Energy Drinks in Youth: Cardiovascular Risk and a Call to Action

Energy drinks are stimulant formulations, not sports drinks, yet they are increasingly embedded in adolescent athletics, gaming, and social media. Most contain substantial caffeine plus taurine, guarana, and other bioactive ingredients whose combined effects may differ from caffeine alone. Randomized pediatric trials document acute changes in blood pressure, autonomic regulation, and cardiac rhythm at commercially available doses; systematic reviews, poison-center surveillance, and sudden-cardiac-arrest series identify a consistent cardiovascular signal with rare severe events. A trigger-substrate-context model explains how rapid stimulant exposure may destabilize unrecognized electrical or structural vulnerability during exercise, heat, dehydration, illness, sleep loss, or co-exposure to other stimulants. Clinicians should specifically ask about energy drinks by name, quantify total stimulant exposure, identify red-flag symptoms, and counsel minors and susceptible patients to avoid these products. Schools, athletic organizations, manufacturers, and regulators should end youth-facing promotion, require transparent labeling, improve hydration education, and strengthen adverse-event surveillance.