Heart abnormalities are semi-common, occurring as a major side effect at least once in the use of 25% of surveyed pre-workout users – typically as abnormal heart rate. (source)
This article will discuss if pre-workout supplements can affect your cardiovascular health adversely and lead to fatal consequences like cardiac arrest.
Pre-workouts provide sudden energy bursts, pumps, and good vascularity, but on the flip side, they can also badly affect the heart and blood vessels.
Although safe in regular smaller servings, pre-workouts can cause cardiovascular diseases like angina, arrhythmias, or heart attack when overdosed or abused.
In the following sections, I have listed pre-workout ingredients that are infamous for affecting heart health so that you may look out for their presence in your supplement while making a purchase and stay safe.
Next up, I will share some case studies and user experiences about pre-workout and heart problems, and we will also discuss if dry scooping can cause a heart attack.
Without any further ado, let’s get right into it.
Is Pre-workout Bad for the Heart? (why?)
No, pre-workouts are safe for the heart when used within a limit, but when you consume many, larger servings of such supplements, they may strain your heart and vascular system.
Different components of pre-workouts influence the circulatory system in different ways.
Here is a quick analysis of such compounds backed by scientific research:
Most pre-workouts contain caffeine anhydrous in varied amounts to induce alertness and focus during exercise.
It is actually a psychostimulant that triggers neural pathways just like the natural neural transmitters do. It affects cognitive functioning, endocrinal secretions, and the cardiovascular system.
Research proves that caffeine raises blood pressure as it induces vasoconstriction. In the long term, elevated BP levels can lead to chronic hypertension, which comes with a whole bunch of cardiovascular troubles.
If you are already diagnosed with hypertension, a high dose of caffeine can aggravate things for you and impose a higher risk of cardiovascular disorders like stroke, heart attack, or arrhythmias.
Yohimbine is an alkaloid added to pre-workouts for quick weight loss and motivation. This compound actively interacts with adrenoreceptors and has stimulatory functions.
A study in cardiovascular pharmacology reports that oral intake of yohimbine is associated with a rise in blood pressure and sympathetic nervous responses in hypertensive people.
But normal individuals are also equally vulnerable to its effects as persons with underlying hypertension issues. This clinical trial shows that it elevated blood pressure in normal males as well.
The increase in blood pressure seems related to the rise in plasma levels of norepinephrine that increase two to threefold after ingestion of yohimbine.
Whatever the exact cause may be, it is recommended to see your doctor before its usage if you have high blood pressure, sympathetic nervous issues, or use any antidepressant medicines.
Bitter Orange (Citrus aurantium)
Bitter orange is another ingredient in pre-workouts that play a stimulatory role.
Its active ingredient is Synephrine which resembles Ephedra components. This citrus derivative has adrenergic properties and tends to increase blood pressure and pulse rate.
A rise in systolic, diastolic blood pressure, and heart rate in healthy adults was observed after a single dose during this clinical study.
Thus, large doses of bitter orange are likely to cause hypertension and related cardiac issues.
This especially becomes a concern when your supplement also has other stimulants like caffeine.
Research conducted in 2017 suggests that a combined dosage of caffeine and synephrine increases the risk of cardiovascular problems.
L-Arginie and L-citrulline
Many pre-workout ingredients cause vasodilation, i.e., widening of blood vessels. This enlargement, on the one hand, improves the supply of oxygen and nutrients to muscles, but on the other, it lowers blood pressure.
This is nothing alarming, but if you are already on blood pressure-lowering medication, the combined effect may reduce the blood pressure to a dangerous level.
L-citrulline and L-arginine are both vasodilatory amino acids. Arginine increases the production of nitric oxide, which eventually leads to vasodilation. A nutritional review from 2019 infers that oral supplementation with arginine reduces blood pressure by 5.39/2.66 mmHg.
Similar results are reported for L-citrulline.
It exhibits hypotensive effects because it is a precursor of arginine, and a good amount of ingested citrulline is converted to arginine.
Taurine is a hypotensive sulfano-amino acid. It improves energy metabolism in muscles and enhances athletic performance.
But it is also known to affect the cardiovascular system by lowering blood pressure.
This study shows that it inhibits transient receptor channels and upregulates the production of sulfide-synthesizing enzymes that leads to a reduction in blood pressure.
If you take BP lowering tablets, it can interact with their constituents, and the enhanced activity can drop your blood pressure too low.
Can pre-workout cause a heart attack?
Yes, pre-workouts can cause a heart attack if you overdose on them. As discussed in the above section, many ingredients in pre-workout formulation alter blood pressure and heart rate.
Stimulants like yohimbine, caffeine, and bitter orange have the most noticeable and potentially harmful effects.
These compounds tend to increase blood pressure and may lead to acute hypertension.
The amount of caffeine in some products is as high as 360 mg per scoop, which is very close to recommended safe dose of 400 mg daily. If you decide to take two scoops of such a formulation, you will be overdosing on caffeine.
Other constituents, including citrulline, arginine, taurine, beta-alanine, and niacin, cause vasodilation and lower blood pressure.
This condition can become a risky deal if you use blood pressure-controlling drugs to regulate your blood pressure.
Reddit users have reported experiencing symptoms of angina and heart attack after consuming pre-workouts.
A 20year old young man felt the tightness of his chest and numbness of his left arm during the gym session after taking a dose of the supplement.
This man posted over Reddit that he suffered from severe chest pain and weakness on the left side after he switched from a low caffeine pre-workout to a high caffeine pre-workout.
He felt these effects after converting from 150 mg to 250 mg of caffeine per serving.
Another case study reports that a 42-year-old man had a cardiac arrest at the gym after he took a pre-workout.
Can dry scooping pre-workout result in a heart attack?
Yes, dry scooping can cause a heart attack.
When you ingest pre-workout without diluting it with water, caffeine anhydrous readily gets absorbed in the bloodstream in the concentrated form.
It is the pure form of caffeine, and its amount in workout supplements is already high, so dry scooping will lead to over-consumption.
Caffeine toxicity increases the risk of chest pain, heart arrhythmias, stroke, and myocardial infractions many-fold.
A 20-years old tiktoker who dry scooped pre-workout, reported that she felt pain in her chest, shoulders, and back and shortness of breath shortly after ingesting dry pre-workout powder. These symptoms ended her in a hospital, diagnosed with a heart attack.
Stimulatory compounds in pre-workout have vasoconstricting properties and tend to cause a rise in blood pressure.
As blood pressure can skyrocket due to a high dose of caffeine, synephrine, or yohimbine, there is a risk of chest pain, shortness of breath, and heart attack if you overconsume a pre-workout.
If you have a history of cardiovascular issues, I would recommend that you choose a stimulant-free supplement and keep your serving size small.
It is better that you check with your physician and discuss your pre-workout supplementation as well as the type of training you are doing.