Objective: To examine associations of cumulative exposure to proton pump inhibitors (PPIs) with total cardiovascular disease (CVD; composed of stroke, coronary heart disease, and heart failure [HF]) and HF alone in a cohort study of White and African American participants of the Atherosclerosis Risk in Communities (ARIC) study. Methods: Use of PPIs was assessed by pill bottle inspection at visit 1 (January 1, 1987 to 1989) and up to 10 additional times before baseline (visit 5; 2011 to 2013). We calculated cumulative exposure to PPIs as days of use from visit 1 to baseline. Participants (n=4346 free of total CVD at visit 5; mean age, 75 years) were observed for incident total CVD and HF events through December 31, 2016. We used Cox regression to measure associations of PPIs with total CVD and HF. Results: After adjustment for potential confounding variables, participants with a cumulative exposure to PPIs of more than 5.1 years had a 2.02-fold higher risk of total CVD (95% CI, 1.50 to 2.72) and a 2.21-fold higher risk of HF (95% CI, 1.51 to 3.23) than nonusers. Conclusion: Long-term PPI use was associated with twice the risk of total CVD and HF compared with nonusers. Our findings are in concordance with other research and suggest another reason to be cautious of PPI overuse.
Bibliographical noteFunding Information:
Grant Support: Dr Bell was supported by the NIH T32 Training Grant HL07111-40 and by Optum . Ms Rooney was supported by the NIH T32 Training Grant HL007779. The ARIC study was funded by the National Heart, Lung, and Blood Institute under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I.
Grant Support: Dr Bell was supported by the NIH T32 Training Grant HL07111-40 and by Optum. Ms Rooney was supported by the NIH T32 Training Grant HL007779. The ARIC study was funded by the National Heart, Lung, and Blood Institute under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I.Potential Competing Interests: Dr Bell is currently an employee of Optum. AstraZeneca, Astellas, Celgene, EMD Serono, Novartis, and Sandoz have provided funding to Dr Bell for oncology studies, and Pfizer has provided funding to Dr Bell for a study on ulcerative colitis.
© 2021 Mayo Foundation for Medical Education and Research
PubMed: MeSH publication types
- Journal Article