{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T21:49:04Z","timestamp":1773179344455,"version":"3.50.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,7,15]]},"abstract":"<jats:sec id=\"jah310985-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Functional inhibitors of acid sphingomyelinase enhance human immune function in\u00a0vitro. We compared the risk of acute infection in users of amlodipine, a functional inhibitor of acid sphingomyelinase, to users of other first\u2010line antihypertensive drugs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310985-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a cohort study using the UK Clinical Practice Research Datalink GOLD (2000\u20132021). We included new monousers of amlodipine, ramipril, or bendroflumethiazide without preexisting cardiovascular disease. In 2 pairwise comparisons (amlodipine versus ramipril\/bendroflumethiazide), we followed patients for as long as they were exposed to compare risk of the primary outcome (acute outpatient infections including respiratory, genitourinary, gastrointestinal infections, and sepsis) and diagnosed SARS\u2010CoV\u20102 infections in 2020\/2021 (amlodipine versus ramipril). We estimated incidence rates (IR) and IR ratios using negative binomial regression, overall and in subgroup analyses. We controlled for confounding using fine stratification on the propensity score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310985-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">After propensity score weighting, we included 121\u2009847 amlodipine versus 122\u2009096 ramipril users and 46\u2009368 amlodipine versus 153\u2009660 bendroflumethiazide users. IRs for the primary outcome ranged from 38.9 per 1000 person\u2010years for amlodipine to 51.6\/1000 person\u2010years for bendroflumethiazide. The weighted IR ratios for acute infections were 0.77 (95% CI, 0.75\u20130.80) for amlodipine versus ramipril, and 0.78 (95% CI, 0.75\u20130.81) for amlodipine versus bendroflumethiazide. These results were robust after excluding patients with diabetes, after restriction to patients with diagnosed hypertension, and within other subgroup analyses. Amlodipine (versus ramipril) was associated with an IR ratio for SARS\u2010CoV\u20102 infection of 0.57 (95% CI, 0.48\u20130.67).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310985-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Amlodipine may be associated with a lower risk of acute infections compared with ramipril and bendroflumethiazide.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.040242","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T10:23:49Z","timestamp":1752488629000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Risk of Acute Infections in New Users of Antihypertensive Drugs: An Observational Cohort Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6723-300X","authenticated-orcid":false,"given":"Noah","family":"Aebi","sequence":"first","affiliation":[{"name":"University of Basel","place":["Basel, Switzerland"]},{"name":"University Hospital Basel","place":["Basel, Switzerland"]},{"name":"University Psychiatric Clinics Basel, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7120-6378","authenticated-orcid":false,"given":"Christoph R.","family":"Meier","sequence":"additional","affiliation":[{"name":"University of Basel","place":["Basel, Switzerland"]},{"name":"University Hospital Basel","place":["Basel, Switzerland"]},{"name":"Boston Collaborative Drug Surveillance Program","place":["Lexington, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan S.","family":"Jick","sequence":"additional","affiliation":[{"name":"Boston Collaborative Drug Surveillance Program","place":["Lexington, USA"]},{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3585-6533","authenticated-orcid":false,"given":"Undine","family":"Lang","sequence":"additional","affiliation":[{"name":"University Psychiatric Clinics Basel, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-1928","authenticated-orcid":false,"given":"Julia","family":"Spoendlin","sequence":"additional","affiliation":[{"name":"University of Basel","place":["Basel, Switzerland"]},{"name":"University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-6618(03)00051-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.embor.7400208"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0023852"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000315101"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1021\/jm070524a"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcab020"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057510"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13390"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1101\/2020.07.21.214577"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.8069"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41421-020-00235-0"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.5.686.32205"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03537.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.006"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-014-0306-5"},{"key":"e_1_3_2_17_2","volume-title":"Hypertension in Adults: Diagnosis and Management","author":"National Institute for Health and Clinical Excellence","year":"2019","unstructured":"National Institute for Health and Clinical Excellence . Hypertension in Adults: Diagnosis and Management. NICE; 2019."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1758-5996-2-44"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5657"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000595"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6058"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.118.3.392"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2011.179"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19880"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3006827"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.01055-17"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19092465"},{"key":"e_1_3_2_28_2","first-page":"1","volume-title":"Hypertension in Adults (Update) [K] Evidence Summary for Pharmacological Treatment in CVD","author":"National Institute for Health and Care Excellence (Great Britain)","year":"2022","unstructured":"National Institute for Health and Care Excellence (Great Britain) , National Guideline Centre (Great Britain) . Hypertension in Adults (Update) [K] Evidence Summary for Pharmacological Treatment in CVD. NICE; 2022:1\u201340."},{"key":"e_1_3_2_29_2","first-page":"67","volume-title":"Type 2 Diabetes in Adults: Management","author":"NICE","year":"2006","unstructured":"NICE . Type 2 Diabetes in Adults: Management. Vol 20. NICE; 2006:67."},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.94253"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-023-00302-0"},{"key":"e_1_3_2_32_2","first-page":"11","volume-title":"Chronic Kidney Disease Assessment and Management: Updated Guidance","author":"National Institute for Health and Care Excellence (Great Britain)","year":"2021","unstructured":"National Institute for Health and Care Excellence (Great Britain) . National Guideline Centre (Great Britain). Chronic Kidney Disease Assessment and Management: Updated Guidance. Vol 36. NICE; 2021:11."},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.2217\/cer-2019-0190"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.04.029"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2013.79"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.122.321762"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70187-2"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.040242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T10:11:45Z","timestamp":1752660705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.040242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":36,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2025,7,15]]}},"alternative-id":["10.1161\/JAHA.124.040242"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.040242","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]},"assertion":[{"value":"2024-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e040242"}}