Randomized Controlled Trial of High‐Volume Energy Drink Versus Caffeine Consumption on ECG and Hemodynamic Parameters

Abstract

BackgroundCaffeine in doses <400 mg is typically not considered arrhythmogenic, but little is known about the additional ingredients in energy drinks. We evaluated the ECG and blood pressure (BP) effects of high‐volume energy drink consumption compared with caffeine alone.Methods and ResultsThis was a randomized, double‐blind, controlled, crossover study in 18 young, healthy volunteers. Participants consumed either 946 mL (32 ounces) of energy drink or caffeinated control drink, both of which contained 320 mg of caffeine, separated by a 6‐day washout period. ECG, peripheral BP, and central BP measurements were obtained at baseline and 1, 2, 4, 6, and 24 hours post study drink consumption. The time‐matched, baseline‐adjusted changes were compared. The change in corrected QT interval from baseline in the energy drink arm was significantly higher than the caffeine arm at 2 hours (0.44±18.4 ms versus −10.4±14.8 ms, respectively; P=0.02). The QTc changes were not different at other time points. While both the energy drink and caffeine arms raised systolic BP in a similar fashion initially, the systolic BP was significantly higher at 6 hours when compared with the caffeine arm (4.72±4.67 mm Hg versus 0.83±6.09 mm Hg, respectively; P=0.01). Heart rate, diastolic BP, central systolic BP, and central diastolic BP showed no evidence of a difference between groups at any time point. Post energy drink, augmentation index was lower at 6 hours.ConclusionsThe corrected QT interval and systolic BP were significantly higher post high‐volume energy drink consumption when compared with caffeine alone. Larger clinical trials validating these findings and evaluation of noncaffeine ingredients within energy drinks are warranted.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02023723.

Cardiovascular and Autonomic Responses to Energy Drinks—Clinical Implications

“…Notably, 22% of the subjects who consumed the energy drinks experienced palpitations, an adverse effect that was not present in the caffeinated beverage group. Furthermore, the group that consumed the energy drink experienced a significantly prolonged QTc interval of 10 ms at 2 h after consuming the energy drink and an elevated peripheral systolic BP of 4 mmHg at 6 h after energy drink consumption [34]. The QT prolongation is clinically meaningful since, as pointed out by Fletcher et al, the Food and Drug Administration requires thorough investigation of QT prolongation effects of all new drugs, with increases of more than 10 ms raising regulatory concern [35].…”

“…That these effects are not primarily caffeine-mediated is suggested by Fletcher et al, who conducted a randomized, double-blind, cross-over, controlled study examining ECG and hemodynamics after energy drink intake versus a beverage with an equivalent caffeine content [34]. Subjects consumed a drink containing 320 mg of caffeine versus a "high-volume" energy drink containing 320 mg of caffeine.…”

Isolated systolic hypertension — evaluation of the scale of the problem among medical students — pilot study

“…Furthermore, the ISH group was more likely to use energy drinks containing caffeine. It should be noted that the effect of caffeinated energy drinks on peripheral BP is stronger than that caused by pure caffeine [25]. Caffeine also increases the cBP and AIx values [26].…”

Barn og unge må beskyttes mot energidrikker

“…To timer etter inntak av energidrikk var det signifikant lengre QT-tid, en risikofaktor for fatale hjertearytmier, enn ved inntak av samme mengde koffeindrikk. Begge drikkene medførte økning i systolisk blodtrykk, men seks timer etter inntak var dette signifikant høyere ved inntak av energidrikk enn ved inntak av koffeindrikk (5). Kombinasjonen av koffein og andre stoffer, for eksempel sukker, kan vaere medvirkende årsak til den alvorlige reaksjonen, men dette har man ikke fullgod kunnskap om ennå.…”