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Heartburn Drugs Linked to Early Death Risk

Study shows that long-term use of proton pump inhibitors, which are widely prescribed to treat heartburn, ulcers and other gastrointestinal problems, carry an increased risk of death.

Heartburn drugs known as proton pump inhibitors (PPIs) have been shown to be connected to an array of health problems such as dementia, bone fractures, and kidney damage. A new study performed at the Washington University School of Medicine indicates extensive use of such drugs is also tied to a heightened risk of death. Millions of Americans rely on PPIs for heartburn, ulcers and a variety of other gastrointestinal issues. These drugs can be easily obtained over the counter. They are sold under brand names like Prilosec, Nexium and Prevacid.

About the Study

The research team studied the medical records of about 275,000 PPI users and upwards of 75,000 people who took a separate class of drugs referred to as H2 blockers that minimize stomach acid. The findings were recently published in BMJ Open.  H2 blockers and PPIs are prescribed for an array of serious medical conditions like esophageal cancer, gastrointestinal tract bleeding and gastroesophageal reflux disease.

The data from the above-referenced data set was analyzed in-depth. A common theme emerged: PPI users had a heightened risk of death. As an example, when the researchers compared patients who took H2 blockers with patients who took PPIs across one or a couple years, it was determined that those who took PPIs had a 50% higher risk of perishing across the next half-decade. The average person assumes PPIs are safe as they can be obtained quite easily over the counter to treat heartburn and/or indigestion. Yet there are serious risks to taking such drugs, especially if they are consumed across extensive periods of time. Unfortunately, most people are unaware of these risks. This is a major problem as PPIs have quickly become one of the most commonly used drug classes in the country. As an example, about 15 million monthly prescriptions for Nexium were written in 2015.

The study’s authors believe the combined side effects of PPIs might affect mortality rate. To determine if this is the case, the researchers sorted through millions of veterans’ medical records within a database provided by the United States Department of Veterans Affairs. They pinpointed over 275,000 individuals who were prescribed a PPI and more than 73,000 individuals prescribed an H2 blocker across a time span of October of 2006 and September of 2008. The researchers determined how many of these individuals perished and the exact date of death across a five-year period.  

The Results

The researchers determined there is a 25 percent higher chance of death in the PPI group when contrasted against those in the H2 blocker group. The research team determined that for each 500 people consuming PPIs for a single year, there is a single additional death that otherwise would not have occurred. This is important as millions of people use PPIs on a regular basis. This massive scale means PPI use has the potential to cause thousands of deaths every single year.

The researchers also determined the risk of death in those who were prescribed H2 blockers or PPIs even though they did not have gastrointestinal conditions for which these alleged remedies are recommended. In such instances, the research team determined those who took PPIs had nearly a one-quarter increase in the chance of death when compared to those who took H2 blockers. This risk steadily increased with the amount of time people used the drugs. After 30 days of use, the risk of death in H2 blocker and PPI groups was similar. However, those who took PPI for a one to two years endured a nearly 50% hike in odds of death compared to those who used H2 blockers.

Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian, Yan Yan, Ziyad Al-Aly. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ Open, 2017; 7 (6): e015735 DOI: 10.1136/bmjopen-2016-015735

https://medicine.wustl.edu/news/popular-heartburn-drugs-linked-higher-death-risk/

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