BP drugs reduce pneumonia risk in stroke patients

Treatment with an ACE inhibitor, a type of blood pressure drug that includes Zestril and Accupril among others, appears to reduce the risk of pneumonia in patients who’ve suffered a stroke, new research suggests.

Because of the muscle and nerve problems that occur with stroke, these patients are at risk for aspiration pneumonia, a serious type of pneumonia that arises when stomach juices or other caustic substances enter the lungs.

Dr. Kiyohisa Sekizawa, at the University of Tsukuba in Ibaraki, Japan, and associates assessed the risk of pneumonia in more than 1000 stroke patients who were followed for 35 months. Some of the patients were treated with ACE inhibitors, some with other blood pressure drugs, and some were not treated with any of these medications.

The researchers’ findings are published in the medical journal Neurology.

During follow-up, 2.8 percent of patients treated with ACE inhibitors developed pneumonia. By contrast, the rate in the other groups was around 8.5 percent.

The researchers believe that ACE inhibitors may reduce the pneumonia risk by increasing levels of a chemical called substance P. A known muscle stimulant, substance P may temporarily tighten the muscular junction between the esophagus and stomach, making regurgitation of stomach juices, and therefore aspiration pneumonia, less likely.

SOURCE: Neurology, February 9, 2005.

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Revision date: July 8, 2011
Last revised: by Jorge P. Ribeiro, MD