• Jae-Hyun Yun, Seung Yeon Rhee, Sungyoun Chun, Hyoung Seop Kim, and Byung-Mo Oh.
• Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2022 Apr 18; 37 (15): e112.

BackgroundWe aimed to examine the association between antihypertensive use and the incidence of hospitalized pneumonia in patients with a history of stroke.MethodsIn this case-crossover study, we obtained data from the Korean National Health Insurance Service-National Sample Cohort database. We included the data of patients with history of stroke who were admitted with a disease code of pneumonia. We analyzed the patients' exposure to antihypertensives in the 30 (single case period), 90-120, and 150-180 days (2 control periods) before the onset of pneumonia using conditional logistic regression analysis. Additionally, sensitivity analysis and subgroup analysis according to diabetes status, age, and documented disability were performed.ResultsAngiotensin II receptor blocker (ARB) use was associated with a reduced risk of hospitalized pneumonia (adjusted odds ratio [OR] [95% confidence interval; 95% CI]: 0.718 [0.576-0.894]). However, the use of angiotensin converting enzyme inhibitors and other antihypertensives were not associated with a change in hospitalized pneumonia incidence (adjusted OR [95% CI]: 0.902, [0.603-1.350] and 0.788 [0609-1.018], respectively). Subgroup analysis revealed that ARB use was associated with a reduced incidence of hospitalized pneumonia in patients with a history of stroke who were older than 65 years, but not in younger (≤ 65 years) group (adjusted OR [95% CI]: 0.687 [0.536-0.880]).ConclusionARB use is associated with a reduced incidence of hospitalized pneumonia in patients with a history of stroke, especially in older adults.© 2022 The Korean Academy of Medical Sciences.

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