Energy drinks, hypertension and stroke

A man in his 50s, normally fit and well, had an ischaemic thalamic stroke confirmed on MRI, manifesting with left-sided weakness, numbness and ataxia. Admission BP was 254/150 mm Hg. All tests for secondary hypertension were normal. After 72 hours as an inpatient, starting antihypertensives reduced the systolic BP to 170 mm Hg; however, after discharge, his BP rose again and remained persistently high despite up-titration of antihypertensives to five medications. After further questioning, the patient revealed an average daily consumption of eight cans of energy drink, each containing 160 mg caffeine, a habit which had not been specifically asked about during admission. On cessation of this consumption, his BP normalised and antihypertensives were successfully withdrawn. This article explores what we can learn from this case about whether energy drink consumption could be a risk factor for stroke and cardiovascular disease, and therefore the importance of targeted questioning in clinical practice, and greater public awareness.