Proton pump inhibitors and heart attack: the risks of omeprazole for the heart

By Cristiano Antonino On Feb 28, 2023

Taking proton pump inhibitors increases the risk of myocardial infarction: omeprazole and antacid medications are a commonly prescribed class of drugs that are very effective, especially in the long-term treatment of gastroesophageal reflux disease, but may have side effects for the heart

Omeprazole and antacid drugs: risks for the heart

A US study published in Plos One assessed the association between long-term intake of these drugs and the risk of acute cardiological events, particularly myocardial infarction.

The work showed a 16% increased risk of heart attack in patients on the drugs and a twofold increase in mortality from acute cardiovascular events.

It is true, the authors acknowledge, that the association could select a subgroup of patients already at increased risk of cardiovascular disease, but this association was not observed in patients on so-called anti H2 drugs, i.e. cimetidine derivatives, thus indicating a specific association with proton pump inhibitors.

The mechanism is not known, but it would not seem to be related to an alteration in platelet aggregation but rather to the ability to inhibit an enzyme.

Using omeprazole with caution

The association, although present, was statistically weak and should not prompt a change in therapy in patients in whom the indication is correct.

However, it is one more reason not to abuse these drugs, which are so effective that they are now also sold as over-the-counter products that do not require a prescription, which, in my opinion, is a big mistake and an incentive to encourage their inappropriate use.