Popular Heartburn Drugs Linked to Heart Attacks

• The population studied included people with acid reflux but no heart disease — The researchers focused on adults with gastroesophageal reflux disease (GERD), the most common reason PPIs are prescribed.

They isolated individuals who had GERD but had not suffered a heart attack before. Importantly, they excluded people taking clopidogrel, a blood thinner often prescribed after a heart attack, to rule out drug interactions. This allowed them to evaluate how PPIs affect the general population, not just those at high cardiovascular risk.

• PPIs were linked to a 16% higher heart attack risk — The data revealed that GERD patients who used PPIs were 1.16 times more likely to experience a heart attack compared to those who didn’t take these medications. This increase was found in multiple datasets and remained consistent across different PPI brands.

• PPI users faced double the risk of dying from heart problems — In a long-term study of 1,503 adults who underwent heart imaging, researchers followed participants over several years.

They found that people taking PPIs were twice as likely to die from cardiovascular events, like heart attacks, strokes, or cardiac arrest, compared to those not taking the drugs. This increased risk remained even after accounting for factors like blood pressure and smoking history.

• H2 blockers did not show the same cardiovascular risks — To compare drug types, researchers also studied H2 blockers like famotidine (Pepcid), which reduce stomach acid by a different mechanism. Unlike PPIs, H2 blockers showed no increased risk of heart attack or cardiovascular death. This key distinction suggests the problem is something unique to how PPIs work.

• The biological mechanism involves a molecule that blocks nitric oxide — PPIs interfere with an enzyme responsible for breaking down a naturally occurring molecule that inhibits nitric oxide production. Nitric oxide is essential for healthy blood vessels, helping them stay relaxed, elastic, and resistant to clots.

Without enough of it, the lining of your blood vessels stiffens and becomes inflamed. In vein samples from coronary bypass patients, PPIs were shown to suppress nitric oxide production, confirming the drug’s impact on actual human blood vessels, not just cells in a lab.

• PPIs affect kidneys, bone density, and your nervous system — Long-term use of PPIs has been linked to serious kidney disorders such as chronic kidney disease,⁵ acute kidney injury and end-stage renal disease.

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Neurological side effects including confusion, mood changes and even dementia also occur.⁶ Nutrient absorption becomes impaired, which increases the likelihood of magnesium, calcium and vitamin B12 deficiencies, further weakening your body’s ability to regulate systems.

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• Your bones become more fragile, increasing your risk of fractures — PPIs lower stomach acid so much that calcium is poorly absorbed. This leads to weaker bones over time.⁶ The U.S. Food and Drug Administration has issued warnings that chronic PPI use increases the risk of hip, wrist, and spinal fractures.⁷ If you’re already dealing with osteopenia or osteoporosis, this puts you at even greater risk, especially if you’re over 60, postmenopausal or inactive.

• You’re more likely to get infections when your stomach acid is too low — Stomach acid isn’t just there to digest food; it’s your body’s first line of defense against pathogens. With less acid, harmful bacteria survive and thrive. PPI users are more prone to infections like Clostridium difficile (C. diff), pneumonia, Salmonella and E. coli. These infections are often severe, especially in older adults or people with compromised immune systems.

• These effects happen even at common doses — The damage isn’t limited to high doses or long durations. Even standard over-the-counter use repeated multiple times a year builds up risk. The FDA has recommended no more than three 14-day treatment periods per year due to these long-term effects, a warning many consumers and doctors overlook.

• The problem affects tens of millions of Americans each month — More than 60 million Americans experience heartburn at least once a month, and 15 million suffer from it daily.⁹ Meanwhile, over 800,000 Americans have a heart attack each year.

These overlapping numbers create a dangerous gray area where heartburn is wrongly assumed to be harmless when it’s actually a sign of something far more serious. Heartburn often feels like “a burning sensation in your chest between your stomach and your mouth,”¹⁰ while heart attack pain is often described as pressure, tightness, or heaviness.

• A heart attack doesn’t always follow the classic pattern — Cardiologist Dr. Juan Carlos Rozo with Houston Methodist explains that many people still believe heart attacks always involve sharp, crushing chest pain.¹¹ That stereotype leads people to dismiss their symptoms. In reality, heart attacks often present with subtler signs like fatigue, mild shortness of breath, cold sweats, or pain in your arms, jaw or back.

• Key differences reveal when to call 911 — There are several differences between heartburn and heart attacks that help you assess what’s happening in the moment:¹²

• Treat chest symptoms as an emergency — The advice is clear: don’t wait it out. If chest discomfort is also associated with shortness of breath, cold sweats, nausea, or lightheadedness, Rozo recommends seeking emergency care. Many people try to tough it out or assume it’s just something they ate. That decision could cost you important minutes during an actual heart event.

Every minute counts when your heart is deprived of oxygen, and survival depends on how fast blood flow is restored. Methylene blue and melatonin are two important compounds that are beneficial in case of a heart attack. Methylene blue administration helps mitigate tissue damage, while melatonin helps reduce reperfusion injury if taken immediately after a heart attack or stroke.

• Low acid leads to poor protein digestion and gut imbalance — Stomach acid is essential for breaking down protein into usable amino acids. When acid is suppressed, large protein fragments pass into your gut undigested. This feeds harmful bacteria and yeast. Over time, this causes dysbiosis — a state where bad microbes in your gut outnumber the good ones — leading to gas, bloating and more reflux.

• PPIs create dependence by triggering a rebound acid surge — Your body doesn’t stop trying to produce stomach acid just because a drug blocks it. Over time, it increases the number of acid-producing cells to compensate. So, when you stop a PPI suddenly, those cells flood your stomach with acid. That rebound effect often feels worse than the reflux you started with.

• Tapering off slowly is the safest way to get off PPIs — If you’ve been on PPIs for months or years, stopping cold turkey isn’t wise. You’ll need to reduce the dose slowly, ideally while supporting digestion naturally, using betaine HCl, bitters or apple cider vinegar. Once you’re at the lowest dose, switch to Pepcid, an H2 blocker shown to be safer for your heart. Then gradually taper off that, too.

• It takes several months up to two years to fully recover acid function — For long-term users, your body needs time to normalize stomach acid levels and restore proper function of your lower esophageal sphincter (LES), the valve that keeps acid in your stomach. This isn’t a quick fix. But if you stay consistent with rebuilding gut health and energy production, you’ll resolve the root cause rather than just silencing the symptom.

1. Restore the cellular energy needed to make stomach acid — Making stomach acid takes energy — lots of it. If your mitochondria, the tiny power plants in your cells, aren’t working well, acid production slows down. That leads to poor digestion, bloating, and reflux.

Start by supporting your mitochondria with daily sun exposure, healthy carbohydrates (about 250 grams daily if you’re moderately active) and eliminating seed oils, which contain linoleic acid that disrupts energy production. This gives your body what it needs to turn food into acid, not symptoms.

2. Feed your stomach what it needs to make acid — You need raw materials to produce hydrochloric acid. In addition to optimizing your mitochondrial function, consuming hydrogen-rich foods, such as fresh fruits, vegetables and proteins, and chloride-rich foods, such as salt, tomatoes, lettuce, celery, and olives, provides the dietary sources for your body to make stomach acid. Consuming sauerkraut or cabbage juice will also stimulate your body to produce stomach acid.

3. Use time-tested digestive support tools — Bitters before meals signal your body to start acid production. If your stomach acid is already too low, try betaine HCl, starting with one capsule before meals and slowly increasing until you feel warmth or mild discomfort. That’s your threshold.

Back off slightly and stay at that dose. Another option: mix 1 tablespoon of raw, unfiltered apple cider vinegar in a full glass of water and drink it just before or after eating. It gives your stomach the extra push it needs.

4. Rebuild zinc levels to support acid production — Zinc is required to make hydrochloric acid. If you’re deficient, your body won’t produce enough acid. Most adults need 8 to 11 milligrams per day. I recommend getting it from food first — like grass fed beef and raw yogurt. If you’re dealing with poor digestion, you’re probably not absorbing enough zinc from supplements, so focus on real food sources.

5. Step down from PPIs slowly and switch to safer support — If you’re already taking a PPI, don’t stop suddenly. As mentioned, your stomach will rebound and create even more acid, which triggers severe symptoms. Instead, work with the steps above while gradually reducing your dose. Once you reach the lowest available dose, switch to Pepcid. After that, taper off the H2 blocker over several weeks until you no longer need it at all.