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Concerning research shows that acid blocking drugs may calm heartburn at the price of a heart attack - or even death
The burning pain of acid reflux can be unbearable. Most doctors offer a quick-fix in the form of drugs like Prevacid, Nexium, or Prilosec. But a new study finds those drugs may calm heartburn at the price of a heart attack.
PPIs block acid production in the stomach to reduce or eliminate heartburn. They are prescribed primarily for gastroesophageal reflux disease (GERD).
According to the Stanford researchers PPIs are among the most widely used drugs in the world with over 113 million PPI prescriptions filled globally every year. Add to that over-the-counter versions of the drugs, and worldwide sales top $13 billion. In the U.S. alone about 21 million people use PPIs.
But they've been called one of the most dangerous and over-prescribed medications on the market.
The Stanford study published online in the journal PLoS One found that people taking PPIs were 16 percent to 21 percent more likely to suffer a heart attack and 122 percent more likely to die of cardiovascular disease.
The researchers reviewed health data contained in 16 million electronic records of 2.9 million patients. The data came from Stanford medical facilities between 1994 and 2011, as well as from small practices around the country between 2007 and 2012.
They identified 297,000 people who suffered from acid reflux. Then they compared the frequency of heart attacks among those taking six specific PPIs and those who didn't take the drug. The PPIs in the study included omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), esomeprazole (Nexium), rabeprazole (Aciphex), and dexlansoprazole (Dexilant).
The data revealed that GERD patients taking PPIs had a 16 percent to 21 percent increased risk of a heart attack.
The researchers also analyzed data from a separate prospective study called the Genetic Determinants of Peripheral Arterial Disease (GenePAD) cohort. That study showed a shocking 122 percent increased risk of cardiovascular death among PPI users.
The data mining technique used by the researchers is similar to the analysis done on the drug Vioxx. In 2004 that drug was pulled from the market when 1.4 million patient records revealed that heart attack and cardiac death rates were three times higher in people taking Vioxx compared to a rival drug.
Why do proton pump inhibitors increase risk of heart attack and death?
The researchers theorized that PPIs inhibit the enzyme activity of nitric oxide synthase in endothelial cells. Low levels of nitric oxide activity are known to increase vascular resistance, and promote inflammation and thrombosis.
The Stanford researchers also examined histamine blockers (H2Bs) for a similar link to heart attacks but found no association. They looked at cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac).
But H2Bs have side effects like diarrhea, constipation, headaches, dizziness, nausea, vomiting and hives. And like PPIs histamine blockers been linked to hip fractures.
Many natural remedies have been proven to be more effective than drugs for heartburn. They include herbs like ginger, and a simple glass of water.
[i] Shah NH, LePendu P, Bauer-Mehren A, Ghebremariam YT, Iyer SV, Marcus J, et al. (2015) "Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population." PLoS ONE 10(6): e0124653. doi:10.1371/journal.pone.0124653