{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:42:01Z","timestamp":1789684921926,"version":"4.0.1"},"reference-count":36,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sanofi Pasteur M\u00e9xico","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,11,18]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In Mexico, patients with systemic arterial hypertension (SAH) are excluded from the influenza vaccination programme despite their risk of cardiovascular events as influenza-related complications. We investigated the impact of influenza on morbidity and mortality in patients with SAH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a retrospective cross-sectional study that analysed data from early 2014 to mid-2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were obtained from the Influenza Epidemiological Surveillance System in Mexico database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>32\u2009663 cases of influenza in people aged \u226520 years with a confirmed case of influenza-like illness, severe respiratory infection and\/or influenza death were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Influenza deaths, hospitalisation frequency and the impact on hospitalisation and\/or death due to influenza by the SAH variate alone and in combination with diabetes, obesity, chronic obstructive pulmonary disease, cardiovascular disease and\/or smoking, and by vaccination status were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The hospitalisation frequency increased with age. Notably, 46.0% (15 033\/32 663) of confirmed influenza cases had at least one comorbidity, with SAH (19.2%; 6260\/32 663) and obesity (18.7%; 6106\/32 663) being the most prevalent. Most confirmed SAH cases (80.8%; 5057\/6260) were in those who had not been vaccinated against influenza. There were 3496 deaths due to influenza (mortality rate, 0.69\u00d71\u200900\u2009000 inhabitants), with the highest rates seen in those aged \u226580 years (80\u201389 years, 2.0%; \u226590 years, 3.6%). The case fatality rate due to influenza and SAH was significantly higher than those due to influenza without SAH in those aged &lt;50 years, but not in the other age groups (20\u201329 years, 9.8%, p&lt;0.0005; 30\u201339 years, 8.2%, p&lt;0.035; 40\u201349 years, 17.8%, p&lt;0.0005; vs 15.1%\u201320.0%, p=0.31\u20130.99 for those aged \u226550 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings support the need to include SAH in public policies of influenza vaccination as a secondary prevention measure to avoid fatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057225","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T12:25:04Z","timestamp":1639743904000},"page":"e057225","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020"],"prefix":"10.1136","volume":"11","author":[{"given":"Alejandrina","family":"Malacara-Villase\u00f1or","sequence":"first","affiliation":[{"name":"Departamento Medico, Sanofi Pasteur Mexico, Ciudad de Mexico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermes","family":"Ilaraza-Lomeli","sequence":"additional","affiliation":[{"name":"Rehabilitacion Cardiaca, Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Tapia-Conyer","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3112-2679","authenticated-orcid":false,"given":"Elsa","family":"Sarti","sequence":"additional","affiliation":[{"name":"Departamento Medico, Sanofi Pasteur Mexico, Ciudad de Mexico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"2025121300172630000_11.12.e057225.1","unstructured":"World Health Organization . 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