Study Highlights: 
 
 A commonly used heartburn medication caused blood vessel cells to age faster in laboratory testing. 
 
 These findings could help explain recent reports linking long-term use of heartburn medication to several serious illnesses, including heart disease, kidney disease and dementia. 
 
 Clinical studies still are necessary to determine if the drugs damage blood vessel cells within the body. 
 
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 DALLAS, May 10, 2016 — A popular over-the-counter medication for heartburn, caused laboratory blood vessel cells to age quicker, according to new research in Circulation Research, an American Heart Association journal. 
 
 Reflux, often called heartburn, occurs when stomach acid backs up into the esophagus, causing irritation and damage. Mild reflux is fairly common, but frequent, severe occurrences, known as GERD for gastroesophageal reflux disease, can cause significant discomfort and may require treatment. Many people find relief by using over-the-counter medications called proton pump inhibitors (PPIs), which reduce acid produced by the stomach. In fact, the U.S. Food and Drug Administration estimates that 1 in 14 Americans have used PPIs. 
 
 After recent evidence linking long-term PPI use to several serious illnesses, including heart disease, kidney disease and dementia, researcher sought to identify how PPIs increase risk by studying their effects on blood vessel cells. 
 
 Now, researchers at Houston Methodist Research Institute (HMRI) say they have discovered that long term exposure to PPIs “accelerated biological aging in human endothelial cells which line the inside of blood vessels. When healthy, human endothelial cells create a Teflon-like coating that prevents blood from sticking. When older and diseased, the endothelium becomes more like Velcro, with blood elements sticking to the vessel to form blockages.” 
 
 They also found that long-term PPI exposure impairs acid production by the lysosomes in the cells lining the blood vessel walls. They noted that the lysosome — the part of the cell that typically clears waste products — did not produce enough acid to clear waste. In turn, the buildup of waste caused the cell to age rapidly. Notably, another type of antacid known as an H2 antagonist, did not have this adverse effect. 
 
 “Lysosomes are like the garbage disposal of cells,” said John P. Cooke, M.D., Ph.D., study lead author and professor and chair of the Department of Cardiovascular Sciences at the HMRI and director of the Houston Methodist Research Institute Center for Cardiovascular Regeneration in Texas. “They need to generate acid to get rid of cellular rubbish, and when cellular rubbish accumulates the cells age faster.” 
 
 Although PPIs can be effective for short-term use, they are not meant for extended treatment, researchers said. PPIs do not require a prescription or doctor’s supervision, which can lead to overuse. 
 
 “With the knowledge that PPIs are being used by millions of people for indications and durations that were never tested or approved, it may be time for the pharmaceutical industry and regulatory agencies to re-visit the specificity and the safety of these agents,” Cooke said. “Unless otherwise indicated, physicians should consider PPIs only for short-term use for relief of symptoms of GERD, since we now have a ‘smoking gun’ that helps explain the consistent observational evidence of increased risk.” 
 
 Cooke added that there are other approaches to long-term treatment that might be considered for GERD including H2 antagonists, lifestyle modifications, and in severe cases, surgical approaches. 
 
 The current one has several limitations. Although two different PPIs were tested, only one of these esomeprazole (brand name Nexium) is commercially available. In addition, it did not show how PPIs actually impair the lysosome’s ability to produce enough acid to clear waste. Finally, since this study was in a laboratory setting, it could not show whether PPIs act in the same way within the human body, and long-term clinical trials are necessary. 
 
 Co-authors are Gautham Yepuri, Ph.D.; Roman Sukhovershin, Ph.D.; Timo Z. Nazari-Shafti, M.D.; Michael Petrascheck, Ph.D. and Yohannes T. Ghebre, Ph.D. Author disclosures are on the manuscript. 
 
 The National Institute of Health and the Swiss National Science Foundation funded the study. 
 
 Additional Resources: 
 
 Researcher photo, medication images, and heart graphic are located in the right column of this release link http://newsroom.heart.org/news/heartburn-drug-damages-blood-vessel-cells-in-lab-finding?preview=9c99da54e21c70a1a941c9610398ecef 
 
 Heartburn or heart attack? 
 
 Follow AHA/ASA news on Twitter @HeartNews. 
 
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 Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. 
 
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 heart.org and strokeassociation.org ||||| Millions of Americans take proton pump inhibitors to treat acid reflux and heartburn. Known as PPIs, they are among the most prescribed drugs in the United States and are widely available over the counter. 
 
 But according to preliminary research presented today at an American Heart Association conference in New Orleans, these medications may also increase the risk of ischemic stroke 
 
 Ischemic strokes are the most common type of stroke, according to the Centers for Disease Control and Prevention . They occur when a blood clot cuts off blood flow to the brain. 
 
 "PPIs have been associated with unhealthy vascular function, including heart attacks, kidney disease and dementia," said Dr. Thomas Sehested, the study's lead author and a researcher at the Danish Heart Foundation . "We wanted to see if PPIs also posed a risk for ischemic stroke, especially given their increasing use in the general population." 
 
 Most serious warning yet 
 
 Protonix, The research was conducted in Denmark among a quarter-million patients who suffered from stomach pain and indigestion, and were taking one of four PPIs: Prilosec Prevacid or Nexium 
 
 Overall stroke risk increased 21% among patients who were taking a PPI, according to the study. At the lowest doses, the authors found either no or minimal increased risk of stroke. At the highest doses, they found that stroke risk increased 33% for Prilosec and Prevacid patients, 50% for Nexium patients and 79% for Protonix patients. 
 
 In an email to CNN, P&G, the company that makes Prilosec, said the drug is an "FDA approved, safe and effective remedy to relieve frequent heartburn symptoms. Prilosec OTC has the longest history of safe and effective consumer use of any [over the counter] PPI." 
 
 Takeda, the maker of Prevacid, said it could not comment on the results and conclusions of the study until the full data is published for review. "Patient safety is a top priority ... and we continuously monitor the safety of all our medicines and collaborate with regulatory agencies to ensure this information is reflected in the respective prescribing information," a spokesman said in an email to CNN. 
 
 AstraZeneca, the maker of Nexium, said, "Patient safety is an important priority ... and we believe all of our PPI medicines are generally safe and effective when used in accordance with the label." A spokeswoman said the company was not consulted during the research, so it could not comment on the data. 
 
 Pfizer, the maker of Protonix, did not respond to CNN's request for comment. 
 
 "At one time, PPIs were thought to be safe, without major side effects," Sehested said. "This study further questions the cardiovascular safety of these drugs." 
 
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 A pair of 2010 studies found that PPIs were associated with an increased risk of a serious bacterial infection . Stomach acid seems to play a role in killing off both good and bad bacteria in our gut. When someone is taking PPIs, their amount of stomach acid is reduced, and it creates an environment in which bacteria can flourish. 
 
 "As a culture, we tend to want a pill to deal with our problems, when a lot of people could reduce their heartburn by eating smaller meals, drinking less alcohol or not smoking," Dr. Michael Katz, who wrote an editorial accompanying the studies, told CNN in 2010 
 
 In April, another study published in the Journal of the American Society of Nephrology found that patients who took PPIs had a 96% increased risk of kidney failure and a 28% increased risk of kidney disease, compared with those who were prescribed alternative medications. 
 
 What are the alternatives? 
 
 Medical professionals estimate that the majority of people who suffer from acid reflux or heartburn could drastically or completely reduce their discomfort by making a few lifestyle changes: quit smoking, lose weight and cut back on spicy and fatty foods. 
 
 If your doctor determines that you do need pills for your problem, pharmacist NaaDede Badger-Plange suggests starting with an antacid , such as Tums, Rolaids or Maalox. 
 
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 "Antacids usually would help if you have less than one incident a week," Badger-Plange said . "So, if you have heartburn very rarely -- especially people who have heartburn associated with certain foods -- they could take antacids." 
 
 Antacids provide quick relief, but only for a short amount of time, said Badger-Plange, and consumers should pay close attention to the ingredients on the label. If you're pregnant, you should avoid sodium bicarbonate and magnesium trisilicate. Patients with kidney disease should avoid antacids that contain aluminum. 
 
 For longer-lasting relief, H2 antagonist medications (also called H2 blockers) are also an option, but they can take a few hours to kick in. 
 
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 "One thing to keep in mind is, certain products that are in the H2 receptor antagonist class have drug interactions," Badger-Plange said. "So, if you have a lot of medications, you probably want to check with your pharmacist at the counter to make sure it's OK to take those medications." 
 
 As always, you should talk to your doctor before starting or stopping any medication -- prescribed or over the counter. 
 
 For years, Katz has been worried that PPIs "reinforce the idea that the solution to behavioral health issues is to take a pill, and that's just not how we're going to get healthier," he said in 2010. "Consumers need to ask their doctors, 'Why am I taking this? Do I still need this? Do I have an alternative?' "
– Heartburn is a big problem in the US. In fact, proton pump inhibitors (PPIs), which are used to treat acid reflux and heartburn, are among the most prescribed drugs in the country, with millions taking them, and they're becoming more widely available over-the-counter, reports CNN. But a preliminary report just released by the American Heart Association is concerned that the drug—already associated with a higher risk of heart attack and other vascular problems, as the AHA reported earlier this year—may also increase one's risk of ischemic stroke, the most common type caused when a clot cuts off blood flow to the brain. "At one time, PPIs were thought to be safe, without major side effects," the study's lead author says. “This study further questions the cardiovascular safety of these drugs." Researchers followed nearly a quarter-million patients in Denmark who were suffering from stomach pain and indigestion and had an endoscopy. Their average age was 57, and six years later those taking one of four PPIs (Prilosec, Protonix, Prevacid, or Nexium) had a 21% higher risk of stroke than those not taking one. Lowest-dose PPIs didn't increase the risk much if at all, while highest-dose increased it, from 30% for Prevacid to 94% for Protonix. Another type of acid-lowering meds called H2 blockers (think Pepcid and Zantac) showed no elevated risk. "As a culture, we tend to want a pill to deal with our problems, when a lot of people could reduce their heartburn by eating smaller meals, drinking less alcohol, or not smoking," one doc told CNN in 2010. (PPIs are also associated with a higher risk of dementia.)