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Letter by Montenegro and Lundberg Regarding Article, “Unexpected Effect of Proton Pump Inhibitors: Elevation of the Cardiovascular Risk Factor Asymmetric Dimethylarginine”
Author(s) -
Marcelo F. Montenegro,
Jon O. Lundberg
Publication year - 2014
Publication title -
circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 7.795
H-Index - 607
eISSN - 1524-4539
pISSN - 0009-7322
DOI - 10.1161/circulationaha.113.005585
Subject(s) - asymmetric dimethylarginine , montenegro , medicine , nitric oxide , arginine , cardiology , pharmacology , biochemistry , chemistry , ethnology , amino acid , history
We read with interest the article by Ghebremariam et al1 demonstrating that proton pump inhibitors (PPIs) reduce endogenous formation of nitric oxide (NO) and impair vascular reactivity.1 This deleterious effect of PPIs occurred through inhibition of the enzyme dimethylarginine dimethylaminohydrolase, which degrades asymmetrical diemethylarginine, an endogenous NO synthase inhibitor.1 The authors discuss this as a possible mechanism explaining the increased risk of adverse cardiovascular events with prolonged PPI treatment.2 We bring up another mechanism by which PPIs may alter vascular NO homeostasis, with possible added deleterious effects …

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