by Phyllis Hanlon, Contributing Writer
Certain over-the-counter (OTC) medications such as Pepcid®, Tagamet® and Zantac® are used to treat ulcers and excess stomach acid. These drugs, technically known as histamine-2 (H2) receptor antagonists, suppress stomach acid, which can be caused by certain foods, caffeine, allergens, insulin and other substances.
A recent analysis shows these common antacids may have benefits for patients with pulmonary hypertension (PH). A team of researchers led by Peter Leary, M.D., MS, co-director of the pulmonary vascular disease program at the University of Washington Medical Center, recently explored a possible connection between H2 receptor antagonists and death in more than 19,000 people in the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program between 2008 and 2014 who had PH confirmed with a right-heart catheterization. The researchers conducted a data analysis supported by the National Institutes of Health (NIH), the Pulmonary Hypertension Association (PHA), the American Heart Association, the Cardiovascular Medical Research and Education Fund, the CHEST Foundation; and Systemic Sclerosis Foundation; it was published in the American Journal of Respiratory Critical Care Medicine.
After examining all of the data, the researchers found that participants who potentially used an H2 receptor antagonist within 90 days of their right heart catheterization were associated with a 10 percent lower risk of death from any cause.
The findings in this analysis are consistent with evidence that Dr. Leary and others presented previously that suggests histamine is important for cardiac health in left-heart disease. Histamine is a compound the cells release in response to an allergic or inflammatory reaction; it causes smooth muscles to contract and capillaries to widen.
Although these findings are encouraging, the researchers pointed out that they cannot be applied to a more general population. This was an analysis of data collected for other purposes and not necessarily designed to test whether antacids may be beneficial in persons with PH. The researchers also noted that the participants in this database were mostly men. More women would need to be included in future studies looking at the role of H2 receptor antagonism. In addition, they noted that some specific mortality details the scientists ideally needed were not available in this data (e.g., deaths may have been the result of a non-cardiac event).
The authors soon will begin enrolling patients with pulmonary arterial hypertension into a randomized controlled trial of H2 receptor antagonists at the University of Washington funded by the NIH.