The use of energy drinks among our young adult and adolescent population has increased tremendously over recent years. At the same time, doctors in emergency rooms are faced with an increase of critical cardiac conditions in otherwise healthy patients (Chrysant & Chrysant, 2015).
Multiple studies regarding the effects of energy drinks on the cardiovascular system have been done. The purpose of this blog is to review and synthesize a review of published literature on the topic of energy drinks.
Lifestyle Interventions for Control of Hypertension
In this evidence summary, multiple recommendations were made for improved management of hypertension. Evidence showed that the amount of caffeine found in five or more cups of coffee per day were associated with an increase in blood pressure. One energy drink on the market can contain as much caffeine as 5 cups of coffee and multiple cans are being consumed each day by young adults fighting fatigue.
Evidence supports the reduction in consumption of caffeine-rich products (including energy drinks) is highly recommended to reduce the increase in blood pressure associated with the consumption of large quantities of caffeine (Chu, 2016). The evidence behind this research represents many studies which have been reviewed by peers and compiled, giving this study a higher weight in consideration of the recommendations it contains.
Energy Drinks and Cardiovascular Complications
In an evidence summary of thirty-two papers, highly caffeinated energy drinks have been associated with several cardiovascular complications along with neurophysiological complications. In large doses, caffeine has proven to be toxic, causing many life-threatening responses in otherwise healthy young adults.
Those complications begin with elevated blood pressure but may lead to abnormal heart rhythms which can send the subject to the hospital in fight for survival. When the energy drink is consumed concurrently with alcohol, it can cause heart palpitations, insomnia, irritability, and a false sense of cognitive clarity which can lead to risk-taking behaviors that are also life threatening.
Hospitals have reported ventricle arrhythmia, ST elevation, QT-segment elongation, cardiomyopathy, and cardiac arrest in patients who should be perfectly healthy (Manchester, Eshel, & Marion, 2017). This article was critically appraised by peers and remains in the top three layers of evidence as a filtered resource, giving this research greater weight in reliability, credibility, and scientific merit.
Benefits and Risks of Energy Drink Consumption
In a randomized control study performed with military personnel and young adults in the United States, the subject of energy drink use was considered for the purpose of physician’s necessary knowledge.
Over the last 20 years the use of energy drinks has increased among the military and young adult population. Fatigue and mental stress were noted as reason for this use.
The combination of high doses of caffeine mixed with taurine and additional sugars was identified as the reason for a considerable difference in response noted from the consumption of energy drinks as compared to coffee. As this combination does give the positive response of increased alertness and improved athletic performance, the negative responses are far more considerable. Increased blood pressures are responsible for developing cardio symptoms that might include atrial and ventricle arrhythmias, QT-segment prolongation, ST elevation, and cardiac arrest in otherwise healthy individuals (Manchester, Eshel, & Marion, 2017).
In addition to cardiovascular responses, high intake of caffeine has also been associated with new on-set of seizures, stroke and vasoconstriction of the brain in young adults. Findings include an increase in risk-taking behaviors among patients who mix energy drinks with alcohol, placing them at high risk for injury. A higher incidence of suicide is also associated with the combined use of energy drinks with alcohol (Manchester, Eshel, & Marion, 2017).
As a randomized control study, this is the best design to use in determining a causal relationship between the dependent variable of life threatening events and the independent variable of energy drinks. This evidence supports conclusions made in higher level of evidence studies.
In a randomized prospective cohort study, the effects of the consumption of coffee on blood pressure was researched. Out of over 10,700 possible participants of Polish European descent, 2,725 were included in this study and followed over a five-year period of time. Taking food consumption, daily activity, gender and socio-demographic information into account, the study separated the group by the number of cups of coffee they drank per day and smoking status.
After compilation of all analyses, it was determined that smoking was a stronger determinant for increased blood pressure than coffee, except when small amounts of coffee was consumed by non-smokers. Four cups of coffee a day produced less blood pressure change than those drinking one cup per day, stating a protective factor instead (Grosso, Stepaniak, Polak, Micek, Topor-Madry, Stefler, Szafraniec, & Pajak, 2016).
While this is at the highest level of unfiltered evidence, this research was counter to all previous research presented here. The difference is explained in the fact that coffee, by itself, does not have quite the same composition as an energy drink. By itself, coffee does not contain extreme quantities of caffeine mixed with taurine or the added carbohydrates (Manchester, et al, 2017).
In general, this research only touches the outside question of coffee’s effect on the cardiovascular system. There are also confounding factors in that the subjects were self-reporting the information and the subjects may not have been completely honest in answering the questions. Reliability is in question due to the confounding factors.
Impact of Energy Drink Consumption on Blood Pressure
In a case-controlled meta-analysis, the effect of a large intake of energy drinks on the blood pressure and heart rate was measured and compiled. Energy drink consumption containing over 200 mg. of caffeine was positively associated with an increase in blood pressure in subjects, but there was no association with an increase of heart rate (Shah, Chu, Lacey, Riddock, Lee, & Dargush, 2016).
The literature reviewed were cross-over studies. This study made a strong effort to eliminate any outside con-founders to reach conclusions and did a thorough compilation of literature reviewed. Being at the lowest level of evidence, there would need to be multiple corroborative research studies to validate the results.
Conclusion
The research has revealed strong evidence supporting the relationship between the use of highly caffeinated energy drinks with a clinical presentation of high blood pressure. Polit and Beck (2017) suggest triangulation of multiple resources before coming to final conclusions. Continued research would need to be performed before a decisive conclusion could be made.
References:
Chu, W.H. (2016). Hypertension (Essential): Lifestyle Interventions. The Joanna Briggs Institute EBP Database. JBI@Ovid. JBI728.
Chrysant, S.G. and Chrysant, G.S. (2015) Cardiovascular complications from consumption of high energy drinks: recent evidence. Journal of Human Hypertension. 29, 71–76.Grosso G., Stepaniak U., Polak M., Micek A., Topor-Madry R., Stefler D., Szafraniec K. and Pajak A. (2016). Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study. European Journal of Clinical Nutrition. 70:1, 109–115.Manchester J., Eshel I., Marion D.W., (2017). The Benefits and Risks of Energy Drinks in Young Adults and Military Service Members. Military Medicine. 182:7, e1726-e1733. Association of Military Surgeons, United States.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
Shah, S.A., Chu, B.W. Lacey, C.S., Riddock, I.C., Lee, M., and Dargush, A.E. (2016). Impact of Acute Energy Drink Consumption on Blood Pressure Parameters: A Meta-analysis. Annals of Pharmacotherapy. 50:10, 808–815.