title: Pneumonia risk and use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers.
abstract: BACKGROUND
  Recent studies have shown that use of angiotensin-converting enzyme (ACE) inhibitors may decrease pneumonia risk in various populations. We investigated the effect of ACE inhibitors and angiotensin II receptor blockers (ARBs) on pneumonia hospitalization in the general population of Taiwan.
  
  
  METHODS
  We conducted a case-crossover study using the Taiwan Longitudinal Health Insurance Database for the year 2005. Data from patients hospitalized for the first time for pneumonia during 1997-2007 were analyzed. The case period was defined as the 30 days before admission; the periods 90 to 120 days and 180 to 210 days before admission were used as control periods. Prescribing status of ACE inhibitors and ARBs during the 3 periods was assessed for each patient. Conditional logistic regression was used to estimate the odds ratio (OR) for pneumonia associated with use of ACE inhibitors and ARBs.
  
  
  RESULTS
  We identified 10 990 cases of hospitalization for new pneumonia. After adjustment for time-variant confounding factors, pneumonia was not associated with use of ACEI or ARBS: the ORs were 0.99 (95% CI, 0.81-1.21) and 0.96 (0.72-1.28), respectively. No association was seen for cumulative defined daily doses (DDDs), as compared with nonusers, for 0 to 30, 31 to 60, or more than 60 DDDs. The results were found to be robust in sensitivity analysis.
  
  
  CONCLUSIONS
  Neither the use nor cumulative dose of ACE inhibitors or ARBs was associated with pneumonia among the Taiwanese general population.
authors.affiliation: Department of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Liu
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Shau
authors.forename: Chia-Hsuin
authors.initials: CH
authors.lastname: Chang
authors.forename: Chi-Shin
authors.initials: CS
authors.lastname: Wu
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D018592:Cross-Over Studies; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced / Q000628:therapy*; D012306:Risk; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
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