Statin use and risk of community acquired pneumonia in older people: population based case-control study.
OBJECTIVE
To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia.


METHODS
Population based case-control study.


METHODS
Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling Group Health members aged 65 to 94; two matched controls for each case with pneumonia. Information on comorbid illnesses and functional and cognitive status, potential confounders of the association between statin use and risk of pneumonia, came from medical record review and computerised pharmacy data.


METHODS
Adjusted estimates of risk of pneumonia in relation to current statin use.


RESULTS
1125 validated cases of pneumonia and 2235 matched controls were identified. Compared with controls, cases were more likely to have chronic lung and heart disease, especially severe disease, and functional or cognitive impairment. Current statin use was present in 16.1% (181/1125) of cases and 14.6% (327/2235) of controls (adjusted odds ratio 1.26, 95% confidence interval 1.01 to 1.56). Among cases admitted to hospital and matched controls, current statin use was present in 17.2% (68/395) of cases and 14.2% (112/788) of controls (adjusted odds ratio 1.61, 1.08 to 2.39, compared with non-use). In people in whom statins were indicated for secondary prevention, the adjusted odds ratio for risk of pneumonia in relation to current statin use was 1.25 (0.94 to 1.67); in those with no such indication, it was 0.81 (0.46 to 1.42).


CONCLUSIONS
Statin use was not associated with decreased risk of pneumonia among immunocompetent, community dwelling older people. Findings of previous studies may reflect "healthy user" bias.
Dublin
Sascha
S
Group Health Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle WA 98101-1448, USA. dublin.s@ghc.org
Jackson
Michael L
ML
Nelson
Jennifer C
JC
Weiss
Noel S
NS
Larson
Eric B
EB
Jackson
Lisa A
LA
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000276:immunology / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007121:Immunocompetence; D008297:Male; D018410:Pneumonia, Bacterial / Q000276:immunology / Q000517:prevention & control*; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors