Cardiovascular Effects of Energy Drinks in the Pediatric Population

Abstract

Consumption of energy drinks in the pediatric population is correlated with more emergency department visits and causes adverse reactions, such as neurological, psychiatric, gastrointestinal, renal, and cardiovascular effects. These cardiovascular complications include increased cardiometabolic risk with high intake of sugar, short-term blood pressure increases and a decrease in cerebral blood flow due to the caffeine content, increased or decreased blood pressure from taurine, unmasked cardiac conditions, such as channelopathies, and atrial and ventral fibrillations. Cardiovascular complications can also arise when energy drinks are mixed with pharmaceutical drugs, such as amiodarone, potent CYP1A2 inhibitors, warfarin, digoxin, or corticosteroids. Combining energy drinks with alcohol also precipitates adverse cardiovascular events, posing a risk to the health of children and adolescents. This review further explores the ingredients in energy drinks and their mechanism of action in causing these cardiovascular complications.

Interaction of Energy Drinks with Prescription Medication and Drugs of Abuse

“…Taurine is a derivative of the amino acid cysteine naturally produced in the body [21]. It is sometimes erroneously classified as a CNS stimulant, although it has anxiolytic effects and interacts with the glutamatergic and GABAergic receptors [43].…”

“…In vitro studies have shown that taurine has inotropic effects on cardiac muscle similar to those of caffeine, and enhances caffeine-induced muscle contracture [36]. It also reduces blood pressure [21].…”

“…Taurine, which does not seem to have liver metabolism, has urinary excretion [45]. In healthy volunteers, adverse effects appeared with high doses and consisted in muscle cramps [21]. Death has been documented only in combination with caffeine [14], or caffeine plus strenuous physical activity in physiologically predisposed individuals [36].…”

“…Ginseng (Panax ginseng) is also a CNS/cardiac stimulant. Ginseng is used to relieve fatigue [46] and to treat hyperglycaemia because it has hypoglycaemic effects [21]. Intoxication leads to insomnia, headaches, vertigo, euphoria, mania, mastalgia, rashes, vaginal bleeding, amenorrhea, tachycardia, palpitations, hypertension, and oedema [34].…”

“…Young people report ED consumption as conferring increased energy, augmented alertness, and improved athletic performance [14,15]. In recent years, many authors have observed that ED intake causes adverse effects, including high blood pressure, changes in corrected QT interval (QTc), serious cardiovascular events, digestive and kidney disorders, metabolic adverse effects, poor sleep, neuropsychiatric adverse effects, seizures, and death [16][17][18][19][20][21]. Furthermore, several studies suggest that EDs may serve as a gateway to other forms of substance dependence [16,22,23].…”