Friday, August 31, 2007

Heartburn Drugs Might Slow Heart Failure

By Ed EdelsonHealthDay Reporter

(HealthDay News) -- Over-the-counter antihistamine drugs used to treat heartburn and acid reflux might be useful against chronic heart failure, a Japanese study suggests.

It's a small study, including only 50 patients. But the results point to possible benefits for many of the 23 million Americans with heart failure, a potentially fatal condition in which the heart cannot pump blood effectively, said a report in the Oct. 3 issue of the Journal of the American College of Cardiology.

"It's still very early, because we know very little about who might benefit from it or what drugs might be best," said Dr. W.H. Wilson Tang, an assistant professor of medicine at the Cleveland Clinic and co-author of an accompanying editorial in the journal. "It is an important thing to validate this data."

The initial work focused on the drug Pepcid, because a major study of medical databases by a group led by Dr. Masafumi Kitakaze of Japan's National Cardiovascular Center found that people with heart failure who were also taking the antihistamine appeared to have fewer heart failure symptoms.

The researchers were looking for such a relationship because previous research pointed to a role of histamine in heart failure. The same type of chemical reaction that allows stomach acid to cause heartburn and ulcers also seems to damage and weaken diseased hearts. Blocking this process with Pepcid might help to slow the progression of chronic heart failure, the researchers theorized.

The biological chemistry is complex, but the basic idea is that one kind of histamine can accelerate the damage done to heart cells, so that blocking the activity of histamine can protect those cells.

Half the patients in the Japanese trial were given Pepcid along with regular therapy. The other half got an alternative heartburn medicine called teprenone, whose protective effect does not involve histamine. Examinations by three cardiologists after 24 weeks found less-severe symptoms in those getting Pepcid.

"Now we need to conduct a large-scale trial to confirm the present findings," Kitakaze said in a statement. "The large-scale trial based on the results of our present research may not help current heart-failure patients because it takes time, but we hope it helps our children and grandchildren and others in the future."

The key point, Tang said, is that the Japanese researchers "found some objective benefit of using this histamine blocker versus another reflux drug that doesn't act on this mechanism."
Further studies are essential not only to determine whether all antihistamine drugs might have some value against heart failure but also to identify drugs that might work best for specific patients, he said.

"It is intriguing because this work indicates that an inflammatory cell mechanism may be pertinent in heart failure," Tang said.

But it's much too early for people with heart failure to take antihistamines because of the many uncertainties that exist, he said.

More information
To learn more about heart failure, visit the American Heart Association.
SOURCES: W.H. Wilson Tang, assistant professor, medicine, Cleveland Clinic; Oct. 3, 2006, Journal of the American College of Cardiology

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