is assigned
in the research study (Dodge, Y. (2003). Quota sampling is utilized to guarantee that minor

groups sufficiently are represented in the study sample, thus this system is known as nonprobabilistic sample of quota sampling (Trochim, W.2000).
A particular population was initially portioned into shared sub-divisions, generally as
in stratified sampling in this quota sampling. Determination of the subjects or units from each
one section taking into a defined size. In this research, 100 samples consisting 50 habitual
and 50 non-habitual coffee consumers selected as participants so this aided to discover
about a small groups in the sample.

4.3 DATA ANALYSIS

4.3.1 Statistical Package for Social Scientists (SPSS)
The Statistical Package for Social Scientists (SPSS) version 22.0 software was used
to obtain accurate statistical analysis by analyze the collected data precisely. SPSS is a
Window based program in which large amount of data entry can be key-in and able to
.implement analyses that covered in texts, numbers and so on.Collection data key-in can be
analyzed in order to create tables and charts (Field, 2009, Discovering statistics using
SPSS).
Data information permits selecting alternatives ranging from displaying data that
sorted by variables with a specific goal to choosing certain cases for analyses. Besides,
change of data incorporates a few choices to transform present variables in which persistent
variables ready to be changed to categorical variables. Thirdly, this software system
incorporates in completing measurable analysis such as calculates graphic data, developing
diagrams including bar charts, box plots, line charts and histograms.

4.3.2

Microsoft Excel 2007 tool

Microsoft Excel 2007 will be used to enter all the data from SPSS used to construct

graphs consisting frequencies for the readings that key-in in SPSS. SPSS data that includes
descriptive statistics, histogram, analysis of variance or correlation test can be done in this
tool determines suitable graphs to be used and cumulative frequencies for a one variable
data set.
4.3.3

Correlation

Correlation is a term that refers to the association of two variables in which this test
makes a table of coefficients for sets of 2 or more independent variables. A high correlation
implies two variables have a solid association with one another. Low correlation implies that
the association is scarcely interrelated with each other (Ashley Crossman, 2011).In this
research study, correlation between coffee consumption and stress level can be correlated.
Correlation creates a table of coefficients for all possible pairs of 2 or more independent
variables.
4.3.4

Hypothesis testing
The t- test were used as a measurable examination of the means of two population in

which two-sample t-test observes whether two examples are distinctive Basically this test is
ordinarily utilized when the differences of two typical conveyances are unclear or unknown.
The impact of caffeine on blood pressure can be accessed by comparing with habitual and
non-habitual coffee consumers group. The test variables that used to compare for both
group are gender, smoking status, working status whether shift worker or housewife, blood
pressure and pulse rate during before and after coffee consumption.
4.3.5 Chi-square test
There are basically two types of random variables. Chi-square test yield two types of
data: numerical and categorical. A chi-square (X2) measurement examined whether
categorical and numerical variables vary from each other. This test serves to see the
contrasts between two variables as these test categorical variable yield information in the
groups and numerical variables yield information in numerical structure.
4.3.6 One-way ANOVA
One-way ANOVA can be used in order to compare means of more than two groups.
The one-way analysis of variance (ANOVA) can tests the null hypothesis that samples in
two or more groups are drawn from populations with the same mean values and determines
whether there are any significant differences between the means of two or more
independent (unrelated) groups.

4.4 DISTRIBUTON OF DATA ENTRY IN DATA ANALYSIS

Data that collected were analyzed into several tests that is Statistical Package for Social
Scientists (SPSS) includes one-way ANOVA, correlation test, chi-square test, independent
and paired t-test.

I.

Correlation test

Data analyzed by correlation to distribute the association of coffee consumption and the
stress level. This test is for to see any caffeine-related changes in respondents stress level
from the scoring of Cohen Stress Scale questions.

II.

ANOVA test

By using one-way ANOVA test, several aspects to be determined whether is there any
significant differences in all BMI categories with blood pressure readings. This test aided in
determines comparison of distribution of systolic blood pressure based on BMI category
before and after 120 minutes coffee consumption. Followed by distribution of diastolic
systolic blood pressure based on BMI category before and after 120 minutes coffee
consumption and distribution of pulse rate in BMI category before and after 120 minutes
coffee consumption.
From this test, significant p values determined and any mean changes in systolic, diastolic
and pulse rate before and after 120 minutes coffee consumption can be illustrated in BMI
categories. Comparison of educational level about coffee and blood pressure whether
respondents have the knowledge about impact of caffeine on blood pressure.

III.

Independent t -test

In this test, comparison of systolic blood pressure among habitual and non-habitual coffee
consumers before and after coffee consumption was determined. This is to identify the
difference between two means when scores for two sets are significant.

IV.

Independent and paired t test

The impact of caffeine after coffee consumption on systolic blood pressure in habitual and
non-habitual coffee consumers over time (15-120 minutes) can be illustrated by using this
both t-tests in order to express the result value in mean and standard deviation. Significant
differences can be obtained by differentiate firstly, systolic blood pressure in habitual and

non-habitual coffee consumer before and after 30,60,90 and 120 minutes coffee
consumption.
Secondly, comparison diastolic blood pressure in habitual and non-habitual coffee consumer
in 15 to 120 minutes (every 15minutes) coffee consumption. Thirdly, pulse rate comparison
in habitual and non-habitual coffee consumers before and after 120 minutes coffee
consumption. By using these tests, significant p value can be obtained to any changes in
systolic, diastolic blood pressure and pulse rate.
V.

Chi-square test

This test is used to compare two different variables. According to this research study,
comparison of caffeine on blood pressure among genders in habitual and non-habitual
coffee consumers can be done to determine the mean changes of systolic and diastolic
blood pressure. In addition, comparison of COHEN stress scale on habitual and non-habitual
coffee consumers to determine stress level of the respondent by using bivariate correlation.

CHAPTER 4
RESULTS

4.1 Descriptive tabulation of demographic factors.

Statistic
AGE

Mean

38.97

95% Confidence Interval for

Lower Bound

37.20

Mean

Upper Bound

40.74

5% Trimmed Mean

38.74

Median

38.00

Variance

79.928

Std. Deviation
Minimum

25

Maximum

58

Range

33

Interquartile Range

14
.351

.241

Kurtosis

-.860

.478

Mean

67.21

1.260

95% Confidence Interval for

Lower Bound

64.71

Mean

Upper Bound

69.71

5% Trimmed Mean

67.34

Median

67.50

Variance

158.652

Std. Deviation

HEIGHT

.894

8.940

Skewness

WEIGHT

Std. Error

12.596

Minimum

34

Maximum

96

Range

62

Interquartile Range

17

Skewness

-.087

.241

Kurtosis

-.161

.478

1.6840

.00832

Mean
95% Confidence Interval for

Lower Bound

1.6675

Mean

Upper Bound

1.7005

5% Trimmed Mean

1.6848

Median

1.6900

Variance
Std. Deviation

.007
.08317

Minimum

1.52

Maximum

1.84

Range

.32

Interquartile Range

.14

Skewness

-.041

.241

BMI

Kurtosis

-1.086

.478

Mean

23.637

.4092

95% Confidence Interval for

Lower Bound

22.825

Mean

Upper Bound

24.449

5% Trimmed Mean

23.461

Median

23.305

Variance

16.744

Std. Deviation

4.0920

Minimum

13.6

Maximum

35.7

Range

22.0

Interquartile Range

5.0

Skewness

COFFEE.SCORE

.640

.241

Kurtosis

1.048

.478

Mean

40.66

.844

95% Confidence Interval for

Lower Bound

38.99

Mean

Upper Bound

42.33

5% Trimmed Mean

40.86

Median

43.00

Variance

71.176

Std. Deviation

4.2

8.437

Minimum

22

Maximum

63

Range

41

Interquartile Range

13

Skewness

-.472

.241

Kurtosis

-.329

.478

Descriptive characteristics of demographic factors.

CHARACTERISTIC
Gender
Male

FREQUENCY (n=100)

PERCENTAGE

63

63%

 Female
Race
Malay
Chinese
Indian
Others
Education level
Primary education
Secondary education
Tertiary education and
above
Marital status
Single
Married
Working status
Shift day worker
Shift night worker
Housewife
Smoking status
Yes
No
Ex-smoker
BMI
Underweight
Normal
Overweight
Obese
Other caffeinated beverages
Chocolate
Coke
Tea
Energy drink

37

37%

41
9
49
1

41%
9%
49%
1%

30
47
23

30%
47%
23%

64
36

64%
36%

30
27
43

30%
27%
43%

20
60
20

20%
60%
20%

9
58
25
7

9.1%
58.6%
25.3%
7.1%

14
12
47
27

14%
12%
47%
27%

4.3 Changes of systolic blood pressure in habitual and non-habitual coffee

consumers.

The effects of caffeine on systolic blood pressure in habitual and non-habitual coffee
consumers are showed in figure below. The results obtained by using independent t-test, the
results value are expressed in the term of 95% confidence interval and mean Standard
deviation (SD).

4.3.1 Changes of systolic, diastolic blood pressure and heart rate in habitual coffee
consumers.

4.3.2 Changes of systolic, diastolic blood pressure and heart rate in non-habitual
coffee consumers.

4.4

Association of coffee consumption and stress level.

The results are obtained by using correlation test in which coffee consumption scoring
is intercorrelated to determine their stress level according to the score. The higher the coffee
consumption, the higher the stress level. Those who consumed higher intake of coffee
having higher stress level. There is a significant value showed between these two variables
(p = 0.00 ).

f(x) = 0.24x + 13.2

R = 0.66

CHAPTER 5
DISCUSSION

5.1

Descriptive characteristics of demographic factors

Total number of respondents who voluntarily participated in this research study is

(n=100). This respondents answered all the questions and their blood pressure reading was
recorded. By data obtained, the impact of caffeine on blood pressure among working adults
were investigated. Socio-demographic are the characteristics of population. Tabulation of
each aspect of demographic factors are tabulated as below.
5.1.1

Race

Race is the main factor in demographic part, race classified respondents into a
group. Race been asked to be answered by respondents as it the most basic question every
individual can answered. According to figure 5.1.1, the majority people who participated in
this research study are Indian are 49 of them, Malay are 41 of them, followed by Chinese
with 9 people and one respondent from other race.

5.1.2

Gender

MALE
FEMALE

Respondents were selected randomly and claasified into gender groups. As the
results showed, male are more higher than female. Male hold higher dominant number of
respondents with the percentage of 63% and followed by female with percentage of 37%.
5.1.3

Education level

Education level of respondents also was analysed and classified by groups. Primary
educations are those who studied primary school and high school. Secondary education
level are those who studied Diploma, Foundation or Matriculation. Tertiary education level

are those who studied until Bachelor, holding a degree, Masters or PhD. According to figure
5.1.3, it showed secondary education are dominant among respondents, followed by primary
education level and then tertiary education level.

5.1.4

Marital status

SINGLE
MARRIED

Marital status also one of the common demographic factor which can be determined
from respondents. According to figure 5.1.4, 64% of respondents are single while 36% of
respondents who already married. This factor useful for comparison data analysis of coffee
consumption and stress level among single and married respondents.

5.1.5

Body Mss Index(BMI)

UNDERWEIGHT
NORMAL
OVERWEIGHT
OBESE

Body Mass Index (BMI) can be grouped into underweight, normal, overweight and
obese. BMI calculated from height and weight of the respondents. Respondents with normal
BMI are the highest among all that is 58%, followed by 25% of respondents with overweight
BMI, 9% of respondents of underweight BMI and respondents under obese group shown the
least percentage of 7%.

5.1.6

Caffeinated beverages other than coffee

There are many caffeinated beverages other than coffee containing caffeine. Most of
the respondents consumed tea for regular basis other than coffee with the percentage of
47%.Second highest consumed by respondents are energy drinks with the percentage of
27%. Respondents chose to consumed chocolate as caffeinated beverages other than
coffee with the percentage of 14% and lastly by carbonated drinks, coke with the percentage
of 12%.
5.1.7 Diagnosis of high blood pressure

YES

NO

There is question in questionnaire form answered by respondents whether they had

been diagnosed with high blood pressure before this or not. Most of the respondents, nearly
57% of them answered No, meaning to say they did not have the knowledge whether they
are having high blood pressure (hypertension) or not. Another 43% of respondents claimed
they have been diagnosed with high blood pressure before this and they are aware of their
blood pressure status.

5.2 Changes of systolic, diastolic blood pressure and heart rate in habitual coffee
consumers.

Figure 5.2.1 : Systolic blood pressure in habitual coffee consumer before and after 15 to 120
minutes of coffee consumption.

Data analysed shows basal BP reading in habitual coffee consumers is 124.89

7.51 mmHg. At 15 to 30 minutes, the reading is increases gradually. At 30 minutes, systolic
BP reading is 129.72 7.68 mmHg. After 45 minutes until 90 minutes of coffee ingestion,
results shows a decrease in systolic BP where reading is 128.51 7.54mmHg. This is due to
coffees action is slow at these particular time. There is drastic changes aft 90 minutes in
habitual coffee consumers,144.77 14.16mmHg. After 120 minutes of coffee consumption,
systolic BP reading result shows 126.97 10.67 mmHg. There is no significant difference in
habitual coffee consumers after caffeine intake. Thus, the hypothesis is accepted.

Figure 5.2.2 : Diastolic blood pressure in habitual coffee consumer before and after 15 to
120 minutes of coffee consumption.

Data analysis expressed the basal diastolic BP reading of habitual coffee consumers
is 78.89 8.53 mmHg. This data were continuously taken every 15 minutes to 120 minutes
after the coffee is consumed. Within 15 to 30 minutes, the diastolic BP reading is increasing
slowly. At 30 minutes, biggest changes can be observed where the reading is 83.92 8.28
mmHg. From 30 to 45 minutes, the reading shows stable value and then after 45 minutes
the caffeine reduces its action, there is reduction in diastolic BP reading (80.57 8.70
mmHg). At 90 minutes, the diastolic BP reading shows increase progressively, the reading is
83.20 8.84. After 120 minutes of coffee consumption, an increase of diastolic reading

shows in habitual coffee consumers (85.37 7.94 mmHg) shows a significant value which is
p = 0.00.

Figure 5.2.3 : Heart rate in habitual coffee consumers before and after 15 to 120 minutes of
coffee consumption.

Heart rate changes in habitual coffee consumers were observed over time that is
before and after coffee consumption. The data analysed for every 15 minutes until 120
minutes. Other than systolic and diastolic BP reading, caffeine also shows its impact towards
heart rate (beats per minute).The basal heart rate reading was 67.49 7.03 bpm and it is
increasing slowly until 30 minutes, 70.09 6.74 bpm. After 30 minutes, heart rate reading fall
to 69.55 6.99 bpm. From 45 minutes to 75 minutes, the heart rate reading was upside
down. At 90 minutes, the heart rate reading shows a drastic increase (79.14 9.20 bpm) and
then the reading drop to 70.20 7.31 bpm at 105 minutes. After 120 minutes, there are no
significant differences of value in habitual coffee consumers on heart rate reading. The heart

rate reading was the highest at 90 minutes due to extreme caffeine action in the blood at that
time,

5.3 Changes of systolic, diastolic blood pressure and heart rate in non-habitual coffee
consumers.

Figure 5.3.1: Systolic blood pressure in non- habitual coffee consumers before and after 15
to 120 minutes of coffee consumption.

The data analysis was for non-habitual coffee consumers to investigate the impact of
caffeine after coffee intake over time. The results expressed the basal systolic BP reading in
non-habitual coffee consumers are 127.46 8.89 mmHg. Biggest systolic BP reading
changes can be observed at 15 to 30 minutes after coffee consumption where the results
shows 130.89 8.77 mmHg. At this internal, caffeine showed extreme action on blood
causing the systolic BP reading rises. After 30 minutes of coffee consumption, the systolic
BP reading drops to 128.14 8.70 mmHg and at 60 minutes, the reading was 128.03 8.81

mmHg. After 75 minutes of coffee consumption, the systolic BP reading in non-habitual

coffee consumers increases gradually again,129.54 8.87 mmHg. There is a significant
difference in systolic BP reading at the end of the studies, that is after 120 minutes of coffee
consumption the reading shows elevation of systolic BP reading (132.46 8.43 mmHg)
when compared with basal systolic BP reading. The p value are p=0.00which is less than
0.05 (p<0.05).

Figure 5.3.2: Diastolic blood pressure in non- habitual coffee consumers before and after 15
to 120 minutes of coffee consumption.

The impact of caffeine on diastolic blood pressure in non-habitual coffee consumers

were analysed over time for two hours. As the data illustrated above, the basal diastolic BP
reading is 80.69 10.21 mmHg. From 15 minutes to 60 minutes, the diastolic BP reading
rises slightly (84 9.95 mmHg). After 60 minutes of coffee consumption, the diastolic BP
reading in non-habitual coffee consumption declining until 90 minutes (79.09 10.09
mmHg).These shows caffeine does not showed extreme action toward diastolic BP in nonhabitual coffee consumers. The impact of caffeine only can be seen at 105 minutes, the
diastolic BP is 102.26 12.64 mmHg and drops to 85 9.27 mmHg. This due to caffeine
showed its action on diastolic BP in non-habitual coffee consumers after more than one hour

of caffeine ingestion, it shows no significant difference (p=0.41) when compare with basal
diastolic BP reading, p >0.05.

Figure 5.3.3 : Heart rate changes in non- habitual coffee consumers before and after 15 to
120 minutes of coffee consumption.

Heart rate changes in non-habitual coffee consumers were examined over time,
before and after coffee consumption. Data analysis shows that basal heart rate reading for
non-habitual coffee consumers is 72.97 7.45 bpm. After coffee ingestion, the heart rate
changes slightly where it shows rise from 15 minutes until 30 minutes of coffee consumption
(75.14 7.37 bpm). At interval of 30 to 45 minutes of coffee consumption, the heart rate
drops to (73.69 7.24 bpm). However the heart rate readings fluctuate at 60 to 120minutes

of coffee consumption. At 90 minutes, heart rate readings show a sudden rise in nonhabitual coffee consumers, 92.29 11.98 bpm. At the end of the studies, that is after 120
minutes of coffee consumption there is reduction in heart rate readings in non-habitual
coffee consumers, 77.91 7.52bpm. Caffeine ingestion does not shows much impact
towards heart rate of non-habitual coffee consumers.

CHAPTER 6
CONCLUSION

5.1 LIMITATION
There are some limitations in this research study that influences the data collection
and data analysis in this research study. Surveys are problematic to people who struggle
with real or perceived time constraints. They are less likely to respond to surveys because
these possible respondents feel overworked they just do not have the time to complete the
survey. It seems a hard task to control the entire respondents who participated throughout in
this research study. Respondents were asked not to do physical activities through this study
but some of them did not obey. Thus, controlling all the respondents who voluntarily
participated in this research study isa hard task to conduct. There are also Bias is when an
individuals perception or their self-reported data shown in an inaccurate way because bias
are commonly negative or fake. A self-reported data may contain several types of selective
bias. For instance, selective memory is whether they remember an event that occurred at
the past as they remember or not the number of coffee drink they consumed every week.

5.2 Future research recommendation

A huge concern for the future recommendation of research study should be conduct
to future research should be done among those have higher risk of high blood pressure or
pre-hypertensive individuals to create preventative measure against cardiovascular disease.

Further research should be persist to conduct caffeine exposure on blood pressure with
longer period of time. Moreover, conduct a research by increase the sample size (1,0005,000 area of urban small) and different states in Malaysia. Besides that, a research study
should be conduct by preparing a dietary dairy for selected respondents to determine their
pattern of dietary and coffee consumption they took on their routine day before the
consumption of coffee given during the research.

5.3 Summary of research findings

This research study is carried out in order to investigate the impact of caffeine on
blood pressure among habitual and non-habitual coffee consumers. The caffeine in the
coffee shows significant changes on blood pressure where the ingestion of caffeine
stimulates bodys cardiovascular system and thus, it causes elevation of blood pressure in
short term period.
The data analysis showed that demographic factors showed from BMI category,
those who classified into obese group having higher systolic, diastolic blood pressure and
heart rate readings before and after the caffeine ingestion compared to other BMI category.
Those who consumed higher intake of caffeine tends to have higher stress level after
analysed by coffee scoring and stress scale scoring has showed a positive correlation.
In addition, the data analysis indicated that systolic blood pressure in non-habitual
consumers are more higher(132.46 8.43 mmHg) than habitual coffee consumers (126.97
10.67 mmHg) when compared before and after the coffee consumption. After 120 minutes
coffee consumption, systolic blood pressure increased in non-habitual coffee consumers
while there is no significant change observed in habitual coffee consumers. Diastolic blood
pressure in habitual and non-habitual coffee consumers shows an increase in both group.
However, after 120 minutes, significant increase in habitual coffee consumers (85.37 7.94
mmHg) than in non-habitual coffee consumers (80.00 9.27 mmHg). The heart changes
also compared in both group over time. The findings showed both habitual and non-habitual
coffee consumers has shown reduction after 120 minutes of coffee consumption.
In conclusion, this research study supports the hypothesis that there is an impact on
blood pressure among habitual and non-habitual coffee consumers but gives higher effects
on non-habitual coffee consumers and the alternative hypothesis is accepted.