KATHMANDU — Popular heartburn — medically as gastroesophageal reflux disease (GERD) — medications like Nexium, Pantoprazole, Omeprazole, Lansoprazole, Esomeprazole or Prevacid may increase your risk of early death when taken for extended periods, a new study has warned.
Further, the longer you take these drugs, known as proton pump inhibitors (PPIs), the greater your risk of early death, said senior researcher Dr. Ziyad Al-Aly, a kidney specialist and assistant professor of medicine with the Washington University School of Medicine, in St. Louis.
“There was a relationship between duration of use and risk of death,” Al-Aly said adding “More prolonged use was associated with even higher risk.”
The study, published online on July 3 in the journal BMJ Open, found that people taking PPIs for a year or more had a 51 percent increased risk of premature death, compared with 31 percent for people on the drugs for six months to a year, and 17 percent for three-to six-month users.
That said, Al-Aly pointed out that some patients really do need to take PPIs to deal with medical issues, even long-term.
“Proton pump inhibitors actually save lives,” Al-Aly said. “We don’t want to leave people with a scary message. If you need this drug and you’re under guidance of a doctor, you should continue to take your medication until otherwise advised.”
Short-term use of PPIs — up to 90 days –however, did not appear to affect death risk, the findings showed.
PPIs work by blocking the enzyme system that produces stomach acid. PPIs have become one of the most commonly used classes of drugs in the United States, with 15 million monthly prescriptions in 2015 for Nexium alone, the researchers said.
However, concerns about the drugs’ safety have been growing in recent years, as studies have linked PPIs to kidney disease, heart disease, pneumonia, bone fractures and dementia.
To take a broad look at PPIs and whether they increase a person’s chances of premature death, Al-Aly and his colleagues compared the medical records of nearly 276,000 users of PPIs against those of about 73,000 people who took another class of heartburn drug called H2 blockers.
Overall, PPI users have a 25 percent increased risk of premature death compared with people taking H2 blockers (such as Pepcid or Zantac), the investigators found.
The researchers calculated that for every 500 people taking PPIs for a year, there is one extra death that would not have occurred otherwise, Al-Aly said.
“This finding is certainly cause for concern and something that should be considered as doctors continue to prescribe PPIs at a high rate and often fail to discontinue these drugs in a timely fashion,” said Dr. Louis Cohen. He is an assistant professor of gastroenterology with the Icahn School of Medicine at Mount Sinai, in New York City.
At the same time, Cohen noted that people taking PPIs also tend to have many other health problems, and these might influence their risk of death as well.
No one is sure why PPIs might cause all these health problems or increase risk of early death, Al-Aly said. It is possible the drugs might cause cellular or genetic damage.
Even though this study could not prove a direct cause-and-effect relationship, Al-Aly noted that the increased risk with longer duration adds weight to concerns over the drugs’ safety.
“Why would prolonged use be associated with higher risk if there were no real relationship between exposure and untoward outcomes?” he said.
Recommended treatment regimens for most PPIs are relatively short, the researchers said. For example, people with ulcers are advised to take the drugs for only two to eight weeks.
But since the drugs are available over-the-counter, many people take PPIs for months or years to manage heartburn or acid reflux, Al-Aly said.Follow @gorkhapost
Drinking 3 cups of coffee or tea daily may keep stroke risk at bay
KATHMANDU — There have been several conflicting studies on the health benefits of drinking coffee and tea and their various varieties. But drinking up to three cups of coffee or tea in a day is safe because it reduces irregular heartbeat and stroke risk, according to a new study published in the journal JACC: Clinical Electrophysiology.
Coffee has previously been believed to worsen abnormal heart rhythms, as doctors generally discourage patients suffering from the condition. However, the results of this particular study say that a daily consumption of upto 300 mg of caffeine may be safe for arrhythmic patients.
This is because the caffeine acts as a stimulant to the central nervous system and blocks the effect of adenosine. Adenosine is a chemical which causes Atrial Fibrillation (AFib).
A single cup of coffee contains about 95 mg of caffeine. It acts as a stimulant to the central nervous system and works to block the effects of adenosine — a chemical that causes AFib.
AFib is the most common heart rhythm disorder, causes the heart to beat rapidly and skip beats, and if left untreated, can cause strokes.
“There is a public perception, often based on anecdotal experience, that caffeine is a common acute trigger for heart rhythm problems,” said lead author Peter Kistler, Director at Melbourne’s Alfred Hospital.
But, “caffeinated beverages such as coffee and tea have long-term anti-arrhythmic properties mediated by antioxidant effects and antagonism of adenosine,” he added.
A meta-analysis of 228,465 participants showed that AFib frequency decreasing by 6 per cent in regular coffee drinkers, and an analysis of 115,993 patients showed a 13 per cent reduced risk.
Another study of 103 post-heart attack patients who received an average of 353 mg of caffeine a day showed improvement in heart rate and no significant arrhythmias — or abnormal heart rhythms, that cause the heart to beat too fast, slow or unevenly.
However, in two studies, where patients drank at least 10 cups and nine cups of coffee per day, showed an increased risk for ventricular arrhythmias (VAs) – a condition in which the lower chambers of the heart (ventricles) beat very quickly.
On the other hand, patients with pre-existing heart conditions who consumed two or more energy drinks — that contains concentrated caffeine — per day reported palpitations within 24 hours.
With Agency InputsFollow @gorkhapost