Does omeprazole raise blood pressure
Pro Research Analysisby 
Searched over 200M research papers
Omeprazole and Blood Pressure: A Comprehensive Review
Introduction to Omeprazole and Blood Pressure
Omeprazole, a commonly used proton pump inhibitor (PPI), is primarily prescribed for acid-related disorders. However, its effects on blood pressure have been a subject of investigation due to potential drug interactions and cardiovascular implications.
Omeprazole and Antihypertensive Therapy
A study examining the co-administration of omeprazole with amlodipine in patients with hypertension and acid-related disorders found that omeprazole could enhance the antihypertensive effect of amlodipine, particularly in patients with certain CYP2C19 polymorphisms. Intermediate metabolizers (IMs) of CYP2C19 experienced a more pronounced reduction in both systolic and diastolic blood pressure compared to extensive (EMs) and ultrarapid metabolizers (UMs)1. This suggests that omeprazole may have a beneficial effect on blood pressure in specific genetic subgroups.
Omeprazole's Direct Impact on Blood Pressure
Contrary to the findings in human subjects, an animal study involving anesthetized rats demonstrated that omeprazole, even at high doses, did not alter blood pressure, heart rate, or electrocardiogram readings. This study highlights the cardiovascular safety of omeprazole in vivo, suggesting that the drug does not directly influence blood pressure in a significant manner2.
Omeprazole and Vascular Remodeling
Further research has indicated that long-term use of omeprazole may lead to vascular remodeling and increased oxidative stress. In a study involving Wistar rats, omeprazole treatment resulted in increased aortic cross-sectional area and media/lumen ratio, indicating vascular changes. These effects were associated with increased activity of matrix metalloproteinases (MMPs) and xanthine oxidoreductase (XOR)-derived reactive oxygen species. However, these vascular changes did not translate into altered systolic blood pressure in the study4. This suggests that while omeprazole may induce vascular changes, it does not necessarily raise blood pressure.
Conclusion
The current body of research indicates that omeprazole does not directly raise blood pressure. In fact, it may enhance the antihypertensive effects of certain medications in specific genetic subgroups. However, long-term use of omeprazole could lead to vascular remodeling and oxidative stress, which warrants further clinical investigation to fully understand its cardiovascular implications. Overall, omeprazole appears to be safe from a blood pressure perspective, but its broader cardiovascular effects should be monitored.
Sources and full results
Most relevant research papers on this topic
Antihypertensive Effect Of Amlodipine In Co-Administration With Omeprazole In Patients With Hypertension And Acid-Related Disorders: Cytochrome P450-Associated Aspects
Adding omeprazole to long-term amlodipine therapy may lead to a more pronounced antihypertensive effect in patients with CYP2C19 intermediate metabolizers.
Observational Study
Very Rigorous JournalOmeprazole, lansoprazole and pantoprazole had no effect on blood pressure and electrocardiogram of anesthetized rat.
Proton pump inhibitors omeprazole, lansoprazole, and pantoprazole show cardiovascular safety in anesthetized rats, but may cause negative inotropic effects on human atrial strips.
Non-RCT
Animal StudyThe effects of omeprazole on gastro-oesophageal sphincter pressure, intragastric pH, and the migrating motor complex in fasting healthy subjects.
Omeprazole shows great promise for treating oesophagitis by maintaining a stable pressure profile and significantly reducing acid secretion without affecting the migrating motor complex in fasting healthy subjects.
RCTOmeprazole induces vascular remodeling by mechanisms involving xanthine oxidoreductase and matrix metalloproteinase activation.
Long-term use of omeprazole promotes vascular dysfunction and remodeling by promoting oxidative stress and MMP activation, which can be prevented by allopurinol treatment.
Omeprazole induces high intraglandular pressure in the rat gastric mucosa.
Omeprazole treatment in rats leads to high intraglandular pressure, suggesting fluid accumulation and potential enlargement of the gastric gland lumina.
Non-RCTAnimal StudyAbstract 189: Omeprazole Decreases Chronic Antihypertensive Effects of Sodium Nitrite
Omeprazole reduces the chronic antihypertensive effects of sodium nitrite in 2K1C rats, but this effect may not be associated with significant differences in plasma nitrite concentrations.
The clinical safety of omeprazole.
Omeprazole is a safe and effective treatment for heartburn, with no significant adverse effects observed in long-term studies and no significant changes in laboratory parameters.
The effects of omeprazole on interdigestive motility and early postprandial levels of gastrin and secretin.
40 mg omeprazole increases fasting plasma gastrin, decreases secretin in phases I and III, enhances meal-stimulated gastrin response, and lowers secretin levels in the immediate postprandial period.
RCTEffect of omeprazole treatment on feed intake and blood gastrin and pepsinogen levels in the calf.
Omeprazole treatment significantly reduces feed intake and increases blood gastrin levels in calves, potentially affecting appetite and gastrointestinal motility.
Non-RCTAnimal StudyThe effects of omeprazole on intragastric pH, intestinal motility, and gastric emptying rate.
Omeprazole disrupts the relationship between intragastric pH and intestinal motility, leading to a delay in gastric emptying of both liquid and solid foods, with a non-significant increase in postprandial motility duration.
RCT