Document Detail

Antihypertensive medications and risk of community-acquired pneumonia.
MedLine Citation:
PMID:  20051911     Owner:  NLM     Status:  MEDLINE    
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.
Kenneth J Mukamal; Sanjay Ghimire; Rudra Pandey; Ellen S O'Meara; Shiva Gautam
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-20     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  401-5     Citation Subset:  IM    
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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MeSH Terms
Adrenergic beta-Antagonists / adverse effects
Angiotensin-Converting Enzyme Inhibitors / adverse effects
Antihypertensive Agents / adverse effects*
Calcium Channel Blockers / adverse effects
Case-Control Studies
Cohort Studies
Community-Acquired Infections / etiology*
Hypertension / complications,  drug therapy
Middle Aged
Odds Ratio
Pneumonia / etiology*
Risk Factors
Sodium Chloride Symporter Inhibitors / pharmacology
United States
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Sodium Chloride Symporter Inhibitors

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