A new study examined the risk of mortality with long-term use of heartburn medicine, finding PPIs associated with increased mortality.
Heartburn medications are some of the most commonly used drugs in North America, both with or without a prescription. However, their widespread and unnecessary usage may have serious long-term health effects. Medications for heartburn and acid reflux are widely used in the US, with more than 15 million active prescriptions at a time, in addition to over the counter usage. Many of these prescriptions are for proton pump inhibitors (PPIs), which inhibit the production of acid in the stomach walls. Previous research suggests that PPI use is associated with a higher risk of premature death. However, quantitative data for specific conditions and causes of death was lacking.
Researchers at the Washington University School of Medicine recently completed a quantitative study comparing mortality rates with PPI usage. Their work was published in the BMJ and included data from the U.S. Department of Veterans Affairs. Their dataset included approximately 157,000 patients who had been prescribed PPIs and approximately 56,000 who had been prescribed H2 blockers, another class of heartburn medication.
Proton pump inhibitors associated with increased risk of mortality
The researchers followed up on these patients for 10 years and found that the patients who were prescribed PPIs had a 17 percent increased mortality risk compared with patients prescribed H2 blockers. The death rates were 387 per 1,000 and 342 per 1,000 respectively. The leading cause of death for these patients was cardiovascular disease, followed by chronic kidney disease, and gastrointestinal cancer. These adverse effects were observed even at low doses and among patients with no medical need for the drugs. Notably, a previous history of these conditions did not affect the relationship between PPI use and the respective risk of death.
This study supports previous research in this area, which had associated heartburn medicine with risk of premature death. The study authors recommend to avoid taking these drugs if not medically necessary, and to limit their use to the minimum dose and duration required. Taking these medications unnecessarily may be more harmful than helpful in the long term.
Written by Agustin Dominguez Iino, BSc
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Xie Y et al. Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study. BMJ. 2019 May 29;365:l1580. doi: 10.1136/bmj.l1580.
WUSTLnews. Heartburn drugs linked to fatal heart and kidney disease, stomach cancer. EurekAlert! https://www.eurekalert.org/pub_releases/2019-05/wuis-hdl053019.php.