Heartburn Drug Omeprazole Linked to Increased Heart Attack Risk, Study Suggests

Long-term use of common heartburn medications, such as omeprazole, may significantly increase the risk of heart attack and other serious heart complications, according to a new study.

Researchers analyzed 13 existing studies and found that individuals taking proton pump inhibitors (PPIs) for more than 30 days had a 58% higher likelihood of experiencing cardiovascular events like heart attacks and cardiac arrest compared to those not using the drugs. The study also indicated a 38% increased risk of death from heart-related issues. However, no significant increase in stroke risk was observed.

PPIs, which include medications like omeprazole, lansoprazole, esomeprazole, pantoprazole, and rabeprazole, work by reducing the amount of acid produced in the stomach. In England alone, over 35 million prescriptions for omeprazole are issued annually, making it one of the most frequently prescribed drugs. While GPs typically prescribe PPIs for four to eight weeks, NHS guidelines advise using them for the shortest possible duration to minimize side effects. Despite this, studies suggest that a substantial number of patients, around 40%, take PPIs for at least a year, with one in ten using them for five years or more.

The study, led by researchers at the National University of Malaysia, explored potential explanations for the observed link. One theory suggests that PPIs might lower nitric oxide levels in the body, a molecule crucial for blood vessel relaxation. Another hypothesis is that these drugs could alter gut bacteria, potentially leading to inflammation associated with heart problems. Concerns were also raised about possible interactions between some PPIs and blood-thinning medications.

While the observational nature of the study means a causal link cannot be definitively proven, the authors stressed that the findings warrant careful consideration. They advised clinicians to thoroughly evaluate the risk-benefit profile of long-term PPI therapy, especially for patients with existing cardiovascular risk factors. The researchers cautioned against abruptly stopping PPIs without medical guidance, as this can exacerbate symptoms, and emphasized that the drugs remain vital for managing certain acid-related disorders when clinically indicated.

Experts suggest that patients can explore alternative methods to manage acid reflux. Dr. Philippa Kaye, a GP columnist, recommends lifestyle modifications such as weight loss, as excess abdominal weight can worsen reflux. Other suggested changes include avoiding large meals close to bedtime, and limiting intake of alcohol, caffeine, chocolate, fatty or spicy foods, and fizzy drinks, all of which can trigger heartburn. Raising the head of the bed can also help reduce nighttime acid reflux.

Gut scientist Dr. Sam Treadway shared his personal experience of successfully discontinuing PPIs after nine years by adopting similar lifestyle changes, including dietary improvements and avoiding late-night meals. He noted that over-the-counter remedies like Gaviscon also proved effective. Both Dr. Kaye and Dr. Treadway emphasized that for some patients, PPIs are essential and should not be stopped without consulting a healthcare professional.