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Energy Drinks: A Jolt to the Heart You Don’t Want

A concerning link between energy drinks and sudden cardiac arrest in patients with genetic heart conditions has doctors issuing an “urgent warning” to consumers.

Caffeine-craving kids are fueling an explosion in US energy drink sales. This billion dollar industry is booming, however makers are facing increased scrutiny as concerns grow over the potential health risks posed by these popular beverages. 

Emergency room visits by youngsters doubled between 2007 and 2011.2 The culprit? Energy drinks such as Red Bull, Monster Energy and 5-Hour Energy. One in ten of these visits resulted in hospitalization, highlighting the potential severity of health complications linked to these beverages.

The dangers are particularly pronounced when energy drinks are mixed with alcohol or other drugs, a combination responsible for 42% of the ER visits in 2011.2 This risky cocktail is especially popular among college students, with a quarter reporting mixing the two. 

While popular brands like Red Bull and Monster rake in profits, experts warn that these energy drinks, often packed with caffeine levels exceeding those found in coffee, along with other unregulated stimulants like taurine and guarana, are slipping through the cracks of FDA regulation.1,2 This lack of oversight raises red flags, especially for individuals with pre-existing heart conditions.3-5 

A new Mayo Clinic study, published June 6th in Heart Rhythm by Dr. Michael J. Ackerman and his team, are in the midst of investigating whether energy drinks could trigger sudden cardiac arrest in people with genetic heart diseases, a question that has both consumers and health officials buzzing with concern.

Unmasking the hidden dangers of energy drinks

To investigate the potential link between energy drinks and heart problems, the Mayo Clinic researchers conducted a deep dive into the medical records of over 5,000 patients evaluated at their Genetic Heart Rhythm Clinic. They homed in on 144 patients who had survived sudden cardiac arrest due to irregular heart rhythms, meticulously examining their medical histories and genetic information.

Importantly, the study focused on those who had experienced a cardiac event close in time (anywhere from immediately before to within 12 hours) to consuming an energy drink. Researchers relied on detailed electronic medical records, which included patients’ self-reported energy drink habits dating back to 2000. This approach ensured a near-complete record of energy drink consumption, bolstering the study’s reliability. By analyzing patient demographics, underlying heart conditions, genetic variants, and the timing of energy drink consumption relative to cardiac events, the researchers aimed to shed light on the potential dangers of these beverages for those with pre-existing heart issues.

Are energy drinks triggering heart attacks?

To investigate the potential link between energy drinks and heart problems, the Mayo Clinic researchers conducted a deep dive into the medical records of over 5,000 patients evaluated at their Genetic Heart Rhythm Clinic. They homed in on 144 patients who had survived sudden cardiac arrest due to irregular heart rhythms, meticulously examining their medical histories and genetic information.

Importantly, the study focused on those who had experienced a cardiac event close in time (anywhere from immediately before to within 12 hours) to consuming an energy drink. Researchers relied on detailed electronic medical records, which included patients’ self-reported energy drink habits dating back to 2000. This approach ensured a near-complete record of energy drink consumption, bolstering the study’s reliability. By analyzing patient demographics, underlying heart conditions, genetic variants, and the timing of energy drink consumption relative to cardiac events, the researchers aimed to shed light on the potential dangers of these beverages for those with pre-existing heart issues.

Are energy drinks triggering heart attacks?

Out of 144 survivors of sudden cardiac arrest, a concerning 5% experienced this life-threatening event within the 12-hour window after consuming an energy drink. Notably, six out of the seven were female, and the average age at the time of the event was 29 years old.

For 87% of these individuals, the sudden cardiac arrest was their first cardiac event, underscoring the potential risks even for those with no prior history of heart problems. Various underlying genetic heart conditions played a role: while the majority (43%) were diagnosed with unexplained sudden cardiac arrest or idiopathic ventricular fibrillation (IVF), 29% had catecholaminergic polymorphic ventricular tachycardia (CPVT), and another 29% had long QT syndrome (LQTS).

Energy drink consumption habits varied among the patients, with 43% reporting frequent use and 57% reporting infrequent use. The timing between energy drink consumption and the sudden cardiac arrest ranged from immediately before to up to 12 hours prior. The majority of these patients (86%) required a rescue shock for their arrhythmia, underscoring the severity of the cardiac events.

Following their sudden cardiac arrest and necessary treatment, all patients stopped consuming energy drinks and were placed on appropriate therapies, such as implantable cardioverter-defibrillators or medications. Thankfully, with an average follow-up period of over four years, none of these patients experienced any further cardiac events.

Sudden cardiac arrest stories

The study shared several compelling case studies highlighting the potential dangers of energy drinks for individuals with genetic heart conditions. In one instance, a 32-year-old woman experienced sudden cardiac arrest just hours after consuming an energy drink post-pregnancy. Another 37-year-old woman, who regularly consumed energy drinks, suffered a similar fate in the middle of the night. A 20-year-old collegiate athlete, accustomed to drinking energy drinks before workouts, collapsed during practice, requiring resuscitation with an automated external defibrillator.

Other cases involved a 28-year-old woman who collapsed after consuming a large amount of an energy drink, a 21-year-old woman who experienced sudden cardiac arrest despite being on medication for a known heart condition, and a 42-year-old woman who had a sudden cardiac arrest after drinking an energy drink while taking antibiotics. In the final case, a 26-year-old woman lost consciousness while drinking an energy drink after exercising, possibly due to dehydration. 

These cases demonstrate the diverse scenarios in which a lack of energy drink warnings could potentially trigger cardiac events in individuals with underlying genetic predispositions.

It’s time to sound the alarm

A concerning link has emerged between energy drinks and sudden cardiac arrest in patients with genetic heart conditions. While not all people with an underlying heart condition are affected, researchers say these findings underscore the need for the FDA to take action. Clearer guidelines on the safe consumption of these beverages, they say, are essential, especially for those with pre-existing heart issues.

Dr. Peter Schwartz, director of Italy’s Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, wrote in a press release, “critics might say of these findings, ’it’s just an association by chance.’ We, as well as the Mayo Clinic group, are perfectly aware that there is no clear and definitive evidence that energy drinks indeed cause life-threatening arrhythmias and that more data are necessary, but we would be remiss if we were not sounding the alarm. At one point, clinical experience, solid understanding of pathophysiology, and common sense should join and speak up.”6

What’s in energy drinks?

Energy drinks, promising a quick burst of energy and alertness, are the second most consumed dietary supplement in the US after multivitamins. These beverages come in two main forms: standard-sized cans or bottles, and smaller, concentrated “energy shots.”1

Caffeine is the star ingredient in both, but the amount can vary drastically, ranging from 70 to 240 mg in a standard drink and a whopping 113 to 200 mg in a tiny energy shot.1 To put that in perspective, a can of cola has about 35 mg of caffeine and your average cup of coffee contains about 100 mg of caffeine. But energy drinks aren’t just about caffeine. 

They also often pack a punch with other stimulants like guarana, along with sugars, taurine, ginseng, and various B vitamins.1 The exact effects of this cocktail of ingredients are still being studied, raising questions about their long-term safety, especially for young people.

Caffeine Content

  • Standard Drinks: 70-240 mg per 16 ounces
  • Energy Shots: 113-200 mg per 2-2.5 ounces

Other Ingredients

  • Guarana: A plant that naturally contains caffeine.
  • Sugars: Various types of sugar are common, adding to the calorie content.
  • Taurine: An amino acid, its effects in energy drinks are debated.
  • Ginseng: A herb traditionally used for energy and stress reduction.
  • B Vitamins: Often added to promote energy metabolism.
  • Glucuronolactone: A naturally occurring substance, its effects are unclear.
  • Yohimbe: A stimulant derived from tree bark.
  • Carnitine: An amino acid involved in energy production.
  • Bitter Orange: Contains synephrine, a stimulant similar to ephedrine.

The combination of these ingredients, particularly in high doses, can have significant effects on the body and may not be safe for everyone. It’s always best to consult with a healthcare professional before consuming energy drinks, especially if you have underlying health conditions.

References

  1. Martinez, K.A. et al. (2024) ‘Sudden cardiac arrest occurring in temporal proximity to consumption of energy drinks’, Heart Rhythm [Preprint]. doi:10.1016/j.hrthm.2024.02.018. 
  2. Energy drinks (no date) National Center for Complementary and Integrative Health. Available at: https://www.nccih.nih.gov/health/energy-drinks (Accessed: 14 June 2024). 
  3. Nadeem IM, Shanmugaraj A, Sakha S, Horner NS, Ayeni OR, Khan M. Energy Drinks and Their Adverse Health Effects: A Systematic Review and Meta-analysis. Sports Health. 2021;13(3):265-277. doi:10.1177/1941738120949181
  4. (2013) The dawn report: 1 in 10 energy drink-related … Available at: https://www.samhsa.gov/data/sites/default/files/spot124-energy-drinks-2014.pdf (Accessed: 15 June 2024). 
  5. Government of Canada, H.C. (2023) Recalls and safety alerts, Canada.ca. Available at: https://recalls-rappels.canada.ca/en/alert-recall/caffeinated-energy-drinks-what-you-should-know (Accessed: 14 June 2024). 
  6. Energy drinks may trigger cardiac arrhythmias in patients with genetic heart diseases, doctors say. (2024) www.elsevier.com. Available at: https://www.elsevier.com/about/press-releases/doctors-advise-caution-as-energy-drinks-may-trigger-life-threatening-cardiac-arrhythmias-in-patients-with-genetic-heart-diseases (Accessed: 14 June 2024). 
Melody Sayrany MSc
Melody Sayrany MSc
Melody Sayrany is a seasoned science writer with a host of experiences in cancer, neuroscience, aging, and metabolism research. She completed her BSc at The University of California, San Diego, and her MSc in biology, focusing on metabolic diseases during aging, at the University of British Columbia. Melody is passionate about science communication, and she aims to bridge the gap between complex scientific concepts and the broader community through compelling storytelling.
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