Heart-risk signal: energy drink reports to FDA cite cardiac arrest about 11 times as often

For anyone who reaches for an energy drink or a pre-workout powder every morning, a new analysis of federal safety reports points at the heart. Sai Samayamanthula, a fourth-year medical student at the University of Virginia School of Medicine, found that cardiac arrest was mentioned about 11 times as often in reports involving caffeine or stimulant products as in reports about everything else. The work is a preliminary abstract and shows an association only.

Read next on Morning Overview: Two Kentucky residents died when a small plane crashed at Missouri’s Lake of the Ozarks, and the NTSB is investigating

Samayamanthula presented it at the American Heart Association’s Scientific Sessions 2026 in Chicago, held Nov. 6 to 9. He and his colleagues pulled 28,345 reports filed from 2017 through 2025 for people aged 13 and older. Of those, 854 concerned energy drinks or supplements containing caffeine or other stimulants, and 27,491 involved products without them, including soft drinks, smoothies, vitamins, protein bars and meal-replacement shakes. Products were grouped by ingredient rather than brand, so no label was singled out.

The FDA reporting system behind the 11-fold gap

The reports come from the FDA’s complaint and adverse-event reporting system for foods and dietary supplements, which accepts voluntary filings from consumers, clinicians and manufacturers. The agency’s own page says a report in the system does not mean the FDA has decided the product caused the event, and that the data cannot be used to estimate how often an event occurs or how risky a product is. In the American Heart Association’s news release, 612 of the 854 stimulant-product reports had a known age.

Three ingredient families defined the exposed group. Caffeine was one. Methylxanthines such as theobromine, guarana, yerba mate and green tea or coffee extracts were another. The third was sympathomimetics: synephrine, yohimbine, ephedra, DMAA and higenamine.

Cardiac arrest led the list, but it was not alone. According to ScienceDaily’s version of the release, heart attack came up about 4.5 times as often, ventricular arrhythmia or palpitations roughly four times, rapid heart rate nearly three times, chest pain 2.71 times and fainting about twice. Similar patterns showed up in reports for men and women. The AHA release stresses that these are ratios of how often problems appear in the reports, not a measure of how likely a consumer is to suffer them.

Young adults and the 18-to-34 age band

About 45% of the cardiovascular reports involving these products concerned adults aged 18 to 34. The researchers offered three possible explanations and confirmed none: young adults may consume more of these products, they may use them in riskier ways such as before intense exercise or mixed with alcohol or drugs, or some may carry undiagnosed heart conditions. Samayamanthula suggested clinicians ask younger patients with palpitations, chest pain or fainting whether they use these products regularly. He said the products are marketed as everyday pick-me-ups and can quickly exceed the recommended daily limit for caffeine, and, as Medical Daily’s coverage of the abstract recounts, that they are sold next to soda and bottled water, so buyers may assume no real risk.

The limit he refers to comes from the AHA’s 2026 scientific statement on caffeine: up to 400 mg a day is generally safe for most adults, roughly five 8-ounce cups of brewed coffee. Some energy drinks carry up to three times as much caffeine per fluid ounce as brewed coffee, and some pre-workout supplements more than 12 times as much. Sales of caffeinated energy drinks more than doubled over the past decade and passed $20 billion in 2024. The FDA treats the products as foods or dietary supplements, so they skip the premarket safety testing applied to medicines.

Regulation adds a wrinkle. Per Medical Daily, the FDA has no rule specific to energy drinks and advises against them for children and teens, while the AHA release notes that products sold as supplements are not required to pass the safety testing that precedes a medicine.

Reporting ratios versus real-world risk

Gregory M. Marcus, a University of California, San Francisco professor of medicine who chaired the AHA’s caffeine statement and was not part of the work, said the study does not prove that caffeine products cause these events. He also noted that plausible biological reasons exist for such a link.

The supplement industry’s trade group pushed back harder. The Council for Responsible Nutrition’s chief science officer, Andrea Wong, said the result does not mean consumers are 11 times more likely to experience cardiac arrest, according to Nutritional Outlook. The council objected that the abstract lumps drinks, concentrated shots and pills together, includes ephedra, DMAA and higenamine, which it says cannot legally be sold in supplements or food, never verified that people actually used the products, and ignored dose, frequency and concurrent alcohol or medication use. It still supports continued research and safety monitoring.

The missing denominators decide how far the 11-fold figure can travel. Nobody knows how many people drank these products without trouble, or how many had heart events and never filed a report, so no true event rate can be calculated. Abstracts are not peer-reviewed until they become full manuscripts, and Samayamanthula’s own request is for more systematic safety monitoring of caffeine and stimulant products.

This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.