PPI users at increased risk of atherosclerotic cardiovascular diseases, finds study

Based on the study findings, the research team led by Yue Ma, School of Public Health, Tianjin Medical University, Tianjin, China, has cautioned clinicians against the prophylactic use of PPIs.

There have been increased concerns regarding adverse events associated with acid suppressant use. Proton pump inhibitors are medications that work by decreasing the amount of stomach acid made by glands in the lining of the stomach. in recent years. However, the impact of PPIs and histamine‐2 receptor antagonists (H2RAs) on ASCVDs risk is unknown.

Considering the above, the researchers from China aimed to estimate the risk of ASCVDs associated with using H2RAs and PPIs in a prospective cohort study.

The study included patients in the UK Biobank (2006–2010) without cardiovascular diseases or anti-hypertensive treatment at baseline. ASCVDs and each subtype (myocardial infarction, coronary artery disease, ischemic stroke, and peripheral artery disease) were the study outcomes. Cox proportional-hazards models were used to estimate the association.

During a median of 12.5 years of follow-up, the authors documented 13,503 (4.3%) incident ASCVDs among 316,730 individuals (aged 50–88 years).

The researchers reported the following findings:

• Regular PPIs use was associated with a higher risk of ASCVDs (HR: 1.16) and every subtype of ASCVDs.
• Among each type of PPIs, lansoprazole (HR: 1.11), omeprazole (HR: 1.19), and pantoprazole (HR: 1.40) were associated with a higher risk of ASCVDs.
• Stratification analysis showed that PPIs use was associated with a higher risk of ASCVDs among individuals without indications of medications for PPIs.
• In addition, H2RAs use was not related to the risk of ASCVDs (HR: 0.97).

The researchers conclude, "higher ASCVD risk was observed among PPI users without indications for medication, particularly amongst participants without indications for medication."

Reference:

The article "Acid suppressants use and risk of atherosclerotic cardiovascular disease in middle-aged and older adults" was published in Atherosclerosis.

https://doi.org/10.1016/j.atherosclerosis.2022.09.001