By Helly Bartolome Hernandez Marin, M.D.
Society is accustomed to taking medications to relieve a headache, muscle pain, an upset stomach, and even a nervous breakdown.
The problem is that, after this rapid and effective solution, the adverse effects of entering an agent external to the human body usually appear.
In this context, there is a group of drugs that many users consume on a regular basis and that are capable of significantly increasing the risk of premature death: proton pump inhibitors (PPI).
These medications are frequently used for the treatment of heartburn, gastroesophageal reflux, and gastroduodenal ulcers. PPIs, which are sold under brand names such as Prevacid, Prilosec, Nexium, and Protonix, are among the most widely used drugs in the United States. It is estimated that more than 20 million Americans consume these medications indefinitely.
A study recently published in the BMJ links the prolonged use of proton pump inhibitors with an increased risk of premature death. In addition, it was evidenced that the longer these drugs are taken, even in low doses, the greater the risk of early death.
"There was a relationship between the duration of use, and the risk of death, a more prolonged use (months or years) was associated with an even higher risk. of long-term PPI, "said lead researcher Dr. Ziyad Al-Aly, a kidney specialist and assistant professor of medicine at the University of Washington School of Medicine in St. Louis.
Previous research conducted at the University of Washington School of Medicine has linked PPI consumption to health problems such as kidney failure, fractures, pneumonia, dementia, vascular diseases; among others.
Thousands of deaths
For the study, the researchers reviewed the medical records of the U.S. Department of Veterans Affairs. In assessing the medical data acquired between July 2002 and June 2004, the researchers identified 157,625 people, mostly white men over 65, who took PPIs, and 56,842 people taking another class of antacids such as H2 blockers. A follow-up of these patients (214,467 in total) was maintained for ten years.
The researchers showed that patients taking PPIs had a 17 percent increase in the risk of death compared to the H2 blocker group. Mortality rates for PPIs were 387 per 1,000 people, and death rates for H2 blockers were 342 per 1,000. This shows an excess of deaths (45) in patients taking PPIs. The most common causes of death among those who took these medications were heart disease, kidney disease, and gastric cancer. These results take on greater significance if we take into account the millions of people who consume PPIs, which translates into thousands of deaths each year that could be avoided.
An interesting finding of the researchers was that half of the people included in the study took PPI without any proven medical reason. In this group of patients, deaths related to PPIs were more frequent.
"The most alarming thing for me is that the people most affected by the use of PPIs do not require these medications," Al-Aly said.
The study also found that more than 80 percent of PPI users took low doses of these medications. This suggests that the risk of death is not dose-dependent and that even the use of low doses has deleterious effects on the health of people in the long term.
The Food and Drug Administration of the United States has expressed special concern about this situation and urges commercial companies to have a clearer warning about the risk involved in using PPIs in the long term, as well as to recommend the use of these medications for a period no longer than 14 days.
The Al-Aly research team will continue to study the adverse health effects related to PPIs, particularly concerning those at higher risk.
"People who are taking PPIs unnecessarily are exposed to potential harm when it is unlikely that the drugs are benefiting their health. Our study suggests the need to avoid PPIs when they are not medically necessary. For those who have a medical need, the use of PPI should be limited to the lowest effective dose and the shortest possible duration, "said Al-Aly.