Common heartburn drugs taken by millions ‘linked to early death’
COMMON heartburn drugs taken by millions are linked to early death, scientists claim.
The drugs, known as proton pump inhibitors (PPIs), may increase the risk of developing fatal conditions like heart disease and stomach cancer.
New research claims to have found the likelihood increases with the duration of use - even when the medications are taken at low doses.
Senior author Professor Ziyad Al-Aly, of the University of Washington, St Louis, said: "Taking PPIs over many months or years is not safe, and now we have a clearer picture of the health conditions associated with long-term use."
Heartburn is extremely common, affecting one in four British adult, with more than 50 million prescriptions issued each year for heartburn, ulcers and acid reflux.
Taking PPIs over many months or years is not safe
Professor Ziyad Al-Aly
Widely used PPIs include esomeprazole and lansoprazole, which are available over the counter under brand names such as Nexium.
They bring relief by reducing gastric acid and are among the most commonly used tablets in the UK.
Prof Al-Aly has led calls for their restriction and conducted several studies associating them to kidney damage and an increased risk of death.
Other researchers have also linked them to dementia, bone fractures, heart disease and pneumonia, among other illnesses.
'Thousands of excess deaths'
The findings published in The BMJ were based on 214,467 older US veterans - 157,625 of whom were newly prescribed PPIs between July 2002 to June 2004.
The rest received another class of drugs known as H2 blockers to reduce stomach acid.
Over the next decade the mortality rate for the former was 387 for every 1,000 - compared to 342 for the latter.
The extra deaths was equivalent to a 17 per cent increased risk.
Prof Al-Aly, a clinical epidemiologist, said: "Given the millions of people who take PPIs regularly, this translates into thousands of excess deaths every year."
The findings also showed extra deaths per thousand from heart disease, chronic kidney disease and stomach cancer.
What causes heartburn?
Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). I
f it keeps happening, it’s called gastro-oesophageal reflux disease (GORD).
Lots of people get heartburn from time to time. There's often no obvious reason why.
Sometimes it's caused or made worse by:
- certain food and drink – such as coffee, alcohol, chocolate, and fatty or spicy foods
- being overweight
- smoking
- pregnancy
- stress and anxiety
- some medicines, such as anti-inflammatory painkillers (like ibuprofen)
- a hiatus hernia – when part of your stomach moves up into your chest
You can ease symptoms by eating smaller, more frequent meals or tryibg to lose excess weight.
Another lifestyle change includes raising one end of your bed 10-20cm so your chest and head are above the level of your waist, so stomach acid doesn't travel up towards your throat.
Source: NHS
They found more than half of those taking them did so without a medical need - with the number of deaths related to PPIs most common among this group.
Prof Al-Aly said: "Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them. Overuse is not devoid of harm."
The research also showed that more than 80 per cent were on low doses of the prescription drug, or those equivalent to ones offered in over-the-counter versions.
Prof Al-Aly said: "This suggests the risk may not be limited to prescription PPIs, but it also may occur at over the counter doses."
The US Food and Drug Administration (FDA) has expressed interest in data presented by his team.
Prof Al-Aly said: "PPIs sold over the counter should have a clearer warning about potential for significant health risks, as well as a clearer warning about the need to limit length of use, generally not to exceed 14 days.
PPIs sold over the counter should have a clearer warning about potential for significant health risks, as well as a clearer warning about the need to limit length of use
Professor Ziyad Al-Aly
"People who feel the need to take over-the-counter PPIs longer than this need to see their doctors."
The researchers are continuing to study adverse health effects related to PPIs, in particular regarding those at the highest risk.
Prof Al-Aly added: "A lot of people may be taking PPIs unnecessarily. These people may be exposed to potential harm when it is unlikely the drugs are benefiting their health.
"Our study suggests the need to avoid PPIs when not medically necessary. For those who have a medical need, PPI use should be limited to the lowest effective dose and shortest duration possible."
MORE ON HEART DISEASE
It has been suggested the drugs may shorten telomeres, protective caps on the end of chromosomes that have been likened to the plastic tips on the end of shoelaces.
Both PPIs and H2 blockers are prescribed internal bleeding, gastroesophageal reflux disease and cancer of the gullet, or oesophagus. Over-the-counter PPIs are most often used for heartburn and indigestion.
Researchers say people often stay on the pills for too long because they are available over the counter.
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