Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Internal Medicine


Dr. Tom Colletti, DHSc, PA-C, DFAAPA


Purpose: The purpose of this article is to review cardiovascular outcomes when prescribing

proton pump inhibitors, compared to histamine H2 receptor antagonists, for gastroesophageal reflux disease treatment in Type 2 diabetics greater than 30 years old.

Method: A PubMed literature search was conducted utilizing the following search terms: proton pump inhibitor AND risk AND cardiovascular, histamine H2 receptor antagonist AND risk AND cardiovascular. The search was narrowed for peer reviewed articles including human participants from 2010 to 2020. Exclusion criteria included: patients younger than 30 years old and greater than 100 years old, patients with known cardiovascular disease, use of adenosine diphosphate receptor antagonists and dipyridamole, emigration, weight > 136kg, pregnancy, previous anticoagulation, cancer, and death.

Results: Thirteen articles were retrieved, including matched studies, cohort/case control studies, systematic reviews, and meta-analyses. Evidence seems to support that there is increased negative cardiovascular outcomes in patients taking proton pump inhibitors, while those taking histamine H2 receptor antagonists demonstrated cardioprotective benefits.

Conclusion: Type 2 diabetes mellitus is very prevalent in the United States, and gastroesophageal reflux disease is a common ailment frequently encountered by this population. Proton pump inhibitors are a first-line medication for treating gastroesophageal reflux disease; however, use of this medication class may result in increased negative cardiovascular outcomes. Histamine H2 receptor antagonists can be used as a safe alternative treatment for gastroesophageal reflux disease, with future investigations focusing on their cardioprotective potential.

Keywords: Type 2 diabetes mellitus, gastroesophageal reflux disease, proton pump inhibitors, histamine H2 receptor antagonists, and cardiovascular.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.