Proton pump inhibitors may increase risk of first stroke

Data from 244,679 patients that had undergone endoscopy show that stroke incidence was 19% higher in patients who filed a prescription for a PPI compared with those with no PPI exposure

MRI showing intracerebral haemorrhage

Proton pump inhibitors (PPIs) have previously been linked to an increased risk of heart attack and vascular dysfunction.

To explore if PPI use could also be associated with stroke risk, researchers from the Danish Heart Foundation in Copenhagen studied national registry data for 244,679 patients over 30 years of age who had undergone endoscopy between 1997 and 2012 and had no history of cardiovascular disease.

Overall, 9,489 patients had a first stroke during nearly six years of follow-up. The stroke incidence rate was 19% higher among the 44% of patients who filed a prescription for a PPI compared with those who had no exposure to the drug class.

The team, who reported their preliminary results at the American Heart Association’s Scientific Sessions[1]
in New Orleans, Louisiana, says that given the widespread use of PPIs globally, further research into their cardiovascular safety is warranted. 


[1] Sehested TS, Fosbøl EL, Hansen PW et al. Proton pump inhibitor use increases the associated risk of first-time ischemic stroke: a nationwide cohort study. Presented at the American Heart Association’s Scientific Sessions; 13–15 November 2016; New Orleans, Louisiana. Abstract available from: 

Last updated
Clinical Pharmacist, CP, January 2017, Vol 9, No 1;9(1):DOI:10.1211/PJ.2016.20202126

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