{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:11:45Z","timestamp":1778627505678,"version":"3.51.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Angiotensin\u2010converting enzyme inhibitors (ACE\u2010Is) 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\u2010I\/ARB use. We therefore examined the impact of ACE\u2010Is\/ARBs on respiratory tract infection outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">This cohort study included all adult patients hospitalized with influenza or pneumonia from 2005 to 2018 in Denmark using population\u2010based medical databases. Thirty\u2010day mortality and risk of admission to the intensive care unit in ACE\u2010Is\/ARBs users was compared with nonusers and with users of calcium channel blockers. We used propensity scores to handle confounding and computed propensity score\u2010weighted risks, risk differences (RDs), and risk ratios (RRs). Of 568\u00a0019 patients hospitalized with influenza or pneumonia, 100\u00a0278 were ACE\u2010I\/ARB users and 37\u00a0961 were users of calcium channel blockers. In propensity score\u2010weighted analyses, ACE\u2010I\/ARB users had marginally lower 30\u2010day mortality than users of calcium channel blockers (13.9% versus 14.5%; RD, \u22120.6%; 95% CI, \u22121.0 to \u22120.1; RR, 0.96; 95% CI, 0.93\u20130.99), and a lower risk of admission to the intensive care unit (8.0% versus 9.6%; RD, \u22121.6%; 95% CI, \u22122.0 to \u22121.2; RR, 0.83; 95% CI, 0.80\u20130.87). Compared with nonusers, current ACE\u2010I\/ARB users had lower mortality (RD, \u22122.4%; 95% CI, \u22122.8 to \u22122.0; RR, 0.85; 95% CI, 0.83\u20130.87), but similar risk of admission to the intensive care unit (RD, 0.4%; 95% CI, 0.0\u20130.7; RR, 1.04; 95% CI, 1.00\u20131.09).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with influenza or pneumonia, ACE\u2010I\/ARB users had no increased risk of admission to the intensive care unit and slightly reduced mortality after controlling for confounding.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017297","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T09:04:53Z","timestamp":1601543093000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Renin\u2013Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0727-953X","authenticated-orcid":false,"given":"Christian Fynbo","family":"Christiansen","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uffe","family":"Heide\u2010J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0120-1712","authenticated-orcid":false,"given":"Thomas B\u00f8jer","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bodilsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Schmeltz","family":"S\u00f8gaard","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Maeng","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Tilma","family":"Vistisen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Cardiology Regional Hospital West Jutland Herning Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Potteg\u00e5rd","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8651-6072","authenticated-orcid":false,"given":"Lars Christian","family":"Lund","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-4385","authenticated-orcid":false,"given":"Mette","family":"Reilev","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesper","family":"Hallas","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3764-8532","authenticated-orcid":false,"given":"Nanna Borup","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai Constantin","family":"Brun","sequence":"additional","affiliation":[{"name":"Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"},{"name":"Center for Population Health Sciences Stanford University Stanford CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-3474","authenticated-orcid":false,"given":"Reimar Wernich","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"1824","article-title":"Pharmacologic treatments for coronavirus disease 2019 (COVID\u201019): a review","author":"Sanders JM","year":"2020","unstructured":"Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirus disease 2019 (COVID\u201019): a review. JAMA. 2020;1824\u20131836.","journal-title":"JAMA"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30116-8"},{"key":"e_1_3_1_4_2","first-page":"m810","article-title":"Rapid response: Re: preventing a covid\u201019 pandemic: ACE inhibitors as a potential risk factor for fatal Covid\u201019","author":"Sommerstein R","year":"2020","unstructured":"Sommerstein R, Gr\u00e4ni C. Rapid response: Re: preventing a covid\u201019 pandemic: ACE inhibitors as a potential risk factor for fatal Covid\u201019. BMJ. 2020;m810. Website name: . Available at: bmj.com https:\/\/www.bmj.com\/conte\u200bnt\/368\/bmj.M810\/rr-2. Accessed August 14, 2020.","journal-title":"BMJ"},{"key":"e_1_3_1_5_2","first-page":"1769","article-title":"COVID\u201019 and angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers: what is the evidence?","author":"Patel AB","year":"2020","unstructured":"Patel AB, Verma A. COVID\u201019 and angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers: what is the evidence? JAMA. 2020;1769\u20131770.","journal-title":"JAMA"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.052"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30079-5"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_3_1_10_2","first-page":"1775","article-title":"Case\u2010fatality rate and characteristics of patients dying in relation to COVID\u201019 in Italy","author":"Onder G","year":"2020","unstructured":"Onder G, Rezza G, Brusaferro S. Case\u2010fatality rate and characteristics of patients dying in relation to COVID\u201019 in Italy. JAMA. 2020;1775\u20131776.","journal-title":"JAMA"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4326"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2004500"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046941"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr2005760"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1313"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016509"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4260"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis733"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085797"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2018.1499293"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.317134"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1282"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa235"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S179083"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S99476"},{"key":"e_1_3_1_28_2","first-page":"798","article-title":"Data resource profile: the Danish national prescription registry","author":"Potteg\u00e5rd A","year":"2017","unstructured":"Potteg\u00e5rd A, Schmidt SA, Wallach\u2010Kildemoes H, S\u00f8rensen HT, Hallas J, Schmidt M. Data resource profile: the Danish national prescription registry. Int J Epidemiol. 2017;798\u2013798f.","journal-title":"Int J Epidemiol"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms4594"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1823-x"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01629.x"},{"key":"e_1_3_1_32_2","first-page":"9","article-title":"Validity of the coding for intensive care admission, mechanical ventilation, and acute dialysis in the Danish National Patient Registry: a short report","author":"Blichert\u2010Hansen L","year":"2013","unstructured":"Blichert\u2010Hansen L, Nielsson MS, Nielsen RB, Christiansen CF, N\u00f8rgaard M. Validity of the coding for intensive care admission, mechanical ventilation, and acute dialysis in the Danish National Patient Registry: a short report. Clin Epidemiol. 2013;9\u201312.","journal-title":"Clin Epidemiol"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30161-2"},{"key":"e_1_3_1_34_2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012832","article-title":"Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study","volume":"9","author":"Sundb\u00f8ll J","year":"2016","unstructured":"Sundb\u00f8ll J, Adelborg K, Munch T, Fr\u00f8slev T, S\u00f8rensen HT, B\u00f8tker HE, Schmidt M. Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study. BMJ Open. 2016;9:e012832.","journal-title":"BMJ Open"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.017297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:51:24Z","timestamp":1715601084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.017297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,6]]},"references-count":33,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2020,10,6]]}},"alternative-id":["10.1161\/JAHA.120.017297"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.017297","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,6]]},"assertion":[{"value":"2020-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e017297"}}