ACE Inhibitors And ARBs Lower Mortality Risk In Patients Of
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Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) may worsen the prognosis of coronavirus disease 2019, but any association could be confounded by the cardiometabolic conditions indicating ACE-I/ARB use. Researchers therefore examined the impact of ACE-Is/ARBs on respiratory tract infection outcomes.

This cohort study included all adult patients hospitalized with influenza or pneumonia from 2005 to 2018 in Denmark using population-based medical databases. Thirty-day mortality and risk of admission to the intensive care unit in ACE-Is/ARBs users was compared with nonusers and with users of calcium channel blockers.

Propensity scores were used to handle confounding and computed propensity score-weighted risks, risk differences (RDs), and risk ratios (RRs).

-- Of 568 019 patients hospitalized with influenza or pneumonia, 100 278 were ACE-I/ARB users and 37 961 were users of calcium channel blockers.

-- In propensity score-weighted analyses, ACE-I/ARB users had marginally lower 30-day mortality than users of calcium channel blockers, and a lower risk of admission to the intensive care unit.
-- Compared with nonusers, current ACE-I/ARB users had lower mortality, but similar risk of admission to the intensive care unit.

Conclusively, Among patients with influenza or pneumonia, ACE-I/ARB users had no increased risk of admission to the intensive care unit and slightly reduced mortality after controlling for confounding.

Source: https://www.ahajournals.org/doi/full/10.1161/JAHA.120.017297
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