Key result
H. pylori infection, NSAIDs, and low-dose aspirin were independent risk factors for peptic ulcer bleeding, whereas antihypertensive drugs showed no association.
Why the study?
Does the use of low-dose aspirin, NSAIDs, or antihypertensive drugs increase the risk of peptic ulcer bleeding?
Case-Control (n=1,150)
Does the use of low-dose aspirin, NSAIDs, or antihypertensive drugs increase the risk of peptic ulcer bleeding?
Low-dose aspirin and NSAIDs are independent risk factors for peptic ulcer bleeding, whereas antihypertensive drugs do not increase this risk.
Answers are grounded in this paper and cite their sources.
May inform bleeding risk assessment before prescribing aspirin or NSAIDs; leaves open causality and needs prospective confirmation.
BACKGROUND AND AIM: The associations between antithrombotic or antihypertensive drugs and peptic ulcer bleeding (PUB) remain unknown, particularly in Asia, where Helicobacter pylori infection is prevalent. This study aims to evaluate the risks of PUB from antithrombotic drugs, angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, α-blockers, and β-blockers. METHODS: This prospective hospital-based case-control study included 230 patients with endoscopically verified PUB and 920 age and sex-matched controls (1:4) without bleeding on screening endoscopy. Adjusted odds ratios (AOR) for the risk of PUB were determined by conditional logistic regression analysis. RESULTS: In multivariate analysis, alcohol consumption (AOR, 2.2; P < 0.001), history of peptic ulcer (AOR, 4.8; P < 0.001), H. pylori infection (AOR, 2.1; P < 0.001), comorbidity index (AOR, 1.1; P = 0.089), nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR, 2.0; P = 0.025), and low-dose aspirin (AOR, 2.8; P = 0.003) increased the risk of PUB, whereas H. pylori eradication (AOR, 0.03; P < 0.001), proton pump inhibitors (PPIs) (AOR, 0.1; P < 0.001), and histamine 2-receptor antagonists (H2RA) (AOR, 0.1; P < 0.001) reduced it. No significant interactions were observed between H. pylori infection and NSAIDs use for PUB (P = 0.913). ARBs (P = 0.564), ACE inhibitors (P = 0.213), calcium channel blockers (P = 0.215), α-blockers (P = 0.810), and β-blockers (P = 0.864) were not associated with PUB. CONCLUSION: We found that alcohol consumption, history of peptic ulcer, H. pylori infection, NSAIDs use, and low-dose aspirin use were independent risk factors for PUB, whereas H. pylori-eradication, PPIs use, and H2RA use reduced its risk. Interactions between H. pylori and NSAIDs use in PUB were not observed. No antihypertensive drug was associated with PUB.
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Nagata et al. (2014) conducted a case-control in Peptic ulcer bleeding (n=1,150). H. pylori infection, NSAIDs, low-dose aspirin, and antihypertensive drugs vs. Unexposed was evaluated on Risk of peptic ulcer bleeding (AOR 2.1, p=<0.001). H. pylori infection, NSAIDs, and low-dose aspirin were independent risk factors for peptic ulcer bleeding, whereas antihypertensive drugs showed no association.
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