New research shows that long term use of heartburn drugs has been linked to fatal cases of cardiovascular disease, chronic kidney disease, and gastrointestinal cancer. Before this study conducted by researchers at Washington University School of Medicine in St. Louis and Veterans Affairs St. Louis Health Care System, little had been known about the specific causes of death connected to these drugs, called proton pump inhibitors (PPIs).
With more than 15 million American’s taking PPIs for acid reflux, known as heartburn, this was an important study to show the associated risks of taking proton pump inhibitors. Many people even purchase these drugs over-the-counter and take them without doctor’s supervision, often indefinitely. We now have a clear picture of what taking these drugs can do to the body over a long period of time.
The study published in the journal The BMJ has been the first look at long term use risk beyond the adverse health problems that have already been associated with the heartburn drugs such as bone fractures, ulcers, dementia, pneumonia, heart disease, and others.
Senior author Ziyad Al-Aly spoke about the study saying, “Taking PPIs over many months or years is not safe, and now we have a clearer picture of the health conditions associated with long-term PPI use.”
For the study, Al Aly and his team took information from de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs. After examining medical data from July 2002 to June 2004, the researchers identified 157,625 people who had been newly prescribed PPIs and 56,842 people who had been newly prescribed another class of acid-suppression drugs known as H2 blockers. The 214,467 patients were then followed for up to 10 years.
The study showed a 17 percent increased risk of death in the PPI group compared to the H2 blocker group. It was shown that 45 excess deaths were attributed to long-term use of PPIs per 1,000 people. Death rates for PPIs were 387 per 1,000 people, and death rates for H2 blockers were 342 per 1,000.
“Given the millions of people who take PPIs regularly, this translates into thousands of excess deaths every year,” said Al-Aly. “Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them. Overuse is not devoid of harm.”
No Medical Need
The study had additionally found that more than half of the people taking PPIs did so without a medical need. Among this group of individuals, PPIs-related deaths were more common with almost five per 1,000 dying from chronic kidney disease, 23 people per 1,000 from cardiovascular disease, and three from stomach cancer.
Al-Aly’s research team will continue the study of adverse health effects related to PPIs. He concluded this first study by saying, “A lot of people may be taking PPIs unnecessarily.” Al-Aly added, “These people may be exposed to potential harm when it is unlikely the drugs are benefiting their health. Our study suggests the need to avoid PPIs when not medically necessary. For those who have a medical need, PPI use should be limited to the lowest effective dose and shortest duration possible.”
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