In the JournalsPerspective

Frequent energy drink consumption may be harmful to heart

Continual consumption of energy drinks was associated with significantly prolonged corrected QT intervals and higher BP rates, according to findings published in the Journal of the American Heart Association.

Sachin A. Shah, PharmD, and colleagues sought to determine how energy drinks might affect ECG and hemodynamic parameters in young healthy volunteers.

“We found an association between consuming energy drinks and changes in QT intervals and blood pressure that cannot be attributed to caffeine,” Shah, a professor of pharmacy practice at the Thomas J. Long School of Pharmacy and Health Sciences at the University of the Pacific, said in a press release. “We urgently need to investigate the particular ingredient or combination of ingredients in different types of energy drinks that might explain the findings seen in our clinical trial.”

The researchers conducted a randomized, double-blind, placebo-controlled, crossover study on healthy volunteers.

Study participants consumed 32 oz energy drink A, energy drink B or a placebo drink within 60 minutes on 3 study days with a 6-day washout period.

The primary endpoint was QTc interval. Secondary endpoints included QT interval, PR interval, QRS duration, central systolic and diastolic BP, brachial systolic and diastolic BP, and heart rate.

The endpoints were measured at baseline and in 30-minute intervals during a period of 240 minutes after drink consumption.

Shah and colleagues performed a repeated-measures two-way analysis of variance on the effects of intervention, time and an interaction of intervention and time.

The researchers included 34 participants in the study (median age, 22 years; 50% men; 65% Asian).

The interaction term of intervention and time was statistically significant for QT interval, Bazett’s corrected QT interval, Fridericia’s corrected QT interval, PR interval, QRS duration, heart rate, systolic BP, diastolic BP, central systolic BP and central diastolic BP (P < .001 for all), according to the researchers.

Continual consumption of energy drinks was associated with significantly prolonged corrected QT intervals and higher BP rates, according to findings published in the Journal of the American Heart Association.
Source: Adobe Stock

Shah and colleagues found the maximum change from baseline in Bazett’s corrected QT interval was 17.9 milliseconds for drink A, 19.6 milliseconds for drink B and 11.9 milliseconds for placebo (P = .005 for ANOVA; P for drink A vs. placebo = .04; P for drink B vs. placebo < .01).

Peripheral and central systolic and diastolic BP were different compared with placebo (P < .001 for each), Shah and colleagues wrote.

“The public should be aware of the impact of energy drinks on their body, especially if they have other underlying health conditions,” Shah said in the release. “Health care professionals should advise certain patient populations, for example, people with underlying congenital or acquired long QT syndrome or high blood pressure, to limit or monitor their consumption.” – by Earl Holland Jr.

Disclosures: Shah reports he has served as an expert witness in legal cases related to caffeinated energy drinks. Please see the study for all other authors’ relevant financial disclosures.

Continual consumption of energy drinks was associated with significantly prolonged corrected QT intervals and higher BP rates, according to findings published in the Journal of the American Heart Association.

Sachin A. Shah, PharmD, and colleagues sought to determine how energy drinks might affect ECG and hemodynamic parameters in young healthy volunteers.

“We found an association between consuming energy drinks and changes in QT intervals and blood pressure that cannot be attributed to caffeine,” Shah, a professor of pharmacy practice at the Thomas J. Long School of Pharmacy and Health Sciences at the University of the Pacific, said in a press release. “We urgently need to investigate the particular ingredient or combination of ingredients in different types of energy drinks that might explain the findings seen in our clinical trial.”

The researchers conducted a randomized, double-blind, placebo-controlled, crossover study on healthy volunteers.

Study participants consumed 32 oz energy drink A, energy drink B or a placebo drink within 60 minutes on 3 study days with a 6-day washout period.

The primary endpoint was QTc interval. Secondary endpoints included QT interval, PR interval, QRS duration, central systolic and diastolic BP, brachial systolic and diastolic BP, and heart rate.

The endpoints were measured at baseline and in 30-minute intervals during a period of 240 minutes after drink consumption.

Shah and colleagues performed a repeated-measures two-way analysis of variance on the effects of intervention, time and an interaction of intervention and time.

The researchers included 34 participants in the study (median age, 22 years; 50% men; 65% Asian).

The interaction term of intervention and time was statistically significant for QT interval, Bazett’s corrected QT interval, Fridericia’s corrected QT interval, PR interval, QRS duration, heart rate, systolic BP, diastolic BP, central systolic BP and central diastolic BP (P < .001 for all), according to the researchers.

Continual consumption of energy drinks was associated with significantly prolonged corrected QT intervals and higher BP rates, according to findings published in the Journal of the American Heart Association.
Source: Adobe Stock

Shah and colleagues found the maximum change from baseline in Bazett’s corrected QT interval was 17.9 milliseconds for drink A, 19.6 milliseconds for drink B and 11.9 milliseconds for placebo (P = .005 for ANOVA; P for drink A vs. placebo = .04; P for drink B vs. placebo < .01).

Peripheral and central systolic and diastolic BP were different compared with placebo (P < .001 for each), Shah and colleagues wrote.

“The public should be aware of the impact of energy drinks on their body, especially if they have other underlying health conditions,” Shah said in the release. “Health care professionals should advise certain patient populations, for example, people with underlying congenital or acquired long QT syndrome or high blood pressure, to limit or monitor their consumption.” – by Earl Holland Jr.

Disclosures: Shah reports he has served as an expert witness in legal cases related to caffeinated energy drinks. Please see the study for all other authors’ relevant financial disclosures.

    Perspective

    The take home message is that energy drinks are associated with high BP and change in QT interval. We don’t know exactly which energy drinks were used during the study, but this is likely true for all energy drinks and obviously that is a real concern, particularly for patients with heart disease.

    When we see people who have cardiac arrhythmias, we are going to have to be concerned that if they are drinking lots of high energy drinks that that’s possibly a cause.

    These studies were done in normal healthy volunteers. We have to be concerned about their effects in patients that have heart disease, so I would like to see some work in that area.

    Some patients with some sort of heart disease who consume some of these drinks can have life-threatening cardiac arrhythmias or some serious elevations in BP. They can really have some serious problems.

    The study is a wake-up call for people who think these drinks are as benign as a diet soda drink. The amount of caffeine in these drinks can cause real perturbations to the CV system.

    • Kenneth A. Ellenbogen, MD
    • American Heart Association expert
      Kimmerling Professor of Cardiology
      Chair, Division of Cardiology
      VCU Pauley Heart Center
      Medical College of Virginia/VCU School of Medicine

    Disclosures: Ellenbogen reports no relevant financial disclosures.

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