Energy Drinks Significantly Increase Blood Pressure and Pose Cardiovascular Risks
Energy drinks with high concentrations of ingredients such as taurine and caffeine increase blood pressure and may lead to acute or chronic cardiovascular complications, particularly in young adults. 1
Magnitude of Blood Pressure Effects
The most recent and highest quality evidence demonstrates clear hemodynamic effects:
Systolic blood pressure increases by 4.44-6.44 mmHg after acute energy drink consumption, with the largest increases seen with drinks containing ≥200 mg of caffeine (6.44 mmHg increase). 2
Diastolic blood pressure increases by 2.73-4.51 mmHg, with the most pronounced effects occurring at 120 minutes post-consumption. 3, 2
Cardiac output increases significantly by 0.43 L at 30-40 minutes after consumption. 3
These effects are additive to any stress-induced increases in blood pressure. 4
Population-Specific Risks
Young Adults and Adolescents
The 2024 ESC Guidelines specifically warn that energy drinks can lead to acute or chronic cardiovascular complications in young adults. 1
In children and adolescents, sugar-sweetened beverages (which include many energy drinks) increased systolic blood pressure and the risk for incident hypertension. 1
Young athletes with hypertension should avoid excessive consumption of energy drinks and caffeinated beverages entirely. 1
Patients with Hypertension or Cardiovascular Risk
Men with uncontrolled hypertension should avoid caffeine use as it causes acute increases in blood pressure. 5
The American College of Cardiology/American Heart Association guidelines recommend limiting caffeine intake to <300 mg/day and avoiding use in patients with uncontrolled hypertension. 6
Patients at risk for hypertension may be more vulnerable to the blood pressure effects of caffeine. 4
Clinical Implications and Timing
The blood pressure effects follow a specific temporal pattern:
Systolic blood pressure peaks at 60-80 minutes post-consumption (4.71 mmHg increase). 3
Diastolic blood pressure peaks at 120 minutes post-consumption (4.51 mmHg increase). 3
After consuming three energy drinks (240 mg caffeine total), diastolic blood pressure increased by over 8%, while blood glucose increased by approximately 21%. 7
Important Caveats
Tolerance Development
Tolerance to cardiovascular effects develops reliably, but overnight abstinence may be sufficient to negate tolerance effects in typical caffeine users. 4
This means that regular energy drink consumers may experience repeated acute blood pressure spikes with each consumption after periods of abstinence.
Comparison to Regular Coffee
Regular coffee consumption (3-4 cups/day) shows a protective J-shaped curve for cardiovascular disease, with lowest risk at moderate intake. 6
Both caffeinated and decaffeinated coffee associate with lower risk of coronary heart disease and stroke. 6
The key difference is that energy drinks contain high concentrations of multiple ingredients (taurine, caffeine, sugar) that may interact synergistically, whereas coffee benefits appear related to compounds beyond caffeine alone. 1, 6
Practical Recommendations
For healthy individuals: Avoid or strictly limit energy drink consumption, as the acute blood pressure increases (4-6 mmHg systolic, 3-5 mmHg diastolic) are clinically significant and may contribute to long-term cardiovascular risk. 3, 2
For patients with hypertension or cardiovascular risk factors: Energy drinks should be completely avoided, as they can cause acute blood pressure elevations that may precipitate cardiovascular events. 1
For adolescents and young adults: Strongly discourage energy drink consumption given the specific warnings about acute and chronic cardiovascular complications in this population. 1
Alternative recommendations: If caffeine is desired, regular coffee (≤400 mg/day for healthy adults, <300 mg/day for those with hypertension) is a safer alternative that may actually provide cardiovascular benefits at moderate intake levels. 6