Heartburn: Acid blockers promote heart attacks

Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.

More about the experts All content is checked by medical journalists.

MunichHeartburn is extremely unpleasant. Most people quickly resort to medication to relieve symptoms such as acid regurgitation and chest pain. So-called proton pump inhibitors (PPIs) are particularly popular with patients. But the use of these drugs apparently harbors a previously underestimated danger: They increase the risk of a heart attack. This even applies to those that are available without a prescription.

Omeprazole, esomeprazole, lansoprazole - there is a long list of active substances that act as proton pump inhibitors. These medicines reduce the production of stomach acid, which gets into the esophagus in people with heartburn. However, experts have long suspected a connection between PPIs and the risk of heart attack and other cardiovascular diseases. "These drugs have been shown to have negative effects on the endothelium, the Teflon-like lining of the blood vessels," says John Cooke of the Houston Methodist Research Institute. If a blood vessel in the heart becomes blocked, there is a risk of a heart attack. If, on the other hand, a blood vessel that supplies the brain is affected, this can lead to a stroke.

Not only of concern for the elderly

Together with colleagues, the scientist found in a study that PPIs increase the risk of a heart attack by 16 to 21 percent - regardless of the age of the user. This means that not only older patients, who are already in the risk group for cardiovascular events, suffered a heart attack more often, but younger ones too.

The intake of so-called H2 blockers, on the other hand, which are also taken against heartburn, but have a different mechanism of action, did not increase the risk of heart attack.

No prescription but risky

"Our results increase concerns that PPIs - which are even available over-the-counter and are among the most widely prescribed drugs in the world - are not as safe as previously thought," said Nicholas Leeper, co-author of the study. to consider.

In total, the researchers had evaluated health data from 2.9 million patients. More than eight percent of them were taking either H2 blockers or PPIs to treat gastroesophageal reflux disease (GERD). Patients with this diagnosis suffer from a pathologically increased backflow of the acidic stomach contents into the esophagus. Heartburn and pain behind the breastbone are the result.

The study also had another result: it had previously been assumed that PPIs are only risky for the heart in combination with the drug clopidogrel. The drug is often prescribed to patients after a heart attack. It makes the blood thinner and thus reduces the likelihood of blood clots. In fact, the study reveals that the proton pump inhibitors also increase the risk of heart attacks when taken alone.

Reduced gastric acid production

Proton pump inhibitors are taken in tablet form. They get into the blood through the intestine and thus reach special stomach acid-forming cells in the gastric mucosa. There they put the so-called proton pumps out of action. This means that fewer protons, which are necessary for the formation of stomach acid, reach the stomach.

Proton pump inhibitors are used in various diseases on which gastric acid has a decisive influence. In addition to heartburn, this also includes ulcers and inflammation of the stomach, esophagus and duodenum. In addition, PPIs are used as stomach protection when taking certain painkillers for a long time or in combination with antibiotics when treating an infection with the stomach germ Helicobacter pylori.

Sources:

Shah N.H. et al .: Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population. PLOS ONE. DOI: 10.1371 / journal.pone.0124653

Press release from the Houston Methodist Research Institute dated June 10, 2015

Tags:  dental care eyes toadstool poison plants 

Interesting Articles

add