BY QUINN PHILLIPS | MARCH 6, 2023
People with type 2 diabetes who take a proton pump inhibitor (PPI) drug for acid reflux (gastroesophageal reflux disease, or GERD) are at greater risk for cardiovascular disease and death, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.
Proton pump inhibitors are a widely used group of drugs to treat acid reflux (heartburn) and include both prescription and over-the-counter (OTC) options. Some of the most widely used PPIs include Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), and Protonix (pantoprazole). Previous research on the link between diabetes and PPIs offers a somewhat mixed bag of results — one study shows that taking these drugs may help with blood glucose control in people with diabetes, while another showed that these drugs are linked to an increased risk of developing type 2 diabetes. It’s possible, of course, that at least some of the benefits of taking these drugs aren’t specific to the drugs themselves — and are instead due to a reduced incidence of acid reflux. There are other potentially effective ways to help control acid reflux, including lifestyle measures like being physically active, not smoking, limiting your caffeine intake, and following a generally healthy diet.
For the latest study, researchers looked at the relationship between taking a PPI and various cardiovascular and mortality outcomes in a group of 19,229 adults with type 2 diabetes. During a follow-up period that lasted a median of 10.9 to 11.2 years (depending on the outcome researchers looked at), there were 2,971 new cases of coronary artery disease (CAD), 1,827 heart attacks, 1,192 new cases of heart failure, and 738 strokes among study participants, along with 2,297 deaths from all causes.
PPIs linked to a variety of increased risks
The researchers found that taking a PPI was linked to a 27% higher risk of developing coronary artery disease, a 34% higher risk of having a heart attack, a 35% higher risk of developing heart failure, and a 30% higher risk of dying from all causes. There was no significant link between taking a PPI and the risk for stroke. These results remained consistent when the researchers looked at smaller groups of participants, including based on why they were prescribed a PPI, what diabetes drugs they took, and whether they took an antiplatelet drug to help reduce the risk for blood clots.
“Our data suggest that PPI use is associated with higher risks of [cardiovascular] events and mortality among patients with [type 2 diabetes],” the researchers concluded. “The benefits and risks of PPI use should be carefully balanced among patients with [type 2 diabetes], and monitoring of adverse [cardiovascular] events during PPI therapy should be enhanced.”
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