{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:55:00Z","timestamp":1765702500823,"version":"3.48.0"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,1]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evaluate associations between ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs) and clinical outcomes in acute viral respiratory illness (AVRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort analysis of claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The USA; 2018\u20132019 influenza season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Main cohort: people with hypertension (HTN) taking an ACEi, ARB or other HTN medications, and experiencing AVRI. Falsification cohort: parallel cohort receiving elective knee or hip replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Main cohort: hospital admission, intensive care unit, acute respiratory distress (ARD), ARD syndrome and all-cause mortality. Falsification cohort: complications after surgery and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The main cohort included 236\u2009843 episodes of AVRI contributed by 202\u2009629 unique individuals. Most episodes were in women (58.9%), 81.4% in people with Medicare Advantage and 40.3% in people aged 75+ years. Odds of mortality were lower in the ACEi (0.78 (0.74 to 0.83)) and ARB (0.64 (0.61 to 0.68)) cohorts compared with other HTN medications. On all other outcomes, people taking ARBs (but not ACEis) had a &gt;10% reduction in odds of inpatient stays compared with other HTN medications.<\/jats:p>\n                    <jats:p>In the falsification analysis (N=103\u2009353), both ACEis (0.89 (0.80 to 0.98)) and ARBs (0.82 (0.74 to 0.91)) were associated with decreased odds of complications compared with other HTN medications; ARBs (0.64 (0.47 to 0.87)) but not ACEis (0.79 (0.60 to 1.05)) were associated with lower odds of death compared with other HTN medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Outpatient use of ARBs was associated with better outcomes with AVRI compared with other medications for HTN. ACEis were associated with reduced risk of death, but with minimal or no reduction in risk of other complications. A falsification analysis conducted to provide context on the possible causal implications of these findings did not provide a clear answer. Further analysis using observational data will benefit from additional approaches to assess causal relationships between these drugs and outcomes in AVRI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044010","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:10:14Z","timestamp":1616026214000},"page":"e044010","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Association of outpatient ACE inhibitors and angiotensin receptor blockers and outcomes of acute respiratory illness: a retrospective cohort study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3854-6810","authenticated-orcid":false,"given":"Molly Moore","family":"Jeffery","sequence":"first","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan W","family":"Cummins","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy M","family":"Dempsey","sequence":"additional","affiliation":[{"name":"Pulmonary Critical Care Medicine, David Grant Medical Center, Travis AFB, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew H.","family":"Limper","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Robert D and Patricia E Kern Center for the Sciences of the Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilay D","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Robert D and Patricia E Kern Center for the Sciences of the Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Bellolio","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"2025121400502648000_11.3.e044010.1","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.mayocp.2020.03.026","article-title":"Angiotensin-Converting enzyme 2 and antihypertensives (angiotensin receptor blockers and angiotensin-converting enzyme inhibitors) in coronavirus disease 2019","volume":"95","author":"Sanchis-Gomar","year":"2020","journal-title":"Mayo Clin Proc"},{"key":"2025121400502648000_11.3.e044010.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m406"},{"key":"2025121400502648000_11.3.e044010.3","unstructured":"American Heart Association, Heart Failure Society of America, American College of Cardiology . 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