Proton pump inhibitors do not increase risk of ischaemic stroke
There appears to be no significant connection between the use of proton pump inhibitors (PPIs) and risk of ischaemic stroke, a recent study has shown.
The study included 68,154 females (mean age 65±7 years) recruited from the Nurses’ Health Study, and 28,989 males (mean age 69±8 years) from the Health Professionals Follow-up Study. All participants had no previous stroke incidents. Cox proportional hazards models were created to assess the association between incident stroke risk and PPI use.
Over the 12-year follow-up, 2,599 incident stroke cases were documented, most of which were in females (2,037 vs 562). The age-adjusted models showed that PPI users were at higher risk of ischaemic stroke than nonusers (hazard ratio [HR], 1.25; 95 percent CI, 1.08–1.46).
This relationship was attenuated and lost statistical significance after multivariable adjustments for smoking status, diet quality, alcohol use, aspirin and multivitamin use, and personal history, as well as further adjustments for several indications of PPI use (HR, 1.08; 0.91–1.27).
Likewise, PPI users and nonusers were at statistically comparable risks of developing total stroke (HR, 1.11; 1.00–1.24) or haemorrhagic stroke (HR, 1.00; 0.72–1.38).
The findings showed that in age-adjusted and multivariate models, the risk of ischaemic stroke was higher in PPI users. However, after accounting for factors that may be involved in the initiation of PPI therapy, the relationship was fully attenuated.
“Taken together, these data suggest that the association of PPI use with ischemic stroke may be due to residual confounding by factors associated with the indication for PPI use,” said researchers.