title: Angiotensin-converting enzyme inhibitor use and pneumonia risk in a general population.
abstract: The aim of the present study was to assess whether the use of angiotensin-converting enzyme (ACE) inhibitors is associated with a decreased risk of hospitalisation for community-acquired pneumonia (CAP) in a general, essentially white population. Data were obtained from the Dutch PHARMO Record Linkage System. Cases were defined as patients with a first hospital admission for CAP. For each case, up to four population controls were matched by age and sex. The study population comprised 1,108 patients with a first hospital admission for CAP and 3,817 matched controls. After adjusting for several confounders, ACE inhibitor use was not associated with a decreased incidence of pneumonia (adjusted odds ratio (OR) 1.12; 95% confidence interval (CI) 0.88-1.43). Additionally, no significant association was observed in patients with diabetes, respiratory diseases, heart failure, or patients with both of the last two conditions. Furthermore, adjustment of treatment effects on pneumonia risk using stratification on balancing score also showed no significant association between ACE inhibitor use and pneumonia risk within the different strata (overall adjusted OR 1.09; 95% CI 0.87-1.36). In contrast with previous findings in Asian populations, the current authors were not able to confirm the beneficial effect of angiotensin-converting enzyme inhibitors on pneumonia risk in a general, essentially white population.
authors.affiliation: Dept of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences (UIPS), Sorbonnelaan 16, 3583 CA Utrecht, The Netherlands. e.m.w.vandegarde@pharm.uu.nl
authors.forename: E M W
authors.initials: EM
authors.lastname: van de Garde
authors.forename: P C
authors.initials: PC
authors.lastname: Souverein
authors.forename: J M M
authors.initials: JM
authors.lastname: van den Bosch
authors.forename: V H M
authors.initials: VH
authors.lastname: Deneer
authors.forename: H G M
authors.initials: HG
authors.lastname: Leufkens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001996:Bronchopneumonia / Q000453:epidemiology / Q000517:prevention & control; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data*; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000517:prevention & control; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D013223:Statistics as Topic
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors