Milton Robin M, Kelly-Rehm Merry, Brahm Nancy, Fox Mark D
The University of Oklahoma, Tulsa, OK, USA.
The University of Tulsa, Tulsa, OK, USA.
J Pharm Technol. 2014 Jun;30(3):81-86. doi: 10.1177/8755122513503790. Epub 2014 May 13.
To describe the effects of performance-enhancing supplements and caffeine on the blood pressure (BP) of an adolescent male. An adolescent male presented to his primary care provider for a preseason athletic physical. On physical exam, his BP was 162/90, exceeding the 99th percentile for his age. It had been elevated during the previous 2 yearly physicals. He was referred to the Pediatric Preventive Cardiology Clinic for follow-up. Illegal substance use and renal trauma were ruled out. During the evaluation, the patient acknowledged using energy drinks and performance-enhancing supplements, the majority of which were caffeine-based. His intention was to continue the use of supplements, so lisinopril was initiated. On follow-up, however, the patient reported supplement discontinuation, intermittent medication adherence, and lower home-based BP readings. He was subsequently lost to follow-up. An objective causality assessment revealed that the adverse drug event was probable. When working with adolescent patients, it is particularly important to conduct an in-depth interview reflecting lifestyle choices. Use of performance-enhancing supplements and caffeine for adolescent athletes has been well reported in the literature. Adolescent use of supplements may be driven by misguided beliefs and lack of knowledge about potentially detrimental health effects, such as altered heart rate and elevated BP. Little evidence-based research is available to provide treatment guidance for clinicians regarding potential effects. A thorough patient history, including specific questions probing for any recent or chronic use of nutritional supplements, including energy drinks, will help identify substances that may contribute to BP variations. Even mild BP elevations in adolescents should lead clinicians to further investigate supplement use and include specific questions on any product use within the past 24 hours, several days, or longer. Adolescents may not consider the potential for adverse health effects when ingesting performance-enhancing supplements or energy drinks.
描述增强运动表现的补充剂和咖啡因对青春期男性血压（BP）的影响。一名青春期男性因季前体育体检前往其初级保健提供者处就诊。体格检查时，他的血压为162/90，超过了其年龄的第99百分位数。在之前的两次年度体检中血压一直升高。他被转诊至儿科预防心脏病诊所进行随访。排除了非法药物使用和肾外伤。在评估过程中，患者承认使用能量饮料和增强运动表现的补充剂，其中大多数是以咖啡因为基础的。他打算继续使用补充剂，因此开始使用赖诺普利。然而，在随访时，患者报告已停止使用补充剂，间歇性服药依从性差，家庭血压读数较低。随后他失访了。客观因果关系评估显示该药物不良事件很可能发生。在为青少年患者诊疗时，进行反映生活方式选择的深入访谈尤为重要。文献中已充分报道了青少年运动员使用增强运动表现的补充剂和咖啡因的情况。青少年使用补充剂可能是受错误观念驱使，且对潜在的有害健康影响（如心率改变和血压升高）缺乏了解。几乎没有循证研究可为临床医生提供有关潜在影响的治疗指导。全面的患者病史，包括询问近期或长期使用营养补充剂（包括能量饮料）的具体问题，将有助于识别可能导致血压变化的物质。即使青少年的血压轻度升高，临床医生也应进一步调查补充剂的使用情况，并询问过去24小时、数天或更长时间内使用任何产品的具体问题。青少年在摄入增强运动表现的补充剂或能量饮料时可能不会考虑对健康的潜在不良影响。
