Acid-suppressive therapy use associated with antihypertensive agents

Nitrates and calcium channel blockers (CCBs) have been shown to decrease lo wer esophageal sphincter pressure and theoretically may precipitate or aggr avate gastroesophageal reflux. Thus, the authors hypothesized that patients who receive these agents would have greater use of acid-suppressive drug u se, defined as histamine2 antagonists or proton pump inhibitors. A retrospe ctive cohort design was used to assess the use of acid-suppressive drug use in hypertensive patients with respect to both nitrates and antihypertensiv e therapy. Of 15,662 treated hypertensive patients, 20% received acid-suppr essive therapy. An increased use of acid-suppressive therapy was associated with nitrate (odds ratio [OR] = 1.71), CCB (OR = 1.46), and alpha1 antagon ist (OR = 1.32) treatment, which appeared to be additive when patients rece ived two or more of the agents. Within the class of CCBs, there was no sign ificant difference among the individual agents. As the clinical and economi c burden may be substantial, further study is warranted.