Energy drinks, stimulant supplements tied to cardiac arrest reports

Clinical takeaway: Consider asking younger patients with palpitations, chest pain, or syncope about energy drink and stimulant supplement use. 

Energy drinks and stimulant-containing supplements lack safety monitoring because FDA regulates them as foods rather than drugs. Sales of caffeinated energy drinks have more than doubled since 2011, and some energy shots contain three to four times as much caffeine per fluid ounce of brewed coffee. The 2026 American Heart Association scientific statement puts the generally safe limit for most adults at 400 mg of caffeine a day. 

Case reports have described arrhythmias, myocardial infarction, and sudden cardiac death after use of these products, often in young patients without conventional risk factors. This analysis compared reports involving caffeine- and stimulant-containing products with reports involving other products, assessing how often each included a cardiovascular event. 

Reports on energy drinks and stimulant supplements named heart events far more often than reports on other foods and supplements. Eight of the 10 cardiovascular outcomes the authors checked met their criteria for disproportionate reporting. 

Cardiac arrest ranked first: reports on these products were about 11 times as likely to name it, with a plausible range of about six and a half to 19 times. These figures reflect the proportion of reports naming an event, not the rate of events among consumers. Myocardial infarction followed at 4.48-fold, and ventricular arrhythmia (with a wide plausible range) and palpitations came in at roughly four times the expected frequency.

Supraventricular arrhythmia, sinus tachycardia, angina, and syncope each ranged from about two to nearly three times. Five of the 10 outcomes also showed disproportionate reporting among adults ages 18 to 34, and most were observed in both women and men. 

Researchers analyzed roughly 28,000 beverage and dietary supplement reports submitted to the FDA's postmarketing reporting system between 2017 and 2025. About 850 involved caffeine- or stimulant-containing products identified by product-name keywords; the remaining reports were used for comparison.

The findings support prospective surveillance of these products. More research on energy drinks is needed, since coffee is the main caffeine source in most studies. 

“This study raises concerns that products with very high amounts of caffeine may be harmful to the cardiovascular system,” said Gregory Marcus, MD, a professor of medicine at the University of California, San Francisco, who chaired the writing group behind the statement and was not involved in the study. “Although there are biological reasons why that connection could be possible, the study does not prove that caffeine products cause these events.” 

Source: Samayamanthula S, et al. (2026 Nov 2) American Heart Association Scientific Sessions 2026, Abstract MDP0323. Cardiovascular Safety of Caffeine- and Stimulant-Containing Energy Drinks and Dietary Supplements