Abstract
Background
Energy drink consumption in the United States has more than doubled over the last
decade and has been implicated in cardiac arrhythmias, myocardial infarction, and
even sudden cardiac death. We hypothesized that energy drink consumption may increase
the risk of adverse cardiovascular events by increasing platelet aggregation, thereby
resulting in a relatively hypercoagulable state and increased risk of thrombosis.
Methods
Thirty-two healthy volunteers aged 18–40 y were given 16 oz of bottled water or a
standardized, sugar-free energy drink on two separate occasions, 1-wk apart. Beverages
were consumed after an overnight fast over a 30-min period. Coagulation parameters
and platelet function were measured before and 60 min after consumption using thrombelastography
and impedance aggregometry.
Results
No statistically significant differences in coagulation were detected using kaolin
or rapid thrombelastography. In addition, no differences in platelet aggregation were
detected using ristocetin, collagen, thrombin receptor–activating peptide, or adenosine
diphosphate–induced multiple impedance aggregometry. However, compared to water controls,
energy drink consumption resulted in a significant increase in platelet aggregation
via arachidonic acid–induced activation (area under the aggregation curve, 72.4 U
versus 66.3 U; P = 0.018).
Conclusions
Energy drinks are associated with increased platelet activity via arachidonic acid–induced
platelet aggregation within 1 h of consumption. Although larger clinical studies are
needed to further address the safety and health concerns of these drinks, the increased
platelet response may provide a mechanism by which energy drinks increase the risk
of adverse cardiovascular events.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Surgical ResearchAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Energy drinks: an assessment of their market size, consumer demographics, ingredient profile, functionality, and regulations in the United States.Compr Rev Food Sci Food Saf. 2010; 9: 303
- A survey of energy drink consumption patterns among college students.Nutr J. 2007; 6: 35
- Energy beverages: content and safety.Mayo Clin Proc. 2010; 85: 1033
- Cardiac arrest in a young man following excess consumption of caffeinated “energy drinks”.Med J Aust. 2009; 190: 41
- Atrial fibrillation in healthy adolescents after highly caffeinated beverage consumption: two case reports.J Med Case Rep. 2011; 5: 18
- Myocardial infarction in a young adult following the consumption of a caffeinated energy drink.BMJ Case Rep. 2011; 2011
- Energy “drinks” and supplements: investigations of adverse event reports. U.S. Food and Drug Administration, Silver Spring, Maryland2012
- Voluntary and mandatory reports on 5-hour energy, monster energy, and rockstar energy drink. Center for food safety and applied nutrition adverse event reporting system. U.S. Food and Drug Administration, Silver Spring, Maryland2012
- The “high” risk of energy drinks.JAMA. 2011; 305: 600
- Hypercoagulability after trauma: hemostatic changes and relationship to venous thromboembolism.Thromb Res. 2009; 124: 281
- Venous thromboembolism after severe trauma: incidence, risk factors and outcome.Injury. 2010; 41: 97
- Characterization of the hypercoagulable state following severe orthopedic trauma.J Trauma Acute Care Surg. 2014; 77: 231
- Quantification of hypercoagulable state after blunt trauma: microparticle and thrombin generation are increased relative to injury severity, while standard markers are not.Surgery. 2012; 151: 831
- Hypercoagulability is most prevalent early after injury and in female patients.J Trauma. 2005; 58 (discussion 480–471): 475
- Hypercoagulability after injury in premenopausal females: a prospective, multicenter study.Surgery. 2014; 156: 439
- Comparing clinical predictors of deep venous thrombosis versus pulmonary embolus after severe injury: a new paradigm for posttraumatic venous thromboembolism?.J Trauma Acute Care Surg. 2013; 74 (discussion 1237–1238): 1231
- Rapid thrombelastography delivers real-time results that predict transfusion within 1 hour of admission.J Trauma. 2011; 71 (discussion 414–407): 407
- Energy drinks, race, and problem behaviors among college students.J Adolesc Health. 2008; 43: 490
- Caffeinated cocktails: energy drink consumption, high-risk drinking, and alcohol-related consequences among college students.Acad Emerg Med. 2008; 15: 453
- Energy drink consumption among young Australian adults: associations with alcohol and illicit drug use.Drug Alcohol Depend. 2014; 134: 30
- Assessment of pattern for consumption and awareness regarding energy drinks among medical students.Arch Public Health. 2013; 71: 31
- Psychosis following excessive ingestion of energy drinks in a patient with schizophrenia.Am J Psychiatry. 2010; 167: 353
- Effects of amino acid energy drinks leading to hospitalization in individuals with mental illness.Gen Hosp Psychiatry. 2008; 30: 187
- Perceived stress, energy drink consumption, and academic performance among college students.J Am Coll Health. 2011; 59: 335
- Effect of sugar-free Red Bull energy drink on high-intensity run time-to-exhaustion in young adults.J Strength Cond Res. 2009; 23: 1271
- Improved cycling time-trial performance after ingestion of a caffeine energy drink.Int J Sport Nutr Exerc Metab. 2009; 19: 61
- Effects of red bull energy drink on repeated sprint performance in women athletes.Amino Acids. 2012; 42: 1803
- Effect of Red Bull energy drink on cardiovascular and renal function.Amino acids. 2010; 38: 1193
- Detrimental effects of energy drink consumption on platelet and endothelial function.Am J Med. 2010; 123: 184
- Effect of “energy drink” consumption on hemodynamic and electrocardiographic parameters in healthy young adults.Ann Pharmacother. 2009; 43: 596
- Acute effects of an energy drink on myocardial function assessed by conventional echo-Doppler analysis and by speckle tracking echocardiography on young healthy subjects.J Amino Acids. 2013; 2013: 646703
- Cardiovascular effects of coffee: is it a risk factor?.Prog Cardiovasc Nurs. 2005; 20: 65
- Energy drinks: a review of use and safety for athletes.Phys Sportsmed. 2010; 38: 171
- Collaborative overview of randomised trials of antiplatelet therapy-I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration.BMJ. 1994; 308: 81
- Effects of different aspirin formulations on platelet aggregation times and on plasma salicylate concentrations.Thromb Res. 2006; 118: 529
- Antithrombotic potential of low-dose aspirin.N Engl J Med. 1984; 311: 1442
- Comparison of the effect of heparin and aspirin versus aspirin alone on transient myocardial ischemia and in-hospital prognosis in patients with unstable angina.J Am Coll Cardiol. 1994; 24: 39
- Aspirin for the primary prevention of myocardial infarction.N Engl J Med. 1988; 318: 245
- Acute myocardial infarction and the arachidonic acid system in the coronary vessels.Clin Physiol. 1985; 5: 311
- Association of serum levels of arachidonic acid and eicosapentaenoic acid with prevalence of major adverse cardiac events after acute myocardial infarction.Heart Vessels. 2011; 26: 145
- Adipose tissue arachidonic acid content is associated with the risk of myocardial infarction: a Danish case-cohort study.Atherosclerosis. 2013; 227: 386
Article info
Publication history
Published online: June 17, 2015
Accepted:
June 11,
2015
Received in revised form:
May 6,
2015
Received:
January 3,
2015
Footnotes
Presented at the Thrombosis and Hemostasis Summit of North America in Chicago, Illinois, April 10th, 2014.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
