Long-term use of certain drugs for heartburn and gastroesophageal reflux (GERD) may accelerate the aging of blood vessels. This process has been linked to increased cardiovascular disease, vascular dementia, and renal failure. A paper with detailed results was published Tuesday in an American Heart Association journal.

GERD is a condition in which food or liquid flows up from the stomach to the esophagus, said MedlinePlus from the U.S. National Library of Medicine. It is commonly treated with proton pump inhibitors (PPIs) such as esomeprazole.

Heartburn and acid indigestion are very common, affecting more than half of all Americans at least once a month. Image courtesy of Organic Life Style Magazine

PPIs reduce the amount of acid made by glands in the lining of the stomach. These drugs are sold over-the-counter, at drugstores in the United States. They are effective when taken as indicated, the study added. Its use does not require medical surveillance. 

Nonetheless, 70 percent of PPI use may be inappropriate, said researchers at the Houston Methodist Research. They suggested that long-term exposure to PPIs is linked to accelerated biological aging in human endothelial cells, which cover the inside of blood vessels.

Endothelial cells of healthy humans build a Teflon-like coating that impedes blood from sticking, said, researchers. As people age and get diseases, the coating of the endothelium changes. As a result, blood elements stuck to the vessels begin forming obstructions.

Which is the impact of long-term use of proton pump inhibitors?

The paper’s senior author John Cooke, M.D., Ph.D., said that researchers have exposed human endothelial cells, to PPIs. They noted accelerated aging of those cells, he added in a press release issued Tuesday.

“The PPIs also reduce acidity in lysosomes of the endothelial cell. The lysosomes are like cellular garbage disposals and need acid to work properly. We observed cellular garbage accumulating in the endothelial cells, which sped up the aging process.” said Cooke.

A theory proposes that this “unifying mechanism” may account for the increased risk of heart attack, renal failure, and dementia, in patients who take proton pump inhibitors chronically. These medications do not negatively affect the heart and blood vessels when taken for a few weeks.

Cook said physicians “urgently” need new studies, to better understand the impact of long-term use of drugs, on vascular health. He also called for discussion, whether proton pump inhibitors such as esomeprazole should be accessible without a prescription.

The U.S. Food & Drug Administration calculates that one out of four Americans have used a proton pump inhibitors. In 2009, PPIs were the third-most taken type of drug in the country, said, researchers. 

Sales of PPIs generate an estimated  $13 billion in annual global sales. These drugs are also used to treat disorders such as infection by the ulcer-causing bacterium Helicobacter pylori, Zollinger-Ellison syndrome, and Barrett’s esophagus wrote researchers.

Source: Houston Methodist Research Press Release