Among older adults, hospitalization for pneumonia raises the short-term (1-month) and long-term (10-year) risk of cardiovascular disease events to a degree comparable to those of smoking, diabetes, and hypertension, according to a report published online Jan. 20 in JAMA.
“Our findings suggest that hospitalization for pneumonia should be considered an independent cardiovascular risk factor” and “should prompt clinical trials to test targeted strategies”’ to prevent the disease in this patient population, said Dr. Vicente F. Corrales-Medina of the University of Ottawa and the Ottawa Hospital Research Institute.
Courtesy NIH National Library of Medicine/Institute for Physical Education and Sport, University of Malta, Malta/Creative Commons License
Hospitalization for pneumonia should be considered an independent CVD risk factor, according to researchers.
The risk of cardiovascular disease (CVD) events within 30 days of severe infections, mainly those involving the respiratory tract, is well established, but the more lasting effects are uncertain. In what the researchers described as “the first study to document the temporal variation in the long-term risk of CVD ... using rigorous methods to adjust for many potential confounders,” they analyzed data from two multicenter population-based cohorts that were followed for 21 years.
The 591 participants in the Cardiovascular Health Study were 65 years of age or older and had been hospitalized for pneumonia. When researchers compared their outcomes to 1,182 matched controls without pneumonia, they found that in the pneumonia group the rate of CVD events was fourfold higher at 30 days, dropped to twofold higher throughout the rest of the first year, and leveled out at 1.5-fold higher for the remainder of the decade.
Researchers then verified this risk pattern in a cohort of 680 pneumonia patients aged 45-64 years and 1,360 matched controls in the Atherosclerosis Risk in Communities study. The increased risk conferred by hospitalization for pneumonia persisted after the data were adjusted to account for demographic traits, preexisting CVD risk factors, and measures of patient frailty; it also was robust to numerous sensitivity analyses, the researchers said (JAMA 2015 Jan. 20 [doi:10.1001/jama.2014.18229]).
Moreover, the magnitude of risk conferred by hospitalization for pneumonia “was similar or higher, compared with the risk of CVD associated with traditional risk factors such as smoking, diabetes, and hypertension,” wrote Dr. Corrales-Medina and his associates.
The Ottawa Hospital, the Ottawa Hospital Research Institute, and the Canadian National Institute of General Medical Sciences funded the study. Dr. Corrales-Medina reported having no financial disclosures; an associate reported ties to Biogen Idec, Bristol-Myers Squibb/Pfizer, Boehringer Ingelheim, CardioNet, Daiichi Sankyo, diaDexus, Janssen, Merck/Organon, and Sanofi.