Renin-angiotensin system antagonists and mortality due to pneumonia, influenza, and chronic lower respiratory disease in patients with hypertension
Heng-Xuan CAI
Chen-Chen LIANG
Shan-Jie WANG
Jun-Chen GUO
Ye WANG
Bo YU
Xue-Qin GAO
Shao-Hong FANG
Department of Cardiology,the Second Affiliated Hospital of Harbin Medical University,Harbin,China;The Key Laboratory of Myocardial Ischemia,Chinese Ministry of Education,Harbin,China
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.
机标关键词：hypertensionsystemwithangiotensinantagonistschronicdiseaseinfluenza
论文发表日期：2022-07-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 511-521 )