PPI kidney risks have been joined by a new risk in a recent study that showed PPI drugs may lead to cardiovascular death.

According to US News and World Report, a new study conducted by researchers as the Washington University School of Medicine shows that individuals may face an increased risk of dying due to heart disease, PPI kidney failure, and stomach cancer if they take proton pump inhibitor drugs.

Proton pump inhibitor (PPI) drugs are prescribed to treat numerous gastrointestinal conditions such as acid reflux, stomach ulcers, and more. These medications reduce the amount of stomach acid produced by the stomach which can help with numerous conditions. Common PPI drugs available both by prescription and over the counter include:

• Nexium (esomeprazole)
• Aciphex (rabeprazole)
• Zegerid (omeprazole/sodium bicarbonate)
• Dexilant (dexlansoprazole)
• Prevacid (lansoprazole)
• Prilosec (omeprazole)
• Protonix (pantoprazole)

Using data from the U.S. Department of Veterans Affairs records, researchers examined the information of 157,625 patients who had been prescribed PPI drugs and 56,842 patients who had been treated with H2 blockers, another class of antacid medications that includes drugs such as Zantac, Pepcid, and Tagamet.

Analysis of this data revealed that individuals who took PPI drugs were statistically more likely to die from stomach cancer, kidney failure, or heart disease when compared to the H2 blocker population. 88.7 in every 1,000 PPI patients reportedly died from cardiovascular risk while only 73.3 died from cardiovascular risk for every 1,000 H2 patients.

From kidney disease, the PPI patients reportedly saw 8.6 deaths for every 1,000 people while only 4.4 H2 patients died from kidney disease out of every 1,000 individuals.

In total, the researchers concluded that there would be 45.2 excess deaths for every 1,000 patients taking PPI drugs. As the duration of PPI treatment increased, the risk for death reportedly increased regardless of how low the dosage is.

Another shocking fact revealed by the study is that many of the patients in the study had used PPI prescriptions without any sort of documented need in their medical history. Lead researcher Dr. Ziyad Al-Aly, who serves as an assistant professor at Washington University, called these results “unsettling.”

“It suggests a lot of people were using a PPI without actually needing one,” he said. “They could be taking a risk without deriving any benefit.”

PPI drugs have been repeatedly critiqued as overprescribed. One doctor’s opinion published in Clinical Pharmacist in August 2016 states that PPI drugs may be prescribed without a clear indication in “up to 70% of cases.”

Doctors have spoken out against the practice of overprescribing, stating that the risks posed by repeated, long term use outweigh any benefits of prescribing PPI drugs without a good reason.

“The totality of the results suggests the need to avoid proton pump inhibitors when not medically indicated; for those who have a medical indication for PPIs, use should be limited to the lowest effective dose and shortest duration possible,” Al-Aly wrote in a BMJ blog along with Yan Xie, a biostatician from the St. Louis Health Care System’s Department of Veteran Affairs.