Flu Vaccine and Mortality in Hypertension: A Nationwide Cohort Study
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Flu Vaccine and Mortality in Hypertension : A Nationwide Cohort Study. / Modin, Daniel; Claggett, Brian; Jørgensen, Mads Emil; Køber, Lars; Benfield, Thomas; Schou, Morten; Jensen, Jens Ulrik Stæhr; Solomon, Scott D.; Trebbien, Ramona; Fralick, Michael; Vardeny, Orly; Pfeffer, Marc A.; Torp-Pedersen, Christian; Gislason, Gunnar; Biering-Sørensen, Tor.
In: Journal of the American Heart Association, Vol. 11, No. 6, e021715, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Flu Vaccine and Mortality in Hypertension
T2 - A Nationwide Cohort Study
AU - Modin, Daniel
AU - Claggett, Brian
AU - Jørgensen, Mads Emil
AU - Køber, Lars
AU - Benfield, Thomas
AU - Schou, Morten
AU - Jensen, Jens Ulrik Stæhr
AU - Solomon, Scott D.
AU - Trebbien, Ramona
AU - Fralick, Michael
AU - Vardeny, Orly
AU - Pfeffer, Marc A.
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Biering-Sørensen, Tor
N1 - Publisher Copyright: © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022
Y1 - 2022
N2 - 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 antihyperten-sive 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 cover-age 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.
AB - 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 antihyperten-sive 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 cover-age 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.
KW - acute myocardial infarction
KW - all-cause death
KW - hypertension
KW - influenza
KW - influenza vaccination
KW - stroke
KW - vaccination
U2 - 10.1161/JAHA.121.021715
DO - 10.1161/JAHA.121.021715
M3 - Journal article
C2 - 35132866
AN - SCOPUS:85126831050
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 6
M1 - e021715
ER -
ID: 309123402