Blaming It All on Red Bull

In case you haven't seen it, there's been a report of aborted sudden death circulating about in the press and blog-o-sphere about a guy who drank too many Red Bulls, and had a cardiac arrest.

Everyone wants to blame Red Bull.

But was Red Bull to blame?

Here's how the press painted the episode:

Mr Penbross, a concreter, regularly had four Red Bull drinks a day.

"With the work I do I don't have a lot of time to eat," he said. "I have a couple of Red Bulls in the morning and it carries me through."

Last Sunday he was competing in a motocross event near Port Macquarie when he consumed eight Red Bulls over five hours.

"It was to get a bit of a buzz and keep down my reaction time," he said. "You have got to get off [the mark] and around the first corner first."

After his event, Mr Penbross, from Bonny Hills, noticed his heart racing. He collapsed soon after.

He was taken to Port Macquarie Hospital before being flown to Newcastle.

For the record, Redbull contains the about same amount of caffeine as a cup of coffee:

A 7 oz cup of coffee has the following caffeine (mg) amounts, according to Bunker and McWilliams in J. Am. Diet. 74:28-32, 1979:

Drip 115-175
Espresso 100mg of caffeine
1 serving (1.5-2oz)

Brewed 80-135
Instant 65-100

Sure, too much caffeine can cause the heart to race. And some studies have suggested it raises blood pressure, but at least one long term study did not substantiate this effect. And over five hours, about half of his caffeine had metabolized, provided he had a normal liver. Most reported deaths from caffeine overdose (usually from pills) have occurred with 50-100 times the amount of caffeine as this man ingested.

So was caffeine really the CAUSE? Of was it a mere bystander? We will probably never know.

But I was also intrigued by the part of the article that mentioned what his cardiologist had said:

He said Mr Penbross had no other risk factors apart from smoking and had told him he previously experienced chest pain at times when his intake of the drinks was high.

Now I never saw this dude, but given this story, one wonders about previously undiagnosed coronary disease as the cause of his cardiac arrest. Oh, sure, the Red Bull might have increased the heart's requirement for oxygen if his rate or blood pressure increased, but the lack of delivery of oxygen around an area of fixed obstruction from a plaque is more likely what made a young man's heart fibrillate and develop full cardiac arrest.

I wonder: did anyone suggest this man stop smoking?

-Wes

Smoking Ban Makes Coffee Stands Get Steamy

An unexpected result of Washington state's smoking ban: Starbucks gets some steamy competition:

When the (Washington) state's smoking ban went into effect last year, many bar, casino and convenience-store owners sought to make up for expected losses by renting part of their parking lots to espresso stands, said Lori Bowden, owner of the Cowgirls Espresso stands.

The advent of "sexpresso" is harder to track. Business and baristas debate over who pioneered the edgy outfits, but they agree that by sweetening the product, with a smile and maybe a shot of hazelnut syrup, they've reached out to customers who've never set foot in a Starbucks.

Drive-throughs are a growing part of Starbucks' business, too, with more than 1,500 drive-through locations throughout the United States. But a representative of the company said it has no plans to sex up the dress code, as it wouldn't fit the company's brand.

At places such as Cowgirls, the barista is the brand.

"If I'm going to pay $4 for a cup of coffee" said one male customer, "I'm not going to get served by a guy."

Who would have thought...

-Wes

Heart Disease Prevention Suggestions: Some Good, Some Bad

It's been a while since my last post. I've been looking for something different, creative or idiotic to talk about as it pertains to the heart, but things have been a bit lean of late. Fortunately, heart disease prevention literature seemed to rise to the top this week - some good, and some bad.

In the "good" category, was the American Heart Associations's "Evidence-based Guidelines For Cardiovascular Disease Prevention in Women: 2007 Update," published in Circulation online before print this week. One amazing factoid that I did NOT hear emphasized in the media from that paper:

"In many countries, including the United States, more women than men die every year of cardiovascular disease, a fact largely unknown by physicians."

Some tidbits from that paper:

• Don't smoke
• Get active (Walk 30 min/d)
• Limit saturated and trans fat intake, sodium intake (less than 2.3 grams/day) and eat more fish (at least two times/week)
• Keep your waist less than 35 inches or body mass index between 18 and 25.
• Consider Omega-3 fatty acids for women with coronary disease
• Keep blood pressure under control (<140/90 for sure)
• Keep LDL low and HDL high
• And keep diabetes controlled with hemoglobin A1C measurements less than 7%.
• Take a slightly higher (325 mg) aspirin rather than 160 mg, if you're at high risk of another cardiovascular event
• Use beta blockers and ACE inhibitors (or angiotensin receptor blockers) after a heart attack

In summary, not much new here, really. But what WAS interesting are the things NOT found helpful to prevent coronary disease in women:

• Hormone replacement therapy
• Antioxidant vitamin supplements (Vitamin E, C, and beta carotene)
• Folic Acid with or without B6 or B12 supplementation
• Routine use of aspirin for women under the age of 65

Now in under the category of "bad" prevention recommendations, comes this trial from the American Journal of Clinical Nutrition that was just released today on Reuters newswire touting the benefits of caffeine at preventing heart disease deaths in the elderly. A closer look at this study demonstrates it used survey data from 1982-1984 with follow-up surveys analyzing deaths from follow-up surveys in 1986, 1987, and 1992 and used ICD9 codes to determine the cause of death from death certificates. The "study" data do not take into account improvements in cardiovascular care over that period. Thank goodness the authors admitted:

The current study was an epidemiologic study and does not prove a cause-and-effect relation. This study does not provide a valid basis for recommending increased consumption of caffeinated beverage.

Too bad the press couldn't have read this as well before publishing their piece suggesting that grandma or grandpa get stoked with coffee each morning to prevent a cardiac death.

-Wes

Caffeine-Laced Donuts

This should be filed under "why didn't I think of this?"

With all the popularity of energy drinks, coffee stands, and Dunkin Donuts - these will sell like, er, hotcakes.

Hey, maybe I can add caffeine to hotcakes... or ice cream.... or ....

-Wes