Could Proton Pump Inhibitors Increase Ischemic Stroke Risk?

Proton pump inhibitor (PPI) use is associated with increased risk of ischemic stroke, according to the results of a recent study.

Previous research has suggested a link between PPIs and endothelial dysfunction and increased myocardial infarction risk. Because of this, researchers hypothesized that use of the medications may also be associated with ischemic stroke.
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The researchers conducted a retrospective cohort study including 244,679 participants. Participants were excluded if they had prior cardiovascular disease at baseline.

Overall, roughly 44% of the participants filed prescriptions for a PPI. Compared with those not using PPIs, users tended to be older and have more comorbidities. During follow-up, 9489 instances of first-time stroke occurred. The researchers reported that they observed a dose-response relationship between PPI use and increased risk of ischemic stroke.

“In this nationwide cohort of patients undergoing gastroscopy, we found an association between use of PPIs and increased risk of first-time ischemic stroke and a positive dose-response relationship between PPI dose and stroke risk,” the researchers concluded.

“Considering the wide use of proton pump inhibitors worldwide, our study further questions the cardiovascular safety of these drugs and further studies are warranted.”

—Michael Potts

Reference:

Sehested TS, Fosbol EL, Hansen PW, et al. Proton pump inhibitor use increases the associated risk of first-time ischemic stroke. a nationwide cohort study [presented at the American Heart Association’s Scientific Sessions 2016]. Abstract 18462. November 12-16, 2016. New Orleans, Louisiana.