A team of researchers from Houston Methodist Research Institute reported that chronic use of proton pump inhibitors (PPIs) may accelerate vascular aging, which can lead to greater cardiovascular disease, vascular dementia, and renal failure. Findings from the study are published in Circulation Research. 

PPIs are common over-the-counter drugs used to manage gastroesophageal reflux disease (GERD), heartburn, and other disorders. These drugs are not approved for chronic use and some reports suggest that nearly 70% of PPI use may be inappropriate. In addition, recent data suggested that PPI use was linked to cardiovascular, renal, and neurological morbidity. John P. Cooke, MD, PhD, and colleagues set out to study the long-term effects of PPIs on endothelial dysfunction and senescence, and to study the mechanism involved in PPI-induced vascular dysfunction. 

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When human endothelial cells were exposed to PPIs over a period of time, the study authors saw an accelerated aging of the cells. The PPIs also decreased acidity in the lysosomes of these cells, which are acid-dependent in order to function properly. In addition, chronic PPI exposure accelerated endothelial senescence by reducing telomere length. “We observed cellular garbage accumulating in the endothelial cells, which sped up the aging process,” observed Dr. Cooke.  

The study findings may be the “unifying mechanism that explains the higher risk of renal failure, dementia, and heart attack seen in chronic PPI users,” concluded Dr. Cooke. “We urgently need studies to assess the impact of long-term use of these drugs on vascular health in a broad patient population. We also need to consider if these drugs should be so accessible without medical supervision.”

For more information visit circres.ahajournals.org.