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

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=10530). Intervention: ACEI or ARB medications vs. Non-use of ACEI/ARB. Primary outcome: Respiratory-related mortality (HR 1.07, 95% CI 0.79-1.43, p=0.673).

Hengxuan Cai; Chenchen Liang; Shanjie Wang; Junchen Guo; Ye Wang; Bo Yu; Xueqin Gao; Shaohong Fang

doi:10.11909/j.issn.1671-5411.2022.07.003

July 28, 2022Open Access

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

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Key result

Taking ACEI or ARB medications was not significantly associated with respiratory-related mortality in patients with hypertension (HR 1.07).

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Why the study?

It is controversial whether ACEI/ARB have a potentially beneficial role in the respiratory system in hypertensive patients.

Does ACEI/ARB use reduce respiratory-related mortality in patients with hypertension?

Study Design

Type

Cohort (n=10,530)

Multicenter

Yes

Structured PICO

Does ACEI/ARB use reduce respiratory-related mortality in patients with hypertension?

P

Population

10,530 adults aged 20 years and older with preexisting hypertension, free of lung cancer, emphysema, and congestive heart failure, followed for a median of 12.4 years.

E

Exposure

Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB)

C

Comparator

Patients without ACEI/ARB use (1:1 matched)

O

Outcome

Respiratory-related mortality (including influenza- or pneumonia-related and chronic pulmonary mortality)hard clinical

Main Result

Hazard Ratio: 1.07 (95% CI 0.79–1.43)

p-value: p=0.673

ACEI/ARB use in hypertensive patients is not associated with a change in respiratory-related mortality, suggesting standard administration has little effect on the respiratory system.

Limitations

Patients did not know the difference between primary and secondary hypertension
Pneumonia or influenza-related mortality was not quantified individually
Differences in medication compliance and specific RAS drugs were not considered
Residual confounding could not be completely ruled out

Implication

Reassures on respiratory safety of ACEI/ARB in hypertension; leaves open effects in other populations or randomized settings.

Discussion

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Cite This Study

Cai et al. (2022) conducted a cohort in Hypertension (n=10,530). ACEI or ARB medications vs. Non-use of ACEI/ARB was evaluated on Respiratory-related mortality (HR 1.07, 95% CI 0.79-1.43, p=0.673). Taking ACEI or ARB medications was not significantly associated with respiratory-related mortality in patients with hypertension (HR 1.07).

synapsesocial.com/papers/6a9fa5179bb906707eefd062 https://doi.org/10.11909/j.issn.1671-5411.2022.07.003

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

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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