Key result
ARB use linked to ~28% lower risk of hospitalized pneumonia in stroke patients.
Why the study?
The association between antihypertensive use and the incidence of hospitalized pneumonia in patients with a history of stroke was unclear.
Does antihypertensive use reduce the incidence of hospitalized pneumonia in patients with a history of stroke?
Case-Control
Yes
Does antihypertensive use reduce the incidence of hospitalized pneumonia in patients with a history of stroke?
In patients with a history of stroke, the use of ARBs is associated with a significantly reduced risk of hospitalized pneumonia, particularly in older adults (>65 years).
Answers are grounded in this paper and cite their sources.
May support ARB preference post-stroke to lower pneumonia risk; hypothesis-generating and should not yet change practice.
BACKGROUND: We aimed to examine the association between antihypertensive use and the incidence of hospitalized pneumonia in patients with a history of stroke. METHODS: In this case-crossover study, we obtained data from the Korean National Health Insurance Service-National Sample Cohort database. We included the data of patients with history of stroke who were admitted with a disease code of pneumonia. We analyzed the patients' exposure to antihypertensives in the 30 (single case period), 90-120, and 150-180 days (2 control periods) before the onset of pneumonia using conditional logistic regression analysis. Additionally, sensitivity analysis and subgroup analysis according to diabetes status, age, and documented disability were performed. RESULTS: Angiotensin II receptor blocker (ARB) use was associated with a reduced risk of hospitalized pneumonia (adjusted odds ratio [OR] [95% confidence interval; 95% CI]: 0.718 [0.576-0.894]). However, the use of angiotensin converting enzyme inhibitors and other antihypertensives were not associated with a change in hospitalized pneumonia incidence (adjusted OR [95% CI]: 0.902, [0.603-1.350] and 0.788 [0609-1.018], respectively). Subgroup analysis revealed that ARB use was associated with a reduced incidence of hospitalized pneumonia in patients with a history of stroke who were older than 65 years, but not in younger (≤ 65 years) group (adjusted OR [95% CI]: 0.687 [0.536-0.880]). CONCLUSION: ARB use is associated with a reduced incidence of hospitalized pneumonia in patients with a history of stroke, especially in older adults.
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Yun et al. (2022) conducted a case-control in History of stroke and hospitalized pneumonia. Angiotensin II receptor blocker (ARB) use vs. Control periods (90-120 and 150-180 days before pneumonia onset) was evaluated on Hospitalized pneumonia (OR 0.718, 95% CI 0.576-0.894). Angiotensin II receptor blocker (ARB) use was associated with a reduced risk of hospitalized pneumonia in patients with a history of stroke (OR 0.718; 95% CI 0.576-0.894).
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