Proton pump inhibitors (PPIs) can be a miracle drug for the 15 million Americans who experience heartburn every day. These drugs target the acid-producing enzyme in the stomach wall to reduce the production of stomach acid and prevent the occurrence of reflux. PPIs are among the highest selling classes of drugs in the United States with over-the-counter and prescription sales totaling nearly $13 billion annually, but research shows that these medications could come at a much higher cost.
New findings published in the journal Circulation Research suggest that PPIs accelerate vascular aging, which could explain why these drugs have been linked to dementia, heart disease and renal failure. John P. Cooke, chair of cardiovascular disease research at the Houston Methodist Research Institute, authored a study in which he and his colleagues exposed endothelial cells – the cells which form the lining of the blood vessels – to the popular PPI Nexium, an additional PPI and an H2 blocker. Over the course of a few weeks, the researchers noted that the cells exposed to PPIs developed a “fried egg” appearance.
To verify the aging effects of PPIs, Cooke and his colleagues used a stain called beta-galactosidase to identify age markers in the cells. They also examined lysosomes and telomeres, both of which can indicate vascular aging. The cells exposed to H2 blockers showed no signs of vascular aging, but the cells exposed to PPIs had impaired lysosomes and shortened telomeres.
This is not the first study Cooke has conducted to evaluate the effects of PPIs on the body. In 2013, he assisted in research which found that PPIs appear to decrease nitric oxide in endothelial cells, which can negatively impact cardiovascular health. Cooke also authored a 2015 study which found that long-term PPI use increases the risk of heart attack by 20 percent.
“I’m perplexed that the pharmaceutical industry didn’t run across this first,” said Cooke. “This is something that should have been apparent a long time ago and should have been investigated.”
While Cooke does not believe that PPIs should be removed from the market entirely, he does suggest that doctors and regulators take additional steps to ensure proper usage among patients. Approximately one out of every 14 Americans uses an over-the-counter PPI to control acid reflux symptoms, and up to 70 percent of PPI use does not fall within FDA guidelines.
Cooke and his team intend to continue their research with a prospective, randomized trial (Source: Fox News).