ArticleGastroenterology2018
No Significant Association Between Proton Pump Inhibitor Use and Risk of Stroke After Adjustment for Lifestyle Factors and Indication.
Article in Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Risk of stroke associated with proton pump inhibitor use among individuals with and without pre-existing cardiovascular diseases: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2025Pooled it
- Regular use of proton-pump inhibitors and risk of stroke: a population-based cohort study and meta-analysis of randomized-controlled trials.BMC medicine · 2021Pooled it
- Risk of Ischaemic Stroke Varies With Antithrombotic Drugs Use in Proton Pump Inhibitor Users: A Self-Controlled Case Series Study.Pharmacoepidemiology and drug safety · 2025Article
- Effect of Potassium-Competitive Acid Blockers on Upper Gastrointestinal Bleeding in Patients on Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: A Nationwide Cohort Study.Journal of gastroenterology and hepatology · 2025Article
- Proton Pump Inhibitor Use and Incident Cardiovascular Disease in Older Postmenopausal Women.Journal of the American Geriatrics Society · 2025Observational
- Proton Pump Inhibitors Use in Patients With Ischemic Stroke on Dual Antiplatelet Therapy at Low Risk of Upper Gastrointestinal Bleeding.Journal of the American Heart Association · 2025Article
- Proton pump inhibitor use and risk of stroke: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2024Review
- Proton Pump Inhibitor for Gastrointestinal Bleeding in Patients with Myocardial Infarction on Dual-Antiplatelet Therapy: A Nationwide Cohort Study.Journal of epidemiology and global health · 2024Article
- Article
- Heartburn's Hidden Impact: A Narrative Review Exploring Gastroesophageal Reflux Disease (GERD) as a Cardiovascular Disease Risk Factor.Journal of clinical medicine · 2023Review
- Proton pump inhibitors and gastroprotection in patients treated with antithrombotic drugs: A cardiologic point of view.World journal of cardiology · 2023Review
- Twenty-three medication-taking traits and stroke: A comprehensive Mendelian randomization study.Frontiers in cardiovascular medicine · 2023Article
- Association of Proton Pump Inhibitor Use With All-Cause and Cause-Specific Mortality.Gastroenterology · 2022Article
- Article
- Association of Proton Pump Inhibitors With Higher Risk of Cardiovascular Disease and Heart Failure.Mayo Clinic proceedings · 2021Article
- Clinical Outcomes of Concomitant Use of Proton Pump Inhibitors and Dual Antiplatelet Therapy: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2021Article
Corrections and comments
- Commented on by
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsProton pump inhibitors (PPI) are among the top 10 most prescribed medications worldwide. We investigated the association between PPI use and ischemic stroke.
methodsWe collected data on 68,514 women (mean age, 65 ± 7 years) enrolled in the Nurses' Health Study since 2000 and 28,989 men (mean age, 69 ± 8 years) in the Health Professionals Follow-up Study since 2004, without a history of stroke. We used Cox proportional hazards models to examine the association between risk of incident stroke and PPI use among participants. The primary end point was first incident stroke.
resultsIn the 2 cohorts, we documented 2599 incident strokes (2037 in women and 562 in men) over a 12-year period, encompassing 949,330 person-years. After adjustment for established risk factors for stroke, PPI use was associated with a significant increase in risk of ischemic stroke (hazard ratio, 1.18; 95% confidence interval, 1.02-1.37). The association was reduced after we adjusted for potential indications for PPI use, including history of peptic ulcer disease, gastroesophageal reflux disease, or gastrointestinal bleeding, and prior use of histamine-2 receptor antagonist therapy (hazard ratio, 1.08; 95% confidence interval, 0.91-1.27). Regular PPI use was not associated with increased risk of stroke overall or hemorrhagic stroke.
conclusionsIn an analysis of data from the Nurses' Health Study and the Health Professionals Follow-up Study, we did not find a significant association between PPI use and ischemic stroke, after accounting for indications for PPI use. Prior reports of an increased risk of stroke may be due to residual confounding related to chronic conditions associated with PPI use.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.