Health, Medical, Research, Science

Indigestion drugs linked to risk of heart attacks and strokes…

PROTON PUMP INHIBITORS (PPIs)

Common indigestion drugs used by millions of Britons could increase the risk of heart attacks and strokes, according to research.

Scientists said the drugs, called proton pump inhibitors, or PPIs, can trigger a dangerous rise in chemicals in the body linked with heart disease.

Patients with existing heart problems, such as angina, are at most risk, but healthy adults with no history of such complaints could also be affected, the researchers said.

The number of prescriptions for PPIs such as lansoprazole and omeprazole – sold over the counter as Zanprol – has doubled in recent years to more than eight million a year, costing the NHS around £400 million a year. The exact number of patients on the drugs is not known because some buy them over the counter (OTC) at high street chemists.

PPIs work by blocking the action of cells called proton pumps, which produce stomach acid. Although very effective, they should only be used for a maximum of two months and preferably for between two and four weeks.

But many patients quickly find they cannot live without them and ask for repeat prescriptions from their GP or buy them at the chemist. Previous studies identified a potential link between the drugs and heart problems, although scientists conceded there was no obvious explanation for the connection.

Now experts at the Methodist Hospital Research Institute in Houston, Texas, believe they have uncovered the reason why.

After studying samples of human heart tissue, as well as carrying out experiments on mice, they found that PPIs triggered an increase in a chemical called asymmetric dimethylarginine, or ADMA, produced as the body’s cells make proteins.

It can hinder blood flow by blocking the release of nitric oxide, a gas which helps arteries to stay flexible and healthy. The latest findings, published in the journal Circulation, show PPI medicines increase ADMA levels by about 25 per cent and reduce the ability of blood vessel walls to relax by more than 30 per cent.

In a report on their findings, the researchers said that several studies have raised concern that the use of PPIs in patients with acute coronary syndrome (heart disease) may increase their risk of major adverse events.

Dr John Cooke, who heads the research group, says that whilst a plausible biological explanation has now been found to explain this, also added that the ‘surprising effect still needs further investigation’.

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Health, Medical, Research

Statins can weaken muscles and joints…

New research warns that taking statins will make you more likely to be diagnosed with muscle pain, joint disease and injuries.

Researchers found a 20 per cent increased risk of muscle problems in those patients on the cholesterol-lowering drugs compared with those not taking them.

The risk is deemed to be relatively small but it is important because millions of older patients with heart conditions take statins and their use may eventually widen to include healthy younger people.

Statins are the most widely prescribed drugs in Britain. The number of patients taking them is estimated to be as high as 8 million. There have been persistent complaints about side effects such as muscle pain and weakness.

The most serious adverse reaction of taking statins is myopathy, and affects around one in every 1,000 users. The reactions include muscle pain, tenderness and weakness. This condition can progress to rhabdomyolysis, a complete breakdown of muscle cells that can lead to kidney failure and death.

In some patients muscle weakness may persist even after stopping the drugs. And a British Heart Foundation survey found that one in three patients prescribed statin drugs doesn’t take them, partly because of the side effects.

The latest study carried out in the United States investigated the scale of illnesses linked to statins, including muscle weakness, muscle cramps and tendon diseases.

Researchers based at the Veterans Association in North Texas, Dallas, used data from the US military health care system.

Patients were divided into two equal groups: 6,967 who used statins for at least 90 days in 2005, and 6,967 non-users.

A report published by JAMA internal medicine says that statin patients were almost 20 per cent more likely than non-users to have a diagnosis of a musculo-skeletal disease, a 13 per cent higher risk of dislocation, strain or sprain, and slightly higher risk of muscle pain.

But statin users were no more at risk of joint-diseases such as osteoarthritis than non-users. The report states: ‘To our knowledge, this is the first study to show statin use is associated with an increased likelihood of diagnoses of musculoskeletal conditions, joint diseases and injuries.’ (sic)

Calls have been growing for healthy over-50s to take statins, not just those at extra risk of a heart attack. The researchers also said that any significant effect on general health, however small, needs to be carefully considered. These findings are concerning because starting statin therapy at a young age for primary prevention of cardiovascular diseases has been widely advocated.

Warnings from statin drug manufacturers’ include muscle pain and weakness, memory loss, fatigue, sleep disturbances, sexual dysfunction and depression. There is also a higher risk of developing diabetes.

Scientists in the UK say the study shows a very small impact of statins, increasing the risk of musculoskeletal disorders overall from 85 per cent in those not on statins to 87 per cent on a statin.

The Royal Pharmaceutical Society fears that more patients might stop taking the drugs. Citing that the UK has some five million people taking statins to prevent heart attacks and strokes, the Society says that if 1 per cent of these patients stop taking their statins due to concerns about muscle pains we will see at least 2,000 more heart attacks and strokes over the next ten years as a result, but avoid only 1,000 musculoskeletal problems. The Society also points out that musculoskeletal disorders occur commonly and are rarely due to taking statins.

It is argued, too, that statins save lives when used in the right type of patient – generally those at higher risk of stroke or heart attack because of other medical problems. With statins the benefits are hidden because many people who otherwise would have had a heart attack today were prevented from having a cardiac arrest because of the taking of these drugs. Doctors point out that the side effects of statins are often all too obvious, and this biases many people against a life-saving tablet.

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