Efeitos agudos do consumo de bebidas energéticas nos parâmetros cardiovasculares em adultos saudáveis: uma revisão sistemática com metanálise de ensaios clínicos randomizados

Abstract

The market for energy drinks (EDs) has grown exponentially among the young adult population in recent years due to their ability to improve feelings of fatigue, concentration and physical performance. This is due to the high caffeine content in their composition. Anecdotal evidence suggests that BE consumption may cause acute changes in cardiovascular parameters, but there is no agreement on the true magnitude of these effects. The objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to evaluate the acute and subacute effects of different durations of EDs consumption on systolic (SBP) and diastolic (DBP) blood pressure, resting heart rate (HRrp), cardiac output (CO), endothelial function, QT interval (QT), and corrected QT interval (QTc) in healthy adults. A protocol article was previously developed. Searches included PubMed, EMBASE, Cochrane, LILACS, Web of Science and SportDiscus databases and grey literature. Results are presented as mean difference between the intervention group (EDs) and the control condition (BC) and 95% confidence interval (95% CI). To estimate effects in future studies, 95% prediction interval (95% PI; ≥ 3 studies) was included. Heterogeneity was assessed by the Higgins' test (I²). Outliers were assessed by the lack of overlap of the 95% CIs. Analyses were performed in RStudio using the "meta" package. Seventeen studies (n= 475) were included, of which 14 were crossover RCTs. SBP and DBP data were evaluated in 16 studies, HR in 15, CO in three, QT and QTc in five. After BE consumption, SBP increased 3.23 mmHg (95% CI 1.19 to 5.28, p < 0.01) after 30 to 40 minutes, 4.61 mmHg (95% CI 2.80 to 6.42, p < 0.01) after 60 to 80 minutes, 4.10 mmHg (95% CI 1.63 to 6.56, p < 0.01) after 90 to 100 minutes, and 3.64 mmHg (95% CI 1.66 to 5.63, p < 0.01) after 120 minutes. DBP increased 2.92 mmHg (95% CI 0.91 to 4.94, p < 0.01) before 20 minutes, 2.22 mmHg (95% CI 0.84 to 3.59, p < 0.01) between 30 and 40 minutes, 2.73 mmHg (95% CI 1.46 to 4, 01, p < 0.01) between 60 and 80 minutes, 3.77 mmHg (95% CI 2.02 to 5.52, p < 0.01) between 90 and 100 minutes, and 4.58 mmHg (95% CI 2.73 to 6.43, p < 0.01) after 120 minutes. The CO increased by 0.43 L/min (95% CI 0.08 to 0.77, p= 0.016) only in the 30 to 40 minutes period after the intervention. HRrep, QT and QTc showed no significant changes. No studies were found that evaluated endothelial function. In conclusion, acute consumption of BEs increases SBP and DBP for up to two hours after ingestion. Furthermore, there was little change in CO and no effect on HR and QT/QTc in healthy adults. However, due to the small number of studies involved, the results should be interpreted with caution.