Scientists at Stanford University and Houston Methodist have discovered that people who use a commonly prescribed antacid known as proton pump inhibitors (PPI) are more likely to experience a heart attack compared to those who do not use the medication.
Proton pump inhibitors, such as Prilosec (omeprazole), are often used to treat people who suffer from gastroesophageal reflux disease (GERD) also known as heartburn. These medications are prescribed to more than 20 million people living in the United States each year.
In a study published in the journal PLOS ONE, vascular medicine specialist Dr. Nicholas J. Leeper led a team of researchers in studying the effects of PPIs in adults.
They examined around 16 million clinical records collected from 2.9 million patients diagnosed with heartburn and found that those who use PPIs had a 16 to 21 percent higher risk of suffering a heart attack than people who do not use the drugs.
The findings support the suggestion of previous research that PPIs cause a biochemical reaction in the body that effectively reduces nitric oxide levels in endothelial cells. Keeping stable levels of nitric oxide is vital for dilating the walls of blood vessels and maintaining good cardiovascular health.
A reduction of nitric oxide levels increases the likelihood of a person to experience cardiovascular issues such as heart attacks.
"The AHA (American Heart Association) estimates a heart attack happens every 34 seconds in America. If we're estimating this risk is increasing by 20 percent [with PPI use], the public health impact is substantial," Leeper said.
The recent study also suggests that the increased potential for heart attack affects anyone who uses PPIs, whether they have been diagnosed with predisposed cardiovascular risk or not.
"By looking at data from people who were given PPI drugs primarily for acid reflux and had no prior history of heart disease, our data-mining pipeline signals an association with a higher rate of heart attacks," Dr. Nigam H. Shah, assistant professor of biomedical informatics at Stanford and co-author of the study, said.
"Our results demonstrate that PPIs appear to be associated with elevated risk of heart attack in the general population, and H2 blockers show no such association."
The results of the study showed that H2 blockers, such as ranitidine and cimetidine, do not pose any potential risk of heart attack and cardiovascular disease. Popular brands of H2 blockers include Zantac and Tagamet, respectively.
In earlier research, scientists believed that proton pump inhibitors affected only a small number of patients. These were people who were diagnosed with coronary artery disease and depended on an anti-platelet medication called clopidogrel to prevent future heart attacks.
Leeper explained that the researchers from these earlier studies assumed this was caused by a drug-drug interaction between compounds, and that the U.S. Food and Drug Administration (FDA) even released a warning regarding the concomitant use of PPIs.
Several authors of the recent study also released a report in the journal Circulation in 2013 about the possible connection between PPIs and cardiovascular diseases.
Leeper said that for their latest research, they made use of big-data approaches to find out if proton pump inhibitors could, in fact, be linked to increased risk of heart problems in patients. He said that their findings raise concerns about the safety of using PPIs.
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