The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study
There is evidence of strong association between influenza infections and stroke; however, the influenza vaccination and its effect on strokes is currently unclear. In the present study, Taiwan’s National Health Insurance Database was used in obtaining data for study subjects 55 years and older diagn...
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| Format: | Article |
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MDPI AG
2022-04-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/12/8/4074 |
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| author | Cheng-Hsin Lin Chun-Chih Chiu Tsung-Yeh Yang Yu-Ann Fang Meng-Huan Lei Hsien-Tang Yeh Chun-Chao Chen Wen-Rui Hao Chung-Hsien Kuo Ju-Chi Liu |
| author_facet | Cheng-Hsin Lin Chun-Chih Chiu Tsung-Yeh Yang Yu-Ann Fang Meng-Huan Lei Hsien-Tang Yeh Chun-Chao Chen Wen-Rui Hao Chung-Hsien Kuo Ju-Chi Liu |
| author_sort | Cheng-Hsin Lin |
| collection | DOAJ |
| description | There is evidence of strong association between influenza infections and stroke; however, the influenza vaccination and its effect on strokes is currently unclear. In the present study, Taiwan’s National Health Insurance Database was used in obtaining data for study subjects 55 years and older diagnosed with hypertension (<i>n</i> = 59,251; 25,266 vaccinated and 33,985 unvaccinated subjects) from 2001–2012. Propensity scores were calculated using a logistic regression model to determine the effects of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) for stroke in vaccinated and unvaccinated patients. Influenza vaccination was associated with a 42%, 40% and 44% stroke risk reduction in the entire cohort for all seasons, the influenza season and the non-influenza season, respectively (Adjust hazard ratio [aHR]: 0.58, 95% confidence interval [CI]: 0.56–0.61; aHR: 0.60, 95% CI: 0.56–0.63; aHR: 0.56, 95% CI: 0.52–0.60, for all seasons, the influenza season and the non-influenza season, respectively). The effect of risk reduction by vaccination also revealed a trend of dose dependency. Among subjects between 55 to 64 years old with four or more vaccinations during the study period, there is a 73% risk reduction for stroke during the non-influenza season (aHR: 0.27, 95% CI: 0.20–0.34). In conclusion, the influenza vaccination exerts dose-dependent and synergistic protective effects against stroke in individuals 55 years and older with hypertension. |
| first_indexed | 2024-03-09T11:10:39Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-09T11:10:39Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-03108b9a0a6c4d11b5423b4c45fb28d82023-12-01T00:44:48ZengMDPI AGApplied Sciences2076-34172022-04-01128407410.3390/app12084074The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based StudyCheng-Hsin Lin0Chun-Chih Chiu1Tsung-Yeh Yang2Yu-Ann Fang3Meng-Huan Lei4Hsien-Tang Yeh5Chun-Chao Chen6Wen-Rui Hao7Chung-Hsien Kuo8Ju-Chi Liu9Department of Surgery, Division of Cardiovascular Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanCardiovascular Center, Lo-Hsu Medical Foundation Luodong Poh-Ai Hospital, Yilan 265, TaiwanDepartment of Surgery, Lotung Poh-Ai Hospital, Yilan 265, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanDepartment of Electrical Engineering, National Taiwan University of Science and Technology, Taipei 106, TaiwanTaipei Heart Institute, Taipei Medical University, Taipei 110, TaiwanThere is evidence of strong association between influenza infections and stroke; however, the influenza vaccination and its effect on strokes is currently unclear. In the present study, Taiwan’s National Health Insurance Database was used in obtaining data for study subjects 55 years and older diagnosed with hypertension (<i>n</i> = 59,251; 25,266 vaccinated and 33,985 unvaccinated subjects) from 2001–2012. Propensity scores were calculated using a logistic regression model to determine the effects of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) for stroke in vaccinated and unvaccinated patients. Influenza vaccination was associated with a 42%, 40% and 44% stroke risk reduction in the entire cohort for all seasons, the influenza season and the non-influenza season, respectively (Adjust hazard ratio [aHR]: 0.58, 95% confidence interval [CI]: 0.56–0.61; aHR: 0.60, 95% CI: 0.56–0.63; aHR: 0.56, 95% CI: 0.52–0.60, for all seasons, the influenza season and the non-influenza season, respectively). The effect of risk reduction by vaccination also revealed a trend of dose dependency. Among subjects between 55 to 64 years old with four or more vaccinations during the study period, there is a 73% risk reduction for stroke during the non-influenza season (aHR: 0.27, 95% CI: 0.20–0.34). In conclusion, the influenza vaccination exerts dose-dependent and synergistic protective effects against stroke in individuals 55 years and older with hypertension.https://www.mdpi.com/2076-3417/12/8/4074influenza vaccinationstrokehypertension |
| spellingShingle | Cheng-Hsin Lin Chun-Chih Chiu Tsung-Yeh Yang Yu-Ann Fang Meng-Huan Lei Hsien-Tang Yeh Chun-Chao Chen Wen-Rui Hao Chung-Hsien Kuo Ju-Chi Liu The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study Applied Sciences influenza vaccination stroke hypertension |
| title | The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study |
| title_full | The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study |
| title_fullStr | The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study |
| title_full_unstemmed | The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study |
| title_short | The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study |
| title_sort | association between influenza vaccination and stroke risk in patients with hypertension a nationwide population based study |
| topic | influenza vaccination stroke hypertension |
| url | https://www.mdpi.com/2076-3417/12/8/4074 |
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