Research links heartburn medications to increased heart attack risk

The most widely prescribed drugs for heartburn in the world are being linked to an increased risk of heart attack.

They are called proton pump inhibitors – or PPIs — and they include such well-known names as Prilosec, Prevacid and Nexium.

Researchers at Stanford University analyzed data on almost 3 million patients to see if there was an association between PPI use and heart risk. And while there have been studies in the past pointing to problems with these gastric reflux drugs for people already diagnosed with heart disease, the Stanford team found they affect otherwise healthy people as well.

“They showed a 16 to 21 percent increased risk of heart attacks in patients who were taking proton pump inhibitors versus patients who were not taking this class of drugs,” says Dr. Warren Levy, president and chief medical officer of Virginia Heart — the largest cardiology practice in the greater Washington, D.C. area.

“The data presented in this study is certainly going to make us take a second look at this entire class of medication to see which patients would not be appropriate to use them in terms of increased risk,” say Levy.

It’s long been thought that people with heart disease should stay away from these drugs because of the likelihood of an interaction with clopidogrel — a commonly prescribed blood thinner.

Now, the concern may be growing wider.

In a paper published in PLOS ONE, the Stanford researchers do not detail the reasons why these drugs may increase the risk of heart attack in the general population, but Dr.Nicholas Leeper, the main author, says “these drugs may not be as safe as we think.”

More than 100 million prescriptions are filled every year in the U.S. for PPIs. And while Levy stresses much more study is needed, he notes there is a theory that this particular class of stomach drugs may reduce the production of certain chemicals in the body that facilitate blood flow to some of the vital organs, including the heart.

He says further research will determine who should and should not be taking these medications. In the meantime, Levy says patients who either are or want to take these drugs — including those sold over-the-counter — should talk to their physician about possible alternatives.

Another class of drugs called H2 blockers has been deemed completely safe. These medications have been around longer than PPIs, are reasonably effective against gastric reflux, and are the second-largest-selling type of heartburn medication. They include the brand names Zantac, Tagamet, Pepcid and Axid.


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