Key result
Prescription PPI use is not associated with higher predicted ASCVD or PREVENT risk scores.
Why the study?
Is prescription proton pump inhibitor use associated with higher 10-year predicted cardiovascular risk as measured by ASCVD and PREVENT scores in U.S. adults aged 40–79 years without established cardiovascular disease?
Cross-Sectional (n=4,036)
Is prescription proton pump inhibitor use associated with higher 10-year predicted cardiovascular risk as measured by ASCVD and PREVENT scores in U.S. adults aged 40–79 years without established cardiovascular disease?
In a nationally representative cross-sectional sample of U.S. adults without established cardiovascular disease, recent prescription proton pump inhibitor use was not associated with higher 10-year predicted cardiovascular risk using either the ASCVD or PREVENT risk scores after adjusting for confounders.
Answers are grounded in this paper and cite their sources.
No association with predicted CVD risk after adjustment; leaves open effects on incident events in primary prevention.
Background Proton pump inhibitors (PPIs) are widely used, often without appropriate indication, and have been linked to several adverse outcomes, including possible cardiovascular effects. Whether PPI use is associated with higher predicted cardiovascular risk using validated risk scores remains unclear. Methods This cross-sectional study used 2011–2018 NHANES data and included 4,036 adults without prior cardiovascular disease (CVD) and with complete Atherosclerotic Cardiovascular Disease (ASCVD) and Predicting Risk of Cardiovascular Disease EVENTS (PREVENT) score components. Survey-weighted multivariable linear regression estimated mean differences and 95% confidence intervals (CIs) in ASCVD and PREVENT scores between PPI users and non-users, adjusting for prespecified covariates. Results In unadjusted analyses, PPI use was associated with higher ASCVD (mean difference, 6.31; 95% CI, 4.07–8.55) and PREVENT scores (4.49; 95% CI, 3.10–5.87). After covariate adjustment, associations were attenuated and nonsignificant for both ASCVD (adjusted mean difference, − 0.72; 95% CI, − 2.65 to 1.22) and PREVENT (–0.80; 95% CI, − 1.98 to 0.39). Among secondary component outcomes, hypertension and diabetes remained significant after Benjamini–Hochberg false discovery rate correction. Conclusions Among U.S. adults without established CVD, PPI use was not associated with higher predicted 10-year cardiovascular risk using ASCVD or PREVENT scores. Findings support concern predicted risk estimates rather than incident cardiovascular events.
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Goenawan et al. (2026) conducted a cross-sectional in Primary prevention of cardiovascular disease (adults without prior CVD) (n=4,036). Prescription proton pump inhibitor (PPI) use in the past 30 days (lansoprazole, omeprazole, pantoprazole, esomeprazole, rabeprazole, or dexlansoprazole) vs. Non-users of prescription PPIs was evaluated on Predicted 10-year ASCVD risk score (2013 ACC/AHA Pooled Cohort Equations) (Adjusted MD -0.72, 95% CI -2.65 to 1.22, p=0.461). Prescription PPI use was not associated with higher predicted 10-year ASCVD (adjusted MD -0.72, p=0.461) or PREVENT risk scores (adjusted MD -0.80, p=0.186) in U.S. adults without prior CVD.
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