Flu Vaccine and Mortality in Hypertension: A Nationwide Cohort Study

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Thomas Benfield¹  Ramona Trebbien¹  Brian Claggett¹  Gunnar Gislason²  Lars Køber³  Scott D. Solomon³  Daniel Modin³  Mads Emil Jørgensen⁴  Orly Vardeny⁴  Tor Biering‐Sørensen⁴  Christian Torp‐Pedersen⁵  Marc A. Pfeffer⁶  Morten Schou⁷  Jens‐Ulrik Stæhr Jensen⁷  Michael Fralick⁷ 

[1] Gentofte Hospital University of Copenhagen Denmark;Center for Chronic Disease Outcomes Research Minneapolis VA Health Care System Minneapolis MN;;Department of Cardiology Herlev &Department of Medicine Cardiovascular Medicine Division Brigham and Women’s Hospital Harvard Medical School Boston MA;Department of Medicine Eliot Phillipson Clinician Scientist Training ProgramUniversity of Toronto Ontario Canada;Department of Virus and Microbiological Special Diagnostics National Influenza CenterStatens Serum Institut Copenhagen Denmark;Faculty of Health Sciences Institute of Clinical MedicineUniversity of Copenhagen Denmark;

关键词: acute myocardial infarction;    all‐cause death;    hypertension;    influenza;    influenza vaccination;    stroke;   

DOI  :  10.1161/JAHA.121.021715

来源: DOAJ

【 摘 要 】

Background Influenza infection may increase the risk of stroke and acute myocardial infarction (AMI). Whether influenza vaccination may reduce mortality in patients with hypertension is currently unknown. Methods and Results We performed a nationwide cohort study including all patients with hypertension in Denmark during 9 consecutive influenza seasons in the period 2007 to 2016 who were prescribed at least 2 different classes of antihypertensive medication (renin‐angiotensin system inhibitors, diuretics, calcium antagonists, or beta‐blockers). We excluded patients who were aged <18 years, >100 years, had ischemic heart disease, heart failure, chronic obstructive lung disease, cancer, or cerebrovascular disease. The exposure to influenza vaccination was assessed before each influenza season. The end points were defined as death from all‐causes, from cardiovascular causes, or from stroke or AMI. For each influenza season, patients were followed from December 1 until April 1 the next year. We included a total of 608 452 patients. The median follow‐up was 5 seasons (interquartile range, 2–8 seasons) resulting in a total follow‐up time of 975 902 person‐years. Vaccine coverage ranged from 26% to 36% during the study seasons. During follow‐up 21 571 patients died of all‐causes (3.5%), 12 270 patients died of cardiovascular causes (2.0%), and 3846 patients died of AMI/stroke (0.6%). After adjusting for confounders, vaccination was significantly associated with reduced risks of all‐cause death (HR, 0.82; P<0.001), cardiovascular death (HR, 0.84; P<0.001), and death from AMI/stroke (HR, 0.90; P=0.017). Conclusions Influenza vaccination was significantly associated with reduced risks of death from all‐causes, cardiovascular causes, and AMI/stroke in patients with hypertension. Influenza vaccination might improve outcome in hypertension.

【 授权许可】

Unknown