Angiotensin-converting enzyme inhibitors and active tuberculosis

A population-based study

Jiunn Yih Wu, Meng Tse Gabriel, Si Huei Lee, Shih Hao Lee, Yi Wen Tsai, Shou Chien Hsu, Shy Shin Chang, Chien Chang Lee

Research output: Contribution to journalArticle

Abstract

Numerous epidemiological data suggest that the use of angiotensin-converting enzyme inhibitors (ACEis) can improve the clinical outcomes of pneumonia. Tuberculosis (TB) is an airborne bacteria like pneumonia, and we aimed to find out whether the use of ACEis can decrease the risk of active TB. We conducted a nested case-control analysis by using a 1 million longitudinally followed cohort, from Taiwan national health insurance research database. The rate ratios (RRs) for TB were estimated by conditional logistic regression, and adjusted using a TB-specific disease risk score (DRS) with 71 TB-related covariates. From January, 1997 to December, 2011, a total of 75,536 users of ACEis, and 7720 cases of new active TB were identified. Current use (DRS adjusted RR, 0.87 [95% CI, 0.78-0.97]), but not recent and past use of ACEis, was associated with a decrease in risk of active TB. Interestingly, it was found that chronic use (>90 days) of ACEis was associated with a further decrease in the risk of TB (aRR, 0.74, [95% CI, 0.66-0.83]). There was also a duration response effect, correlating decrease in TB risk with longer duration of ACEis use. The decrease in TB risk was also consistent across all patient subgroups (age, sex, heart failure, cerebrovascular diseases, myocardial infraction, renal diseases, and diabetes) and patients receiving other cardiovascular medicine. In this large population-based study, we found that subjects with recent and chronic use of ACEis were associated with decrease in TB risk.

Original languageEnglish
Article numbere3579
JournalMedicine (United States)
Volume95
Issue number19
DOIs
Publication statusPublished - Jan 1 2016
Externally publishedYes

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Angiotensin-Converting Enzyme Inhibitors
Tuberculosis
Population
Pneumonia
Cerebrovascular Disorders
National Health Programs
Taiwan
Heart Failure
Logistic Models
Medicine
Databases
Bacteria
Kidney

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wu, J. Y., Gabriel, M. T., Lee, S. H., Lee, S. H., Tsai, Y. W., Hsu, S. C., ... Lee, C. C. (2016). Angiotensin-converting enzyme inhibitors and active tuberculosis: A population-based study. Medicine (United States), 95(19), [e3579]. https://doi.org/10.1097/MD.0000000000003579

Angiotensin-converting enzyme inhibitors and active tuberculosis : A population-based study. / Wu, Jiunn Yih; Gabriel, Meng Tse; Lee, Si Huei; Lee, Shih Hao; Tsai, Yi Wen; Hsu, Shou Chien; Chang, Shy Shin; Lee, Chien Chang.

In: Medicine (United States), Vol. 95, No. 19, e3579, 01.01.2016.

Research output: Contribution to journalArticle

Wu, Jiunn Yih ; Gabriel, Meng Tse ; Lee, Si Huei ; Lee, Shih Hao ; Tsai, Yi Wen ; Hsu, Shou Chien ; Chang, Shy Shin ; Lee, Chien Chang. / Angiotensin-converting enzyme inhibitors and active tuberculosis : A population-based study. In: Medicine (United States). 2016 ; Vol. 95, No. 19.
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