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Analysis links energy drinks and pre-workout supplements to cardiac arrest reports in young adults

Digilifetrends Published 4 min read

Key points

Analysis links energy drinks and pre-workout supplements to cardiac arrest reports in young adults

Energy drinks and pre-workout powders have become routine for many students, gym regulars and shift workers. A new review of FDA reports suggests these products may pose heart-related risks, and nearly half of the reports involved adults age 34 or younger.

  • Cardiac arrest was reported about 11 times more often in FDA adverse-event reports involving caffeinated energy drinks and stimulant supplements than in reports involving non-stimulant products such as protein bars and vitamins.
  • Heart attacks were reported about 4.5 times more often, while dangerous heart rhythm problems or palpitations were reported about 4 times more often.
  • About 45% of the heart-related reports involved adults ages 18 to 34.
  • The findings were presented ahead of the American Heart Association’s Scientific Sessions in Chicago. They are preliminary and have not yet appeared in a peer-reviewed journal.
  • The study shows a link, not proof, that these products caused heart problems. Most people who use them occasionally do not experience serious issues.

What the review found

Researchers from the University of Virginia School of Medicine examined more than 28,000 reports filed in the FDA’s adverse-event database by or about people age 13 and older.

Among those reports, 854 involved caffeinated energy drinks or stimulant dietary supplements such as pre-workout powders and fat burners. The team compared them with 27,491 reports tied to products without caffeine or stimulants, including soft drinks, protein bars and vitamins.

The products were sorted by ingredient rather than brand. The stimulant group included caffeine, plant-based stimulants such as guarana, yerba mate and green tea extract, and stronger stimulants such as synephrine from bitter orange, ephedra, DMAA and higenamine.

Compared with reports involving non-stimulant products, reports involving energy drinks and stimulant supplements mentioned:

  • Cardiac arrest: about 11 times more often
  • Heart attack: about 4.5 times more often
  • Ventricular arrhythmias or palpitations: about 4 times more often
  • Rapid heart rate: nearly 3 times more often
  • Chest pain: about 2.7 times more often
  • Fainting: about twice as often

The pattern was similar among men and women.

Why younger adults may be affected

The researchers did not identify a single reason younger adults accounted for so many of the heart-related reports, but they pointed to several possibilities:

  • Frequent use. Young adults are among the biggest consumers of energy drinks and pre-workout supplements.
  • How the products are used. Taking them before hard exercise, or combining them with alcohol or other drugs, may increase stress on the heart.
  • Hidden heart conditions. Some younger people may have inherited rhythm disorders or structural heart problems they do not know about, and stimulants could trigger symptoms.

Caffeine and other stimulants can raise heart rate and blood pressure. In large amounts, they may trigger abnormal heart rhythms, especially in people who are sensitive.

How much caffeine is in these products?

The American Heart Association says up to 400 mg of caffeine a day — roughly five 8-ounce cups of brewed coffee — is generally considered safe for most healthy adults.

But the caffeine content in energy products can climb quickly:

  • Some energy drinks contain up to 3 times more caffeine per ounce than brewed coffee.
  • Some pre-workout supplements contain more than 12 times as much.

Because the FDA regulates these products as foods or dietary supplements, they do not undergo the same safety testing required for medications before being sold. Some also contain stimulants beyond caffeine, and those ingredients may not be well studied.

What the study cannot prove

The FDA database depends on voluntary reports from consumers, health care providers and companies. That makes it impossible to know how many people used these products without any problems, or how many problems were never reported. The reports also cannot confirm that the products caused the events.

An outside cardiologist who chaired the AHA’s caffeine statement said other factors may have influenced the findings. The lead researcher said occasional use likely poses only a small risk for many healthy people, but regular use can quickly push someone beyond recommended caffeine limits.

How to use energy products more safely

  • Read the label and track total caffeine from all sources, including coffee, tea, soda and supplements.
  • Stick to one serving, and avoid combining energy drinks with pre-workouts or caffeine pills.
  • Do not mix energy drinks with alcohol. Caffeine can hide how intoxicated you feel, and the combination may strain the heart.
  • Use caution before intense exercise, especially in hot weather or when dehydrated.
  • Avoid products with ephedra, DMAA or synephrine, which have been linked to serious heart problems.
  • Keep energy drinks away from children and teens. The American Academy of Pediatrics advises against them for young people.
  • Stop and see a doctor if you have palpitations, chest pain, shortness of breath, dizziness or fainting after using these products. Tell them what you took.
  • Call 911 for chest pain, a racing heartbeat with dizziness, or fainting.

This is not a substitute for medical advice. Talk with your doctor about what is right for you.

Sources:

  • Samayamanthula S, et al. Abstract MDP0323, presented at the American Heart Association Scientific Sessions, Chicago.
  • American Heart Association Newsroom: Energy drinks, stimulant products linked to cardiac arrest, heart attack in young adults.
  • American Heart Association. Scientific statement on caffeine and cardiovascular disease.

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