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Risk of peptic ulcer bleeding associated with H elicobacter pylori infection, nonsteroidal anti‐inflammatory drugs, low‐dose aspirin, and antihypertensive drugs: A case‐control study
Author(s) -
Nagata Naoyoshi,
Niikura Ryota,
Sekine Katsunori,
Sakurai Toshiyuki,
Shimbo Takuro,
Kishida Yoshihiro,
Tanaka Shohei,
Aoki Tomonori,
Okubo Hidetaka,
Watanabe Kazuhiro,
Yokoi Chizu,
Akiyama Junichi,
Yanase Mikio,
Mizokami Masashi,
Uemura Naomi
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12805
Subject(s) - medicine , aspirin , gastroenterology , peptic , odds ratio , antithrombotic , antihypertensive drug , peptic ulcer , blood pressure
Abstract Background and Aim The associations between antithrombotic or antihypertensive drugs and peptic ulcer bleeding ( PUB ) remain unknown, particularly in A sia, where H elicobacter pylori infection is prevalent. This study aims to evaluate the risks of PUB from antithrombotic drugs, angiotensin II receptor blockers ( ARB s), angiotensin‐converting enzyme ( ACE ) inhibitors, calcium channel blockers, α‐blockers, and β‐blockers. Methods This prospective hospital‐based case‐control study included 230 patients with endoscopically verified PUB and 920 age and sex‐matched controls (1:4) without bleeding on screening endoscopy. Adjusted odds ratios ( AOR ) for the risk of PUB were determined by conditional logistic regression analysis. Results In multivariate analysis, alcohol consumption ( AOR , 2.2; P < 0.001), history of peptic ulcer ( AOR , 4.8; P < 0.001), H . pylori infection ( AOR , 2.1; P < 0.001), comorbidity index ( AOR , 1.1; P = 0.089), nonsteroidal anti‐inflammatory drugs ( NSAID s) ( AOR , 2.0; P = 0.025), and low‐dose aspirin ( AOR , 2.8; P = 0.003) increased the risk of PUB , whereas H . pylori eradication ( AOR , 0.03; P < 0.001), proton pump inhibitors ( PPI s) ( AOR , 0.1; P < 0.001), and histamine 2‐receptor antagonists ( H 2 RA ) ( AOR , 0.1; P < 0.001) reduced it. No significant interactions were observed between H . pylori infection and NSAID s use for PUB ( P = 0.913). ARB s ( P = 0.564), ACE inhibitors ( P = 0.213), calcium channel blockers ( P = 0.215), α‐blockers ( P = 0.810), and β‐blockers ( P = 0.864) were not associated with PUB . Conclusion We found that alcohol consumption, history of peptic ulcer, H . pylori infection, NSAID s use, and low‐dose aspirin use were independent risk factors for PUB , whereas H . pylori ‐eradication, PPI s use, and H 2 RA use reduced its risk. Interactions between H . pylori and NSAID s use in PUB were not observed. No antihypertensive drug was associated with PUB .