Are heartburn/reflux medicines safe?

Stanford widely publicized a literal data-mining result on their patients suggesting a link between proton-pump inhibitors (PPI's) and heart disease.  While data mining may (or may not) be effective for Amazon in trying to suggest other things you might like to buy, it may not lend itself so readily to the practice of medicine.

PPI's (such as Prilosec, Prevacid and Nexium) are medicines that suppress stomach acid production and are effective in treating hearburn/reflux/GERD, curing ulcers and preventing esophageal cancer in patients with a pre-cancerous inflammation of the esophagus called Barrett's esophagitis.  Prilosec was the hot new thing back in about 1989. Fast forward to the present and there are about half a dozen drugs like it and several are over the counter.

Stanford reported that patients on PPI's had a greater-than-random occurrence of heart disease.  While concerning, this data-mining did not stratify patients or look at their overall health.  For example, people who smoke, drink or are obese are more likely to have reflux.  They are also more likely to have other metabolic problems such as diabetes, and are more at risk for heart disease in the first place.  It would be much more interesting and useful to group patients by pre-existing health conditions putting them at risk for heart disease and see whether there is still a real correlation with PPI's and heart disease once that is taken into account.

Perhaps this will be done.  Until then, the PPI's are not proven across all comers to be related to (let alone actually cause) heart disease. 

If you prefer to err on the side of caution, a previous class of acid reducers called H2 blockers (Tagamet, Zantac, Pepcid and Axid- all over the counter) can help to relieve GERD symptoms and are not being related to heart disease.  You can simply try switching to one of these to see if it works as well for you.  Do NOT do this if you have already failed H2 blockers or are treating pre-cancerous Barrett's.