title: Medical Prevention of Barrett's Esophagus: Effects of Statins, Aspirin, Non-aspirin NSAIDs, Calcium, and Multivitamins.
abstract: BACKGROUND
  Barrett's esophagus (BE) is a complication of gastroesophageal reflux disease (GERD) that is a precursor to esophageal adenocarcinoma. There is limited information regarding whether medications can reduce the risk of developing BE.
  
  
  OBJECTIVE
  We analyzed medical records at a large veterans hospital to determine the effects of statins, aspirin, non-aspirin NSAIDs, calcium, or multivitamins on the risk of developing BE.
  
  
  METHODS
  In this retrospective case-control study, 250 patients with biopsy-confirmed Barrett's esophagus were compared with 250 controls with acid-peptic symptoms but no endoscopic BE. Medication histories were reviewed for the use of the above substances prior to endoscopic evaluation. Logistic and linear regression was used to determine predictors of the outcomes.
  
  
  RESULTS
  Mean age at diagnosis was significantly older in the Barrett's population compared with controls (61.2 vs. 56.7 years, P < 0.001), with no difference in mean BMI (29.1 vs. 29.0, respectively). On multivariate analysis, independently significant factors for risk of BE were found with multivitamins (OR 0.41, P = 0.001), statins (OR 0.53, P = 0.003), age (OR 1.033/year, P = 0.001), and Hispanic ethnicity (OR 0.38, P = 0.007). Furthermore, statin use was associated with less long-segment (3 cm or longer) BE and was inversely correlated with continuous BE length.
  
  
  CONCLUSIONS
  GERD patients with BE are less likely to use multivitamins and statins, as well as less likely to be of Hispanic ethnicity. Additionally, statins were inversely associated with BE length. Prospective studies of this topic are indicated.
authors: Department of Gastroenterology, Carl T. Hayden VA Medical Center, 650 E Indian School Rd, Phoenix, AZ, 85012, USA, aaron.goldberg2@va.gov.
authors: Aaron
authors: A
authors: Goldberg
authors: Richard D
authors: RD
authors: Gerkin
authors: Michele
authors: M
authors: Young
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001471:Barrett Esophagus / Q000517:prevention & control*; D002118:Calcium / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014815:Vitamins / Q000009:adverse effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014815:Vitamins; D001241:Aspirin; D002118:Calcium