How do energy drinks affect the cardiovascular system

Author Ольга Кияница


Recently, the use of energy drinks is becoming increasingly wary, because there is a potential danger to the heart due to their supposedly high concentrations of caffeine in addition to other substances such as taurine, guarana and L-carnitine, which are largely unknown to the general public. In addition, a large number of energy poisoning was registered worldwide, including cases of convulsions and arrhythmias.

Energy drinks (energy or energy drinks) are carbonated drinks that do not contain alcohol at all or in small quantities and have a stimulating or tonic effect on the body. Most energy workers have a stimulating effect on the central nervous system.

As part of the power engineering, caffeine is most often found, which can be represented by other substances such as theine, matein. Additionally, theophylline or theobromine, which are essentially psychostimulants, as well as taurine and carbohydrates are included in the drink. All this is copiously stabilized with carbonic acid.

According to

Energy consumption is increasing every day, since many advertisers see drinks as having a positive effect on performance, general well-being and mood. In fact, energy can bring a lot of harm to health, especially the cardiovascular system.

Video: About energy drinks

Physiological impact of energy on vital functions

It is widely believed that caffeine, especially in high doses, is associated with multiple concomitant heart diseases, including heart palpitations and a number of arrhythmias, such as atrial fibrillation and supraventricular and ventricular tachycardia. Also, caffeine, with an acute increase in blood pressure, has a negative effect on the cardiovascular system, which increases the likelihood of arrhythmias. It has been shown that such hypertension is more pronounced in the elderly and those with hypertension.

According to the companies producing energy drinks, one bank contains from 30 to 360 mg of caffeine, while in Canada, 400 mg is considered the upper limit of caffeine.

A study of 20 young healthy people who consumed Red Bull on the background of mental stress showed that, compared to taking water, 355 ml of Red Bull caused a cumulative cardiovascular load. At the same time, systolic blood pressure increased by about 10 mm Hg, diastolic blood pressure by about 7 mm Hg. Art. and heart rate at 20 beats per minute. In addition, a decrease in blood flow velocity in the brain by -7 cm / s was observed [1]. Grasser EK, Dulloo AG, Montani JP. Am J Cardiol. 2015 Jan 15; 115 (2): 183-9.]

Recently, in a comprehensive and systematic review of case studies related to energy tonic and their adverse effects on health, it was pointed out that energy drinks most often have a negative effect on the neurological and cardiovascular systems.

Neurological side effects are mainly expressed:

  • Bouts.
  • Neuropsychotic arousal.
  • Aggressive behavior.
  • Suicidal thoughts.

This may be because caffeine and taurine are known psychoactive agents.

On the part of the cardiovascular system, side effects are;

  • Arrhythmias (the highest percentage - 35% in other cases).
  • Coronary vasospasm.
  • Dissection of an aortic aneurysm.
  • Heart failure.
  • Lengthening the QT interval.
  • Acute cardiomyopathy.
  • Progressive hypertension.
  • Reversible postural tachycardia syndrome.
  • Acute coronary thrombosis.
  • Myocardial infarction with ST segment.

The authors attributed the cardiovascular side effects of energy ingredients, such as caffeine and taurine, which, on the basis of research, increase platelet aggregation, disrupt endothelial function and possibly cause vasospasm due to the development of hypertension [2 - : A systematic review of the current evidence. Ali F, Rehman H, Babayan Z, Stapleton D, Joshi DD. Postgrad Med. 2015 Apr; 127 (3): 308-22.].

Although there is a direct link between energy drink consumption and platelet aggregation along with endothelial dysfunction, the exact substance that causes these effects is still unknown.

The risk of developing the above diseases increases several times if the energetic is combined with alcohol or other substances.

Caffeine and heart

It is widely believed that most energy drinks contain a significantly higher concentration of caffeine than the same cup of coffee. Cardiovascular reactions to the use of caffeine have been extensively studied. Some effects of caffeine on the heart muscle have long been viewed as a possible culprit in heart disease in some people. Over the past couple of decades, coffee has been associated with various harmful effects, such as:

  • Hypertension.
  • A stomach ulcer.
  • Palpitations.
  • Atrial flutter.
  • Myocardial infarction.

Consequently, caffeine plays an important role in the development of dangerous complications when using energy drinks.

Biochemical effect of caffeine on the heart:

  • In healthy people, caffeine, methylxanthin, increases the activity of the sympathetic nerve. The molecular mechanism of caffeine is its competitive inhibition of phosphodiesterase. This leads to an increase in the level of cyclic adenosine monophosphate and, consequently, to a positive inotropic effect on the myocardium.
  • On the other hand, inhibition of adenosine receptors prevents the negative inotropic effect caused by adenosine.Thus, consuming large amounts of caffeine can contribute to high blood pressure and plasma catecholamine levels, renin and free acids [3 - a systematic review and meta-analysis. Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. Am J Clin Nutr. 2011 Oct; 94 (4): 1113-26.].

Toxic doses of caffeine can affect the conductivity and refractoriness of the heart, which leads to the development of various arrhythmias. Symptoms of a caffeine overdose mainly include:

  • Palpitations.
  • Hypertension.
  • Irritability.
  • Insomnia.
  • Tremor.
  • Cramps.

In addition, the hypertensive effects of caffeine cannot be ignored, as they can lead to dangerous cardiovascular conditions.

There is a widespread belief that caffeine can be arrhythmogenic in those who consume it regularly. However, in a large-scale Danish study, no higher risk of atrial fibrillation / flutter was found with a different amount of caffeine consumed [4 - Caffeine and the Danish Diet, Cancer, and Health Study. Frost L, Vestergaard P. Am J Clin Nutr. 2005 Mar; 81 (3): 578-82.]. In addition, the stimulating effect of caffeine, apparently, varies in individuals, and the degree of tolerance and dependence on this substance, apparently, is a hereditary factor and may be associated with polymorphisms.

Caffeine metabolism

This process is extremely diverse and depends on the particular user; thus, the effects of caffeine are uneven. The half-life is 4.9 hours, however, the level of absorption mainly depends on:

  • human genotype;
  • age;
  • sex;
  • liver conditions;
  • drug consumption, such as oral contraception, antidepressants and antiarrhythmic drugs;
  • tolerance to stimulants.

Caffeine is mainly metabolized through the liver cytochrome P450 1A2 enzyme (CYP1A2). The presence of defects in this enzyme leads to a change in the metabolism of caffeine and its half-life. Consequently, genetic polymorphisms in the CYP1A2 pathway can cause some inconsistencies in the use of coffee and its effects on health.

Table comparing the amount of caffeine in various drinks.

Caffeinated beverage The amount of caffeine in the drink / mg
Herb tea 0
Tea lipton 5
Maxwell House coffee 2-10
Starbucks hot chocolate 25
Arizona Iced Black Tea thirty
Starbucks refreshers can thirty
Coffee dannon thirty
Coca Cola, Coke Zero, Diet Pepsi 34
Snapple Lemon Tea 37
Pepsi 38
Starbucks refreshers can 50
Coffee Maxwell House Light Ground 50-100
Mountain dew 54
Red bull 80
Starbucks ™ Grande Coffee Frapuccino 95
Starbucks Grande Chai Latte 95
Dunkin Donuts ™ Medium Latte 97
Rockstar 160
Monster Energy 160
Starbucks Grande Caffe Mocha 175
Dunkin Donuts Medium Brewed Coffee 178
Caffeine Powder 200
Starbucks Grande Caffe Americano 225
Bang energy 357

Taurine and heart

Taurine is a derivative of amino acid cysteine ​​and is found in large quantities in the heart and skeletal muscles. It is quite a lot defined in energy drinks, such as 5-h energy and Red Bull. Although taurine is considered an essential human nutrient, extensive clinical studies have been conducted to evaluate the effects of taurine.

Previously, it was found that taurine is useful for improving the lipid profile by increasing transcription of CYP7A1, an important enzyme in bile conjugation. He is also involved in increasing the uptake of LDL by the liver and increasing the regulation of LDL receptors.

Taurine use may also be associated with a decrease in blood pressure. Perhaps this is due to the weakening effect of angiotensin II, which causes vasoconstriction or “enhances” the action of the kinin-kallikrein system, which usually contributes to the development of vasodilation.

During the study of ethnic Chinese, an inverse correlation was found between a 24-hour taurine extract and diastolic blood pressure in Han people (main Chinese ethnic group) and a decrease in both systolic and diastolic blood pressure in Tibetan subjects when consumed with the respective products. Similarly, a significant decrease in systolic and diastolic blood pressure was observed in 19 patients with borderline hypertension.

In addition, it was found that a deficiency of taurine causes a decrease in the sensitivity of the heart muscle to Ca ions.As a result, the inotropic capacity of the organ is reduced. This may be the reason that the supplements increase physical performance due to improved blood supply to other organs, especially the musculoskeletal system.

It was determined that the concentration of taurine is higher in the muscles of the left ventricle of the heart of patients who died from chronic heart failure than in patients who died of other causes and who do not have cardiac pathology [5 - Taurine concentration in congestive heart failure. Huxtable R, Bressler R. Science. 1974 Jun 14; 184 (4142): 1187-8.].

The study notes that taurine can, in fact, have an inotropic effect, which is directly related to cardiovascular side effects that occur while taking energy drinks.

A comparison of the effects of drinking caffeine-only energy drinks and those containing caffeine and taurine showed:

  • The mean 24-hour systolic blood pressure, diastolic blood pressure, and mean blood pressure were significantly higher in people who took energy containing caffeine and taurine.
  • Acceptance of taurine-containing energotonics increases the risk of myocardial infarction. This is most likely due to the fact that caffeine and taurine can interact.
  • Drinking caffeine alone does not cause any significant cardiovascular changes determined by magnetic resonance. At that time, when taking a combination of caffeine and taurine, the peak systolic surge significantly increases.

The question of the interaction between taurine and caffeine was dealt with by Schaffer and his colleagues, who, in agreement with the European Union Scientific Committee on Food, concluded that taurine should neutralize some of the adverse effects of caffeine taken in excess. In particular, it was noted that the physiological functions of taurine are incompatible with the adverse symptoms of cardiovascular disorders that have arisen against the background of excessive consumption of drinks containing caffeine and taurine.

Video: The truth about energy drinks. Program "Quality Formula",

Guarana and the heart

Paulliniacapuna, also known as guarana, is a South American plant that was first mentioned in 1872 and used to treat headaches. The natives of Amazonia used the seeds of these fruits to increase the efficiency and charge of energy.

The stimulating effect of guarana is due to the peculiarity of the chemical composition, similar to the structure of caffeine.It is determined that the seeds of guarana is 2% -4.5% caffeine, whereas in the coffee bean contains 1% -2% caffeine.

The effect of guarana is not fully understood. Whether this is an additive or synergistic effect in combination with caffeine is unclear. Guarana in an energy drink with a volume of up to 500 ml ranges from 1.4 mg to 300 mg. The FDA generally recognizes this plant to be safe, although there are no prescribed doses, and it is unclear how much guarana is needed for each drink, because many companies do not give the composition in milligrams. Therefore, it should be assumed that the amount of caffeine in products that have guarana in its composition is actually greater. It is not surprising that young people were hospitalized in the emergency department with cardiovascular manifestations after excessive ingestion of guarana-based energy drinks. [6 - Guarana: revisiting a highly caffeinated plant from the Amazon. Schimpl FC, da Silva JF, Gonçalves JF, Mazzafera P. J Ethnopharmacol. 2013 Oct 28; 150 (1): 14-31.]

Overall rating

The increasing number of overdoses associated with energy drinks and caffeine clearly shows that there is a real risk for the development of adverse effects in the form of the same arrhythmias. However, with moderate use and without combination with other stimulants or alcohol, the risk of such side effects is negligible.

It should be noted that a large number of serious health complications were caused by excessive consumption of energy drinks in a short period of time. Therefore, it may be important that energy drink companies post warnings about their products to avoid problems.

The exact amounts and concentrations that are ideal for minimizing health risks are unknown. Patients with underlying diseases, such as liver failure or cardiomyopathy, should avoid stimulants, including energy, at least be careful when consuming them in small quantities. If symptoms of overdose develop, it is very important to stop consuming energy drinks.

Regarding the components of the energy drinks themselves, the concentration of caffeine seems to be comparable or even lower than that of many popular coffee drinks, which makes energy in small quantities quite safe. In fact, medical studies have shown that moderate caffeine intake is directly related to a decrease in the risk of arrhythmias.

As for taurine, the medical literature shows a general positive effect on health, especially for the cardiovascular system, so it is unlikely that this substance can harm the heart and blood vessels. However, if there is a risk of developing hyperlipidemia, hypertension, and cardiomyopathy, foods containing taurine should be used with caution.

Guarana can have a synergistic effect similar to caffeine, so when you use energy with these substances can have a negative effect on the heart and blood vessels. Such statements still require additional information about their joint effects.

Source 1. Cardiovascular and cerebrovascular effects in response to red bull consumption combined with mental stress. Grasser EK, Dulloo AG, Montani JP. Am J Cardiol. 2015 Jan 15; 115(2):183-9. 2. Energy drinks and their adverse health effects: A systematic review of the current evidence. Ali F, Rehman H, Babayan Z, Stapleton D, Joshi DD. Postgrad Med. 2015 Apr; 127(3):308-22. 3. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. Am J Clin Nutr. 2011 Oct; 94(4):1113-26. 4. Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study. Frost L, Vestergaard P. Am J Clin Nutr. 2005 Mar; 81(3):578-82. 5. Taurine concentrations in congestive heart failure. Huxtable R, Bressler R. Science. 1974 Jun 14; 184(4142):1187-8. 6. Guarana: revisiting a highly caffeinated plant from the Amazon. Schimpl FC, da Silva JF, Gonçalves JF, Mazzafera P. J Ethnopharmacol. 2013 Oct 28; 150(1):14-31.

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