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Journal of Geriatric Cardiology 2022, 19(7): 511-521 https://doi.org/10.11909/j.issn.1671-5411.2022.07.003
Research Article | Open Access | Issue | Published: 28 July 2022

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

Show Author's Information Heng-Xuan CAI1,2,*,  Chen-Chen LIANG1,2,*,  Shan-Jie WANG1,2,  Jun-Chen GUO1,2,  Ye WANG1,2,  Bo YU1,2,  Xue-Qin GAO1,2( ),  Shao-Hong FANG1,2( )
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

*The authors contributed equally to this manuscript

Cite this article:
CAI H-X, LIANG C-C, WANG S-J, et al. Renin-angiotensin system antagonists and mortality due to pneumonia, influenza, and chronic lower respiratory disease in patients with hypertension. Journal of Geriatric Cardiology, 2022, 19(7): 511-521. https://doi.org/10.11909/j.issn.1671-5411.2022.07.003
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Abstract Full text Electronic supplementary material About this article
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). Compared 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 (Hazard 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 hypertensive patients. In hypertensive patients, standard ACEI/ARB administration may have little effect on the respiratory system.


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Abstract
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Electronic supplementary material
About this article

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

Show Author's information Heng-Xuan CAI1,2,*, Chen-Chen LIANG1,2,*, Shan-Jie WANG1,2, Jun-Chen GUO1,2, Ye WANG1,2, Bo YU1,2, Xue-Qin GAO1,2( ), Shao-Hong FANG1,2( )
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

*The authors contributed equally to this manuscript

Abstract

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). Compared 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 (Hazard 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 hypertensive patients. In hypertensive patients, standard ACEI/ARB administration may have little effect on the respiratory system.

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Acknowledgements

Publication history

Published: 28 July 2022
Issue date: July 2022

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© 2022 JGC All rights reserved

Acknowledgements

ACKNOWLEDGMENTS

The authors thank all the participants and staff in the National Health and Nutrition Examination Survey for their great contributions.

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