Heartburn Medications Might Make Your Heart Burn

acid reflux and heart diseaseRegular use of the heartburn medications known as proton pump inhibitors may increase your risk of stroke.

This is the conclusion of a recent study that evaluated the effects of proton pump inhibitors on stroke risk. The four proton pump inhibitors evaluated were omemprazole (Prilosec)1, pantoprazole (Protonix), lansoprazole (Prevacid) and esomeprazole (Nexium).

Heartburn is a burning sensation in your chest caused by acid from the stomach flowing into the esophagus. This occurs when the “valve”, called the lower esophageal sphincter, that separates the lower part of the esophagus and the stomach is not able to close completely.

There are two main classes of medications to treat heartburn: proton pump inhibitors and histamine or H2 blockers. Proton pump inhibitors reduce stomach acid by limiting the function of proton pumps that secrete acid; H2 blockers inactivate acid-producing cells by binding to histamine receptors. This study focused on proton pump inhibitors.

The researchers followed almost 250,000 patients for six years, collecting information on use of proton pump inhibitors and incidence of stroke. At the beginning of the study, participants had an average age of 57 years. Over the course of the study period, nearly 10,000 participants experienced their first stroke.

Researchers found that the overall risk of stroke increased by 21% in patients who were taking a proton pump inhibitor when the stroke occurred. In addition, increased risk was determined, in part, by the dose of the proton pump inhibitor. The lowest doses had little effect on stroke risk, while the highest doses increased stroke risk by between 30% for lansoprazole (Prevacid) and 94% for pantoprazole (Protonix). There was no increased risk of stroke associated with H2 blockers such as famotidine (Pepcid) and ranitidine (Zantac).

Based on their findings, researchers urged patients, especially those at risk for heart disease, to learn about the potential cardiovascular risks associated with proton pump inhibitors and use them with caution. If possible, take a low dose of these medications. If not, the researchers suggest that H2 blockers may be a better option for alleviating heartburn.

Heartburn may be caused by overeating or eating foods that relax the lower esophageal sphincter.

Here are some tips to reduce heartburn without medication:

Eat the following foods in moderation because they relax the lower esophageal sphincter:

  • Tomatoes
  • Citrus (oranges, grapefruits, lemons, etc)
  • Chocolate
  • Peppermint
  • Limit caffeinated coffee to 1 cup per day
  • Reduce alcohol consumption
  • Do not smoke

Heartburn may also be addressed by maintaining a heart-healthy lifestyle, in particular sleeping well and reducing stress. To learn more about heartburn, heartburn medications, and your specific medical condition, talk to your cardiologist or doctor.

Next steps

1 The chemical name of each drug appears first, and the brand name is in parentheses.


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