Proton pump inhibitors (PPI) are widely used medications for gastrointestinal disorders. Recent research suggests a potential association between long-term PPI use and increased cardiovascular (CV) risk, creating a complex clinical dilemma. This review critically evaluates the current evidence for this association, considering the limitations of observational studies and the lack of definitive confirmation from randomized controlled trials.This review delves into the reported association between PPIs and adverse CV events, examining proposed mechanisms such as drug interactions, electrolyte imbalances induced by PPIs and their potential impact on cardiac and vascular function. Evidence suggests these mechanisms converge, with varying influence depending on patient populations.Clinicians require a risk-benefit analysis for each patient considering their CV risk profile. Alternative gastrointestinal therapies should be explored for high-bleeding risk patients. Medications with lower cytochrome-P450 interaction potential may be preferable among essential PPI users. Elucidating the specific mechanisms by which PPIs might influence CV health, assessing long-term vascular effects and investigating interactions with newer anticoagulant medications are crucial for future research.
Keywords: CAD; CVD; PPI; Torsades de pointes; cardiovascular risk; electrolytes; magnesium; ventricular arrhythmia.
Proton pump inhibitors (PPIs) are commonly used medications for gastrointestinal problems. However, recent studies have shown that long-term use of PPIs might increase the risk of heart problems. While this link hasn't been definitively proven, it's important to be aware of it.Researchers think that several factors could contribute to this increased risk. PPIs might interact with other medications, cause electrolyte imbalances, or affect the way the heart and blood vessels work through multiple mechanisms.Doctors need to carefully weigh the benefits of PPIs against the potential risks for each patient. For people at high risk of heart problems, alternative treatments might be better. If someone requires a PPI due to increased risk of gastrointestinal bleeding, providers need to take into account concurrent medications and carefully select those with the least risk of interactions.Future research should focus on understanding how PPIs might impact the heart and blood vessels in the long term, especially considering the increasing use of newer blood-thinning medications.