Certain Antacids Can Increase Cardiovascular Risk

Scientists from Stanford University have found out that certain antacids can increase the risk of heart attack.

The scientific study was published in the journal, PLOS ONE, and based a novel approach for mining clinical data for pharma-covigilance, covering 2.9 million health records.

Researchers analyzed most commonly prescribed medications like Prilosec, Nexium, and Prevacid, which are also known as proton-pump inhibitors (PPI’s). Globally, it is estimated that over 113 million PPI prescriptions are filled annually. This, along with over-the-counter use, accounts for over $13 billion sales worldwide. The lack of medical supervision with the over-the-counter availability of PPI’s does raise concern, according to the authors.

PPI’s are usually used for heartburn or acid reflux (gastroesophageal reflux disease). Based on the study, for people with a history of acute coronary syndrome (ACS), PPI’s appear to decrease the effectiveness of clopidogrel, an antiplatelet agent used to reduce the risk for subsequent ischemic events or restricted blood flow.

But, some studies have also connected PPI with adverse clinical outcomes in high-risk cardiovascular populations, independently of clopidogrel utilization. The study cited an example concerning ACS patients treated with the antiplatelet agents aspirin, and ticagrelor (drug produced by AstraZeneca).

While it may be possible that PPI’s can decrease the absorption rate of drugs — which is a controversial suggestion, when it has been demonstrated that PPI’s have not diminished anti-platelet aggregation in aspirin. Similar reductions in gastric pH have been reported through using H2 blockers (H2Bs), another form of antacid, which has been shown to have no effect in increasing risk.

The study states that an “alternative explanation for it is that the observed risk of PPI’s is due to some unknown mechanistic pathway“.

The researchers, thereby said, that it is in their observation that PPI usage is associated with harm in the general population, including the young, and those taking no antiplatelet agents.