Reduction of risk of pneumonia associated with use of angiotensin I converting enzyme inhibitors in elderly inpatients
Reduction of risk of pneumonia associated with use of angiotensin I converting enzyme inhibitors in elderly inpatients
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DOI：
10.1016/s0895-7061(99)00035-7
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发表时间：
1999-08-01
影响因子：
3.2
通讯作者：
Ogihara, T
中科院分区：
文献类型：
--
作者：
Okaishi, K;Morimoto, S;Ogihara, T
肺炎是老年人死亡的主要直接原因。尽管基于咳嗽反射减弱的误吸是老年人肺炎的原因之一，但血管紧张素I转换酶抑制剂的研究很少血管紧张素转换酶抑制剂（ACE抑制剂），这是一种抗高血压药物，诱导咳嗽，作为一个因素的影响，肺炎的发病率在机构的老年受试者。我们进行了一项基于医院的病例对照研究。病例为55例肺炎患者，年龄大于或等于65岁，在1年期间。对照组为老年受试者，频率与年龄和性别的病例相匹配（n = 220）。收集已知危险因素和高血压药物的数据，包括ACE抑制剂、钙通道阻滞剂和非降压药物。采用病例组和对照组的单变量和多变量比较分析危险因素差异的显著性，校正潜在混杂因素后，肺炎的相对危险度估计值为0.38（95%置信区间[CI]，0.15-0.97）和1.84（95% CI，0.89-3.78）分别为ACE抑制剂和钙通道阻滞剂，相对于非降压药物。长期使用ACE抑制剂对老年住院患者肺炎的预防作用明显（0.24; 95%CI，0.07-0.88），提示ACE抑制剂的使用是降低老年住院患者肺炎风险的独立因素。(C)1999年美国高血压杂志有限公司
Pneumonia is a major direct cause of death in the elderly. Although aspiration based on a reduced cough reflex is one of the causes of pneumonia in the elderly, there are few studies of angiotensin-I converting enzyme inhibitors (ACE inhibitors), which are antihypertensive drugs that induce cough, as a factor influencing the incidence of pneumonia in institutionalized elderly subjects.To assess the effect of ACE inhibitors and dihydropiridine calcium-channel blockers on the incidence of pneumonia, we conducted a hospital-based case-control study. Cases were 55 pneumonia patients aged greater than or equal to 65 years during a 1-year period. The controls were elderly subjects, frequency matched to the cases by age and gender (n = 220). Data were collected on known risk factors and on medication for hypertension, consisting of ACE inhibitors, calcium-channel blockers, and nonantihypertensive medication. The significance of differences in risk factors was analyzed using univariate and multivariate comparisons of cases and controls.After adjustment for potential confounding factors, the relative risk estimates for pneumonia were 0.38 (95% confidence interval [CI], 0.15-0.97) and 1.84 (95% CI, 0.89-3.78) for ACE inhibitors and calcium-channel blockers, respectively, relative to nonantihypertensive medication. The preventive effect of ACE inhibitors on pneumonia was apparent in long-acting ACE inhibitor users (0.24; 95% CI, 0.07-0.88).We conclude that ACE inhibitor use is an independent factor reducing risk of pneumonia among elderly inpatients. (C) 1999 American Journal of Hypertension, Ltd.