Proton pump inhibitors (PPIs), which reduce acid produced in the stomach, are a popular over-the-counter heartburn medication. They have been recently found to speed up the aging of blood vessel cells in laboratory tests, raising potential heart health issues.
The accelerated aging of blood vessel cells exposed to antacid esomeprazole (brand name Nexium) could hinder these cells from optimally preventing blood from sticking and protecting against stroke and heart disease, according to findings from researchers at the Houston Methodist Research Institute.
Long-term exposure to PPIs, too, had been linked to impaired acid production of lysosomes – the part of the cell typically clearing waste – in endothelial cells, with the resulting waste buildup causing rapid cell aging. This effect was not seen in H2 blockers, another kind of antacid.
"Lysosomes are like the garbage disposal of cells," explained study lead author and cardiovascular sciences professor Dr. John P. Cooke. “They need to generate acid to get rid of cellular rubbish, and when cellular rubbish accumulates the cells age faster."
This could hamper the cells’ ability to protect blood vessels, Cooke added, arguing that while PPIs can be effective in the short term for heartburn symptom relief, they may not be best for prolonged use given the “smoking gun” that helps explain evidence of increased heart health risk.
Of the two PPIs tested, only esomeprazole is currently available on the market. Since theirs was a laboratory experiment, the team also encouraged long-term clinical trials to explore the association.
In a statement, Nexium maker AstraZeneca echoed that the research was indeed done in a laboratory setting and “not in humans within a controlled clinical trial,” therefore not establishing any direct causation.
"Patient safety is an important priority for AstraZeneca and we believe all of our PPI medicines are generally safe and effective when used in accordance with the label," HealthDay quoted of the pharmaceutical company's statement.
American Heart Association president Dr. Mark Creager said that this lab study, while raising the question, cannot prove a direct link between using PPIs and increased stroke or heart attack risk. He also called for a “well-designed clinical trial.”
Dr. David Robbins of Lenox Hill Hospital in New York City, on the other hand, said these heartburn drugs should be approached with caution because of their potential harms outside of the digestive system. Ask your doctor to see if you really need one if you are taking a daily PPI, he suggested.
The study authors also emphasized lifestyle modifications, such as exercise and slashing alcohol or caffeine intake, to naturally help ease heartburn.
The findings were published in the journal Circulation Research.
A separate study in April implicated PPIs in an increased risk of kidney failure, supporting a growing body of research linking long-term use of the drugs to serious illnesses that include heart disease and dementia.
The study noted that the projected 15 million Americans with PPI prescriptions could easily climb in numbers given the over-the-counter availability of the medications. The U.S. Food and Drug Administration estimates that one out of 14 Americans has used PPIs.
