PPI Use Linked to Elevated Mortality Risk

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Use of proton pump inhibitors (PPIs) is associated with increased risk for death from certain conditions, according to a study in The BMJ.

Using Veterans Affairs records, researchers compared mortality outcomes between 158,000 adults who were newly prescribed a PPI for more than 90 days and 57,000 newly prescribed a histamine-2 blocker.

During a median 10 years' follow-up, 37% of participants died. There were 46 excess deaths per 1000 PPI users in that time. PPIs were associated with excess mortality from cardiovascular disease (CVD) and chronic kidney disease (CKD). Patients without indications for PPI use had higher mortality risk from CVD, CKD, and also upper gastrointestinal cancer. Longer duration of use was associated with greater risk.

The authors conclude: "Because of the high prevalence of PPI use, the findings have public health implications and underscore the important message that PPIs should be used only when medically indicated and for the minimum duration necessary."