Renin-angiotensin system antagonists and mortality due to pneumonia,influenza,and chronic lower respiratory disease in patients with hypertension

作     者：Heng-Xuan CAI Chen-Chen LIANG Shan-Jie WANG Jun-Chen GUO Ye WANG Bo YU Xue-Qin GAO Shao-Hong FANG Heng-Xuan CAI;Chen-Chen LIANG;Shan-Jie WANG;Jun-Chen GUO;Ye WANG;Bo YU;Xue-Qin GAO;Shao-Hong FANG

作者机构：Department of Cardiologythe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina The Key Laboratory of Myocardial IschemiaChinese Ministry of EducationHarbinChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2022年第19卷第7期

页      面：511-521页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China (No.81870353) supported by the National Natural Science Foundation of China (No.31771241) supported by the Major Instrument Development Project of the National Natural Science Foundation of China (No.81827806) the Key Project of the National Natural Science Foundation of China(No.62135002) 

主　　题：pneumonia influenza hypertension 

摘      要：BACKGROUND It is controversial whether angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ ARB) have a potentially beneficial role in the respiratory system. This study investigated the association between ACEI/ARB medications and respiratory-related mortality in hypertensive patients in a real-world nationally representative cohort. METHODS This was a retrospective analysis based on a prospective cohort study. A total of 10,530 patients with hypertension aged ≥ 20 years were included. The data was extracted from the US National Health and Nutrition Examination Survey during 1988-1994 and 1999-2006. The study was approved by the Institutional Review Boards. Moreover, inform concent was taken form all the participants. RESULTS Overall, 27.7% (n = 2920) patients took ACEI/ARB agents. During a median follow-up of 12.4 years, 278 individuals died of respiratory disease, including chronic lower respiratory disease (n = 155) and influenza or pneumonia (n = 123). Com-pared with the patients without ACEI/ARB use, those taking ACEI/ARB were not associated with respiratory-specific mortality in a multivariable-adjusted Cox model. After 1: 1 matching, taking ACEI/ARB was also not related to respiratory mortality (Haz-ard ratio (HR) = 1.07, 95% CI: 0.79-1.43), influenza- or pneumonia-related (HR = 1.00, 95% CI: 0.65-1.54) and chronic pulmonary mortality (HR = 1.13, 95% CI: 0.75-1.69). After separating ACEI and ARB from anti-hypertensive medications, those associations remained unchanged. CONCLUSIONS We discovered no significant link between ACEI or ARB medication and pulmonary-related mortality in hy-pertensive patients. In hypertensive patients, standard ACEI/ARB administration may have little effect on the respiratory system .