islamabad - A new research suggests that heartburn medication should be used with caution, after finding it could raise the risk of ischemic stroke.

Proton pump inhibitors are a class of drugs commonly used to treat heartburn - pain in the chest or throat caused by the rising of stomach acid into the oesophagus. Lead study author Dr Thomas Sehested, of the Danish Heart Foundation in Copenhagen, Denmark, recently presented his findings at the American Heart Association’s Scientific Sessions 2016, held in New Orleans, LA.

The researchers assessed patients’ use of one of four PPIs - omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid), and esomeprazole (Nexium) - and looked at whether this was associated with ischemic stroke risk.

Overall, the team found that patients were at 21 per cent greater risk of ischemic stroke when they were using PPIs, compared with when they were not using the drugs.

There was little or no greater risk of stroke with low doses of PPIs, the researchers report, and another group of medications used to treat heartburn - called H2 blockers - were not linked to increased stroke risk.

Looking at stroke risk among the highest doses of each of the four PPIs, the researchers found lansoprazole fared worst, increasing the risk of ischemic stroke by 94 percent.

The researchers accounted for a number of possible confounding factors, including age, gender, high blood pressure, arterial fibrillation, and use of medications that have been linked to poorer cardiovascular health.

Because the study is purely observational, the researchers are unable to prove cause and effect between PPI use and increased stroke risk. Still, they believe the results suggest patients should be cautious about using the drugs, many of which are now available over the counter.

“At one time, PPIs were thought to be safe, without major side effects. This study further questions the cardiovascular safety of these drugs.”

Dr Thomas Sehested

Dr Sehested notes that doctors should also apply caution when deciding whether to prescribe PPIs to patients and for how long. “We know that from prior studies that a lot of individuals are using PPIs for a much longer time than indicated, which is especially true for elderly patients,” he adds.  The team concludes that a randomized, controlled trial of the association between PPI use and the risk of cardiovascular disease is needed.