gastroesophageal reflux disease
(GERD), which is
caused due to reflux of acidity from the stomach into the lower esophagus or
food pipe, causes symptoms of stinging sensation in the chest, burning
sensation in the throat, and difficulty swallowing. Symptoms typically appear
on eating spicy foods or lying down soon after a heavy meal.
The proton pump
inhibitor group of drugs, which includes the drugs omeprazole, lansoprazole, esomeprazole, rabeprazole and pantoprazole
commonly used to treat heartburn. Drugs from another group called the H2
blockers like ranitidine, famotidine etc. are also commonly used to treat
A recent study
published in PLoS ONE
these medications may increase the
risk of heart attack
. The researchers of the
data from medical records of 2.9 million individuals using data-mining. The
data-mining procedure allows analysis on a large quantities of data.
analysis of the data, the researchers found that there was an increase in the
risk of heart attack in those who took proton pump inhibitors, but not those
who took H2 blockers
. The authors suggest that proton pump
inhibitors may cause changes at the molecular level of blood vessels. Previous
research has indicated that
may reduce the production of nitric oxide by the
inner lining of the blood vessels. Nitric oxide plays an important role in
maintaining blood circulation.
this does not mean that you press the panic button and stop using the proton
pump inhibitor that you have been taking all this while
The study could not assess for sure whether the medication was directly
responsible for the increased risk. They also could not evaluate if the
patients taking the proton pump inhibitors were already at a high risk for
heart attack before taking the medication. A clinical trial to address the
issue will need to be designed and carried out before any recommendation to
avoid using proton pump inhibitor can be made.
Earlier studies have
indicated that proton pump inhibitors reduce the effect of clopidogrel, an
antiplatelet drug when used to reduce heart attack in patients with history of
acute coronary syndrome
. Thus, patients on
clopidogrel should use proton pump inhibitors with caution. But whether this
caution should extend to all individuals irrespective of whether they are at a
risk of heart disease or not can be addressed only after further studies.
drug is not without side effects, and according to the above study, there is a
possibility that proton pump inhibitors can increase the risk of heart attack
Patients who take the medication over-the-counter without prescription could be
advised more caution.
The importance of lifestyle changes in like
stopping smoking, reducing alcohol intake, eating less spicy foods, losing
weight and sleeping with the head slightly raised in preventing heartburn
should not be underestimated.