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Antihypertensive medications and risk of community-acquired pneumonia.
J Hypertens 2010; 28(2):401-5JH

Abstract

OBJECTIVE

To determine whether angiotensin-converting enzyme (ACE) inhibitors and other antihypertensives are associated with risk of pneumonia.

METHODS

We conducted a nested case-control study of incident pneumonia in a subcohort of hypertensive adults insured by several large commercial plans throughout the United States. Individuals with pneumonia were matched on age, sex, region, and subscriber status with up to 10 controls free of pneumonia at the time of case diagnosis. We examined use of beta-blockers, calcium channel blockers, ACE inhibitors (lipophilic and hydrophilic), angiotensin receptor blockers, and thiazides in the prior 3 and 12 months.

RESULTS

A total of 7429 cases of pneumonia occurred among 305 958 hypertensive individuals. Risk of pneumonia was higher among users of beta-blockers [adjusted odds ratio (OR) 1.11; 95% confidence interval (CI) 1.03-1.19], calcium channel blockers (adjusted OR 1.09, 95% CI 1.00-1.17), and lipophilic ACE inhibitors (adjusted OR 1.15, 95% CI 1.03-1.28) in the preceding 3 months; risks were also higher for use in the preceding 12 months. We observed lower risk with thiazide use in the preceding 3 months (adjusted OR 0.90, 95% CI 0.81-0.99) and hydrophilic ACE inhibitor use in the preceding year (adjusted OR 0.86, 95% CI 0.75-0.99).

CONCLUSION

In this population of middle-aged Americans with hypertension, we observed a modestly higher risk of pneumonia with use of beta-blockers, calcium channel blockers, and lipophilic ACE inhibitors. These results are consistent with possible differences in noncardiovascular outcomes among users of antihypertensives and other commonly used cardiovascular drugs but require confirmation in other populations.

Authors+Show Affiliations

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. kmukamal@bidmc.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20051911

Citation

Mukamal, Kenneth J., et al. "Antihypertensive Medications and Risk of Community-acquired Pneumonia." Journal of Hypertension, vol. 28, no. 2, 2010, pp. 401-5.
Mukamal KJ, Ghimire S, Pandey R, et al. Antihypertensive medications and risk of community-acquired pneumonia. J Hypertens. 2010;28(2):401-5.
Mukamal, K. J., Ghimire, S., Pandey, R., O'Meara, E. S., & Gautam, S. (2010). Antihypertensive medications and risk of community-acquired pneumonia. Journal of Hypertension, 28(2), pp. 401-5. doi:10.1097/HJH.0b013e3283330948.
Mukamal KJ, et al. Antihypertensive Medications and Risk of Community-acquired Pneumonia. J Hypertens. 2010;28(2):401-5. PubMed PMID: 20051911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antihypertensive medications and risk of community-acquired pneumonia. AU - Mukamal,Kenneth J, AU - Ghimire,Sanjay, AU - Pandey,Rudra, AU - O'Meara,Ellen S, AU - Gautam,Shiva, PY - 2010/1/7/entrez PY - 2010/1/7/pubmed PY - 2010/3/23/medline SP - 401 EP - 5 JF - Journal of hypertension JO - J. Hypertens. VL - 28 IS - 2 N2 - OBJECTIVE: To determine whether angiotensin-converting enzyme (ACE) inhibitors and other antihypertensives are associated with risk of pneumonia. METHODS: We conducted a nested case-control study of incident pneumonia in a subcohort of hypertensive adults insured by several large commercial plans throughout the United States. Individuals with pneumonia were matched on age, sex, region, and subscriber status with up to 10 controls free of pneumonia at the time of case diagnosis. We examined use of beta-blockers, calcium channel blockers, ACE inhibitors (lipophilic and hydrophilic), angiotensin receptor blockers, and thiazides in the prior 3 and 12 months. RESULTS: A total of 7429 cases of pneumonia occurred among 305 958 hypertensive individuals. Risk of pneumonia was higher among users of beta-blockers [adjusted odds ratio (OR) 1.11; 95% confidence interval (CI) 1.03-1.19], calcium channel blockers (adjusted OR 1.09, 95% CI 1.00-1.17), and lipophilic ACE inhibitors (adjusted OR 1.15, 95% CI 1.03-1.28) in the preceding 3 months; risks were also higher for use in the preceding 12 months. We observed lower risk with thiazide use in the preceding 3 months (adjusted OR 0.90, 95% CI 0.81-0.99) and hydrophilic ACE inhibitor use in the preceding year (adjusted OR 0.86, 95% CI 0.75-0.99). CONCLUSION: In this population of middle-aged Americans with hypertension, we observed a modestly higher risk of pneumonia with use of beta-blockers, calcium channel blockers, and lipophilic ACE inhibitors. These results are consistent with possible differences in noncardiovascular outcomes among users of antihypertensives and other commonly used cardiovascular drugs but require confirmation in other populations. SN - 1473-5598 UR - https://www.unboundmedicine.com/medline/citation/20051911/Antihypertensive_medications_and_risk_of_community_acquired_pneumonia_ L2 - http://Insights.ovid.com/pubmed?pmid=20051911 DB - PRIME DP - Unbound Medicine ER -